Evidence based medical wellness for active people from a doc who walks the walk

Does dry needling relieve pain?


In my three year search to relieve pain and suffering in my knee, I have tried everything (as long it was legal.) I tried acupuncture, which didn’t work for me. Then my trusty physical therapist sent me to another physical therapist for dry needling. It worked, but let me just say, it hurts so good. Or, put another way, it is very un-fun. So does it work, or is just a placebo?
First, what is dry needling? How is it different from acupuncture? Dry needling, in many states, is performed by licensed physical therapists. They receive specific training in dry needling. In dry needling a mono filament needle (a needle that doesn’t have a hollow core that can be filled with medication) is injected into a trigger point. Most physical therapist target a myofascial trigger point. Huh? Basically, the therapist feels (“palpates”) the muscle and tries to find a nodule along a tight band of muscle. Then, a dry needle is inserted. The patient (me!) then feels a couple of things: first the muscle will twitch (yes it is weird!) which is called the local twitch response, or LTR. This is thought to indicate that the needle has been placed in the correct location. In addition, you may feel a deep ache or even a burning sensation. This is called de qi, and may indicate a correctly placed needle. (This term is from acupuncture.) This is what I am when I say it hurts so good. NO, no, not fifty shades of grey!
So how is this different from acupuncture? Acupuncture, from Chinese medicine, is based on the theory that needles should be placed in meridians that effect blood flow and the like. Dry needling, on the other hand, is based on neuroanatomy– most people will have stereotypical trigger points that will respond to dry needling.
But does it work? Well, like everything in Western Medicine, it depends. First, it is highly dependent on the physical therapists. Finding the correct location or trigger point is huge. Studies show it is very effective for knee osteoarthritis, and effective for osteoarthritis in other areas–like the hip. It also has been proven to work well in carpal tunnel syndrome. Another application is in tendinopathy — when a patient has microscopic tears in the tendon, with or with out inflammation. Dry needling will increase blood flow, which will aid in healing.
How does it work? Many theories abound. The first is that the needle stimulates the muscle to spasm, and then to relax. Additionally, dry needling may cause the release of endorphins (the body’s own pain killers), and also may interrupt a relay from the spinal cord resulting in pain relief.
I think dry needling worked for me. It is worth a try in the hands of a skilled practitioner. I thought it was worth trying, as there are not a lot of risks with it. It has really helped my calf tightness, which seems to occur after every surgery.

Author: PookieMD

I am a board certified internal medicine physician. I love medicine and seek to bring evidence based medicine to the fitness and wellness world.

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