Dry Needling
Dry needling is one of those modalities that is fairly new to physical therapy, although the needles used are very old in the world of Acupuncture. The western side of the world has adopted this tool with a different intention than the Eastern medical world. The Western approach involves more of altering muscles and neurological function, promoting tissue healing and ideally reducing pain. All of these aspects of dry needling have evidence to support them, and provide health care providers with an additional tool that may help the person in front of them. There may be more to it however, it may buy some space with which you can create a new shape and learn new ways with which to move.
Dry needling is very popular in the world of physical therapy right now. For many patients it provided substantial pain relief, and sometimes quite quickly. Many experiments have been done to show that tissue healing occurs after dry needling, that neurological firing patterns change after the intervention and that pain thresholds are altered. Another potential alteration may be that upon inserting a needle into a particular muscle, you may reduce that muscles ability to fire coherently. This reduction in activity allows for the bones attached and associated joints to move more freely, increasing available range of motion. This increase in range of motion promotes the fluid shifts needed for tissues to absorb nutrition more readily and health is restored locally.
The really interesting part, is that after localized tissue mobility returns, learning how to move in this new space becomes an option. I will use dry needling as segue way for patients. The quick response of the system opens the door to moving differently. Exercise prescription can then follow the newly acquired mobility, cementing long-term changes in movement capacity. An example might be placing needles in the upper region of the trapezius muscle, reducing activity in the area and then following this with something like a rolling variation or a reaching activity like low rows for instance. The reduction in trapezius muscle activity facilitates movement of the shoulder blade and allows for the rib cage to follow suit. The activity after needling is paramount, it cements the changes initiated by the needle work.
Dry needling is another tool in a manual therapist’s repertoire. It can be useful in some cases, and the evidence for it is growing. The important thing to remember is that without an active use of the changes attained, default movement patterns most likely return.
Austin Ulrich, Physical Therapist
