Dry needling in physiotherapy

Rehabilitation is a process aimed at restoring fitness, which allows the patient to return to a normal life, as well as the athletes to return to training. Among the many methods of rehabilitation, we can mention dry needling. When is this therapy worth using? What is the course of this therapy and what are the benefits? We answer all questions in the text below.

What is dry needling?

This therapy is called dry needling because in the course of the procedure no substances are injected or withdrawn from the patient’s body. For dry needling, thin needles are used (150-300 micrometers thick). This method involves inserting a needle into a so-called trigger points. These trigger points are hypersensitive areas within a tense muscle that cause local pain due to pressure, stretching or contraction. It is the physiotherapist who decides where to use needling, based on the patient’s complaints, medical history and examination. It is worth mentioning that needle therapy is not acupuncture, even though the needles are the same. In needle therapy, we strive to desensitize painful tissues, while in acupuncture, we strive to unblock energy points (meridians).

How is the procedure performed? When can it be applied?

Prior to dry needling, a physiotherapist performs a palpation test to detect taut bands of pressure-sensitive muscle fibers. The needle insertion itself is usually painless, however it may cause an unpleasant feeling of muscle expanding. Inserting the needle into the detected trigger point causes a natural trembling reaction, which we are able to gradually calm down through stimulation with the needle. As a consequence, the tense area becomes relaxed. Dry needling also influences the biochemical processes that have so far maintained the vicious cycle of pain. Dry needling is also effective due to the activation of the pain inhibition system (brain) and the change in the central sensitization (spinal cord). Dry needling can be used successfully in back pain or chronic overload conditions (e.g. runner’s knee or tennis elbow). It also helps in ailments after excessive exercise (new or too intense physical activity), sprains or sports injuries. It may take more than one session to achieve full effect so that the pain is largely or even completely resolved. At this point, the therapy should be supplemented with exercises, which are the essence of treating the underlying problem.

What are the benefits of using dry needling in rehabilitation?

The result of dry needling is pain reduction and regulation of muscle tone. This not only facilitates achieving full fitness after injuries, but also improves the comfort of everyday functioning and the mobility of individual muscle groups. On the other hand, it should be taken into account that tenderness, somewhat similar to severe muscle fatigue, may persist after the therapy. The advantage of dry needling is also the fact that needles that penetrate the tissues hit the trigger point precisely, which is not possible in the case of typical physiotherapeutic procedures. This allows the treatment to be highly effective also in cases where conventional physiotherapy was ineffective.

Contraindications to dry needling

Although dry needling is considered a very safe technique supporting rehabilitation, due to the safety and health of patients this method is not used when:

  • there are inflammations or skin infections,
  • the patient is taking anticoagulants,
  • the patient suffers from varicose veins, venous thrombosis or lymphedema,
  • the patient is pregnant, the patient is a child,
  • the patient has an extremely strong fear of needles,
  • the patient uses many drugs,
  • the patient is non-communicative in acute inflammation, infections or allergies to metals.