What Is Dry Needling. 

By: Dr. Nick Sanders PT, DPT, CSCS, CIDN, NRT L1 

DRY NEEDLING: What is it?

Dry needling is the application of a single use, sterile, needle to treat soft tissue pain and dysfunction.  The need is solid, and very thin, unlike the needles you may used to in the doctors office.  It is called dry needling because there is nothing on the needle and there is no medication being injected through the needle.  The intention with dry needling treatment is to create a small lesion, or cut if you will, that your body, brain, and immune system must react to.  This stimulation to the system triggers a cascade of events including increased blood flow, activation of pain centers in the brain, and immune response that may be beneficial in treating some pain conditions. 

Dry Needling How Does it Work?

Dry needling works to trigger a response in your brain and immune system to reduce pain feedback and start the healing the process.  While there are many proposed mechanisms the three we discuss most are reduced muscle tightness, increased blood flow, and reduced inflammation. There are many proposed mechanisms behind dry needling. Here are the three we reference the most: 

1. Decreased Muscle Tightness
•  When you have pain, often the muscles around the area will tighten in order to protect the injured site. This in itself can be very painful, almost like a cramp or Charlie horse type pain. Dry Needling can help break the nerve stimulus that is causing the muscle guarding and allow the muscles to relax. As a bonus, relaxing the muscles allows more blood to get to the area to heal.  
2. Increased Blood Flow
•  With muscle tightness, comes a reduction in blood flow. If I can’t enough blood and/or oxygen to an area, the muscles are going to fatigue and fatigue brings on pain. Dry needling has been shown to increase oxygenation in an area for up to 15 minutes. 
3. Decrease Inflammation
•  We all know that inflammation causes pain. In new injuries, that is a good thing. It lets us know something is wrong and needs fixed. In chronic pain or system wide inflammatory disorders, the inflammation is not warranted. For these conditions, if I can reduce inflammation, I can reduce your pain. Dry Needling has been shown to reduce inflammation.

How I Got Started With Dry Needling. 

I remember the first time someone told me about dry needling.  I thought, “How crazy, let’s stick needles in something to make the pain go away? Sounds ridiculous.” I was in my second year of PT school and one of my classmates had come back from a clinical rotation and was telling us about this dry needling thing.   What a “quack” her clinical instructor must have been, I thought.   When I reflect back,  college taught me many things,  but most importantly it taught me that I don’t really know anything.  “You don’t know, what you don’t know.” Ya know?

On my last clinical rotation, I met Frank Gargano and Dave Griswold.  They would shape my clinical thought process into what it is today.   I carefully observed them treat patients.  Time and time again I watched them use dry needling to help people in pain.  I very quickly changed my opinion on dry needling.   I knew then there was more to dry needling than what I was observing on the surface. I needed to learn more.  

Over the last 10 years my understanding of dry needling, and more importantly, pain, neurology, and inflammation has grown immensely. I still live by the adage, the more you learn the more you realize you don’t know. I continue to strive to understand more and more about the mechanisms around dry needling. It has become one of the most powerful treatment options we have.  

My initial reaction to dry needling was probably  similar to what many of you might be thinking.  In our society, we are so accustomed to thinking about how we have to stop the inflammation. We reach for ice, advil, cortisone, and other medications to get rid of the inflammation.  Is that really the best way to treat pain?  With that mind set it is very hard to wrap your head around why you would stick a needle into the body with the goal of pain reduction.  That is until you really dive into the science behind inflammation, pain, and healing. Now dry needling is the first thing I reach for when I need to fix myself. 

Inflammation deployed at the right time isn’t actually bad.  Inflammation is how our body repairs damaged cells.  It is how we fight off foreign substances like viruses and bacterias. It is a good thing.  It is a vital part  in keeping us healthy.  Dry needling lets us stimulate some of these positive inflammatory effects that we need to promote healing. 

Learning to understand how and when to apply dry needling to help someone get out of pain is something I’ve spent the last ten years studying. I know I’m going to learn more as our understanding of  the mechanisms behind dry needling, inflammation, and the nervous system continue to evolve.  I look forward to that journey and helping as many people as I can along the way.  

At PHYT For Function we have created a way to combine dry needling with other treatment techniques to help people get out of pain  with direct access, dry needling treatment.  One on one sessions in a private office, to help you get out of pain and get to work on reaching your goals.  I have seen dry needling  in combination with our model help reduce the need for pain medications, avoid potential surgeries, and help people get control again. 

Dry needling along with our PHYT System of treatments  has helped me get out of pain,  worked for so many of our patients, and I hope we can have the opportunity to help you as well.  Reach out to learn more about dry needling and getting PHYT from a therapist near you.  

Dry Needling is a very effective adjunct to your rehab and physical therapy plan of care.  We have been doing it for over 10 years and are certainly believers in the amazing treatment effects we have seen.  

Learn more about dry needling at PHYT For Function in Beachwood, Cleveland, Hudson, and Fairview Park, Ohio at https://www.phytforfunction.com/dry-needling