What is Dry Needling and can it help you?

By David Bertone, PT, DPT, OCS

The treatment of pain has evolved over the years to encompass many different skills and interventions ranging from pharmaceutical to manual approaches with the ultimate goal of restoring function. This concept was utilized by Karl Lewitt, MD in 1979 in which he began research on using a needle for the treatment of orthopedic dysfunction. This coincided with the work of physicians Travell and Simons that published data on common referred pain patterns from areas in muscle known as "trigger points." In the beginning of dry needling, a hypodermic needle was used but then was quickly replaced with a solid, monofilament needle to treat the tissues without injections.

In 2015, the Federation of State Boards of Physical Therapy developed this definition of dry needling performed by physical therapists: "Dry needling is a skilled technique performed by a physical therapist using filiform needles to penetrate the skin and/or underlying tissues to affect change in a body structures and function for the evaluation and management of neuromuscular conditions, pain, movement impairments and disability." It is important to clarify that dry needling is NOT acupuncture. Acupuncture is a treatment based on eastern medical diagnosis that requires training in traditional Chinese medicine and licensure to practice acupuncture. "While dry needling performed by physical therapists and acupuncture use a similar tool, the filiform needle, the differences are evident in the evaluative tools used by the practitioner, the assessment, the application and the overall intended goal." (Kinetacore, 2015)

Now that you know what dry needling is not, it is essential to learn what it does and how can it help you. Functional Dry Needling® was developed to combine the knowledge of the physical therapist in diagnosing movement disorders with the use of a needle to reset or restore the proper firing of neuromuscular tissue required for proper movement. Pain and localized tender points in muscles can be alleviated with the use of dry needling so that the patient demonstrates improved strength and motor control and thus improved function.

The research used to support this concept is based on the physiologic effects of dry needling. These include but are not limited to increase in blood flow to the tissue, decrease banding of taut muscle or trigger points, decreased spontaneous activity by causing an internal twitch or resest of the muscle, biochemical changes and reduction in pain fiber activity. All these effects will then allow the muscles and supporting structures to fire properly for functional training performed by the skilled physical therapist. The potential complications of dry needling range from mild bruising and muscle soreness to the extremely rare of infection. Dry needling is contraindicated for patients in the 1st trimester of pregnancy, compromised immune system, those using blood thinners, over an area of a cardiac pacemaker or having a history of lymph node removal.

Dr. Bertone is a doctoral trained physical therapist, board-certified in orthopedic rehabilitation by the American Board of Physical Therapy Specialties and trained in Functional Dry Needling®. He is President of db Orthopedic Physical Therapy with locations in Lincroft and Manalapan, NJ. Dr. Bertone can be reached at (732) 747-1262 or via e-mail at dbertone@dborthopt.com. To learn more about Dry Needling or find out if physical therapy is right for you, go to www.dborthopt.com.