Introduction to Dry Needling

What is Dry Needling?

Dry Needling uses fine acupuncture needles inserted into muscle trigger points to release muscle spasm and into tendons to provoke a fresh physiological healing response in cases of chronic Tendinopathy. Often we find a single treatment can produce measurable benefits during the consultation. These benefits can include an increase in strength, range of motion, and pain intensity. The quick acting beneficial effect of dry needling has been documented by others (see reference below by S Passigli et al, 2016).

Is it Acupuncture?

Dry needling does not target acupuncture points and is not Chinese/Eastern Acupuncture.

How old is the treatment of dry needling?

Dr Chit Chan Gunn was associated with the University of British Columbia (Vancouver) According to the https://www.gunnims.com website “The Gunn IMS teaching program has run continuously since 1994.” It has been stated that he introduced the phrase dry needling in 1977. You can read about his early years here.

That website states that Dr Gunn was educated at ‘Peterhouse, Cambridge University, and was elected to an Honorary Fellowship of the College in 1997. He is president of the Institute for the Study and Treatment of Pain in Vancouver, Clinical Professor at the University of Washington in Seattle, and Honorary Professor at the University of British Columbia. In 2001, Dr. Gunn was awarded the Order of British Columbia as well as the Order of Canada…’ Another early pioneer was a Czech doctor called Karel Lewit, who made advances as early as 1979.

Is Dry Needling safe?

Dry Needling and acupuncture are generally very safe. Serious side effects – adverse events – such as pneumothorax and infection are very rare; less than one per 10,000 treatments. One study of thousands of endorsed physical therapists (i.e physiotherapists) working in the United States of America examined the claims made against these physiotherapists that may have been due to dry needling treatment. They found that over a period of four years from 2013 to 2017 there were only 34 claims. It was estimated that during this same period these physiotherapists had provided 125 million dry needling treatments. This means that there were less than 3 claims made for every 100,000 dry needling treatments administered, or a claim rate of less than 0.000003%. (Reference: J Dommerholt et al 2019, Needling: is there a point?, Journal of Manual & Manipulative Therapy vol 27). It is important to note that all reports of adverse events and side effects for any treatment are a guide only, as any one individual doctor or physiotherapist may actually have rates that are higher or lower than that reported in a study. You may find it helpful to read online the pdf titled FAQ: Dry Needling Adverse Events that was produced in 2015 by Physiotherapy Alberta.

One of the most common serious adverse events related to dry needling is pneumothorax.

It is rare, with a rate of only 0.01 per 10,000 treatments. Pneumothorax can cause chest pain, shortness of breath, rapid breathing, rapid heart rate or a dry cough. Tell the physiotherapist immediately if you experience these problems after treatment; you should do this by phoning the clinic and ask to speak to a physiotherapist immediately, informing the receptionist of why you are calling. If no one answers you should call a doctor or a hospital. If you are hoping to call us outside of office hours (8:30 am to 5:00 pm) you should instead call a doctor or a hospital. Pneumothorax symptoms may not start until hours after your treatment, so then you will need to telephone the physiotherapist, or a doctor, or a hospital; whoever you can contact immediately.

Can you choose not to have dry needling?

Yes, we have patients who prefer not to have dry needling. Most of our patients will each be treated with a variety of techniques over several sessions. These treatments may include mobilisation of joints & muscles, massage, specific exercises, and ergonomic advice.

Is Dry Needling painful?

The insertion of the needle gives a slight prick that you will barely feel. When Dry Needling a trigger point we are aiming to elicit a deep ache and/or reproduction of the pain – that way we know we are in the correct spot. A brief muscle twitch or spasm may occur. Dry Needling a tendon may reproduce your pain or it may just feel mildly uncomfortable.

Western Acupuncture points may be painful for a short time after insertion but this is usually mild. If the needling gives you constant pins and needles, constant burning or constant stinging, then let the physiotherapist know and he will change the needles position.

What other side-effects might I suffer?

Drowsiness can occur after treatment in a small number of patients, and if affected you are advised not to drive.

Minor bleeding or bruising can occur after acupuncture in about 3% of treatments.

Infection at the needle site is possible. Therapist hand washing, patient skin cleaning and single-use, sterile, disposable needles are used in this clinic to reduce this risk.

Existing symptoms can get worse for a short time after treatment in less than 3% of patients. You should tell your therapist but it is usually a sign that the treatment will be effective.

Fainting can occur in certain patients, particularly at the first treatment. You will usually be lying down to minimise the risk of further injury.

Wide variety of published research

Disability and rehabilitation. 2019 Sep;41(19):2235-2246. doi: 10.1080/09638288.2018.1461259. Epub 2018 Apr 23. Improvement in clinical outcomes after dry needling versus myofascial release on pain pressure thresholds, quality of life, fatigue, pain intensity, quality of sleep, anxiety, and depression in patients with fibromyalgia syndrome. Castra Sánchez et al

Complementary therapies in medicine. 2017 Aug;33:46-57. doi: 10.1016/j.ctim.2017.06.003. Epub 2017 Jun 15. Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials. L Espejo-Antúnez et al

Neural regeneration research. 2018 Apr;13(4):673-676. doi: 10.4103/1673-5374.230293. Dry needling at myofascial trigger points mitigates chronic post-stroke shoulder spasticity. L Tang et al

Journal of Ultrasound in Medicine. 21 October 2015 https://doi.org/10.7863/ultra.14.08033 Novel Use of Ultrasound Elastography to Quantify Muscle Tissue Changes After Dry Needling of Myofascial Trigger Points in Patients With Chronic Myofascial Pain. D Turn et al

Sports Medicine and Rehabilitation Journal 26 February 2018 The Effects of Dry Needling on Temporomandibular Disorder: A Systematic Review J Girard et al

International Journal of Sports Physical Therapy, 2016 11(2): 254-263. Acute effects of dry needling on posterior shoulder tightness. A case report. Samuele Passigli, et al

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