Dry Needling: Helpful or Not?

Dry Needling: helpful or not?

I spent all of last summer in various physical therapy clinics and rehabilitation settings. Patients of all ages seek muscle pain relief, from frozen shoulders to knee injuries and everything in between. There are so many different ways to approach treatment for patients with musculoskeletal pain (MSP). Yet one of the newer methods is dry needling and is commonly seen, yet professionals everywhere struggle to understand the effect of the treatment. 

Dry Needling is the use of solid filiform needles or hollow hypodermic needles that penetrate the skin and are inserted into muscle tissue and sometimes-specific trigger points of muscle groups. Usually, the needle is then paired with low frequencies of electrical stimulation (e-stem) that activates the muscle causing it to contract and relax at a fast pace. This “fluttering” of the muscles causes the muscle to “reset” and is designed to reduce pain and tension. It helps many physical therapists reach and active deep muscle tissue that is difficult to stimulate with just manual therapy.  Dry needling causes slight discomfort but does not harm the patient. (1) Dry needling has become an incredible widespread treatment for MSP.

How truly effective is dry needling though? In one study researchers looked at the effectiveness of dry needling on patellofemoral pain (PFP) relief. They conduct an experiment where one group of patients with PFP received dry needling and manual therapy and one group of patients with PFP only received manual therapy. They concluded that dry needling made no difference in alleviating pain or overall disability in patients with PFP (2).

However, in another experiment, they found dry needling to be very effective at reducing pain. They studied patients recovering from total knee arthroplasty. A number of patients received a weekly dry needling treatment in combination with manual therapy and therapeutic exercises, they found that the combination of treatments resulted in lower pain, increase range of motion and function for those patients. (3)

         There have been a number of studies with dry needling. The results always vary from experiment to experiment, but yet dry needling is still used to frequently in physical therapy settings everywhere. More research is needed to see the full effects of dry needling. It is difficult to ethical experiment dry needling because patient health and pain relief should be the priority and goal of all physical therapists. Yet, more experiments could help design better treatments for patients everywhere.

References: 

(1) Anandkumar, S., & Manivasagam, M. (2017). Effect of fascia dry needling on non-specific thoracic pain – A proposed dry needling grading system. Physiotherapy Theory & Practice, 33(5), 420-428. doi:10.1080/09593985.2017.1318423

(2)Espi-Lopez, G. V, Serra-Ano, P., Vincent-Ferrando, J., (2017). Effectiveness of Inclusion of Dry Needling in a Multimodal Therapy Program for Patellofemoral Pain: A Randomized Parallel-Group Trial. Journal Of Orthopaedic & Sports Physical Therapy, 47(6), 392-401. doi:10.2519/jospt.2017.7389

(3) Núñez-Cortés, R., Cruz-Montecinos, C., Vásquez-Rosel, Á., Paredes-Molina, O., & Cuesta-Vargas, A. (2017). Dry Needling Combined With Physical Therapy in Patients With Chronic Postsurgical Pain Following Total Knee Arthroplasty: A Case Series. Journal Of Orthopaedic & Sports Physical Therapy, 47(3), 209-216. doi:10.2519/jospt.2017.7089