Dry Needling: What It Is and What To Expect

Dry needling, also known as Trigger Point Dry Needling, is a component of physical therapy treatment. It is used in conjunction with other manual therapy techniques and therapeutic exercises to eliminate pain and dysfunction in patients with neuromusculoskeletal conditions. In a typical dry needling session, dry needles — a needle without medicine — are inserted to deactivate specific “trigger points” or muscle area that is causing you pain.

What are Trigger Points?

Trigger points are small knots within muscles that are often tense or sore to touch. They can increase pain, limit motion, and decrease field performance. If go untreated they can get worse over time.

How Does Dry Needling Work?

When performing dry needling, a trained physical therapist inserts a thin filiform needle through the skin into pathetical areas of the muscle known as trigger points to relieve myofascial pain and muscle spasm to restore function. 

Your physical therapist will first examine the muscle palpating for trigger points. They will clean the area with alcohol and then push the needle quickly into the skin before going deeper into the muscle’s trigger point. Your physical therapist may then piston the needle in the trigger point or apply a small electrical current through the needle using a point stimulator. Sometimes only one needle is inserted at a time, and sometimes several are placed into the same muscle.

The desired reaction is a “twitch response” where the specific band of muscle involuntarily contracts in response to the insertion of the needle. This allows for various neurological, chemical, and physical effects to occur in the muscle. While beneficial effects can occur without elicitation of the twitch response, patients who experience a twitch tend to have increased positive effects. Other benefits of dry needling include: 

• Increase Blood Flow: blood flow in the area will increase and continue to increase following the removal of the needle, allowing increased oxygen and nutrients to flow to the area.

• Decreased Muscle Shortening: by releasing spasms, the muscle can return to a more normal resting length which allows for more efficient firing and thus stronger and more efficient contractions as well as decreased resting tension in a body area.

• Release of Waste Product Build-up: trigger points can hold on to the waste products that develop as a result of muscle contraction rather than allowing them to be excreted back into the bloodstream. Releasing the trigger point can allow those waste products to be excreted into the bloodstream.

All these physiological effects of functional dry needling converge to increased active range of motion, decreased pain, and restore function to the injured body part.

Is Dry Needling Painful?

Dry needling can come with an element of pain or discomfort. For most people, there is little to no discomfort with the insertion of the needle; however, once the needle hits the trigger point, you will experience a twitch response, which only lasts a few seconds and often feels like a quick muscle cramp. 

How Will I Feel After My Dry Needling Session?

• You may feel some soreness immediately after treatment in the area where you were treated. This does not always occur but should be expected and is considered normal. It can also take up to a few hours, or even until the next day, to feel an onset of soreness, which may vary from person to person but usually feels like you had an intense workout at the gym. Soreness typically lasts 24-48 hours. Be sure to let your physical therapist know how long the soreness lasted at your follow-up visit.

• Bruising from the treatment is somewhat uncommon but is possible. Some areas are more likely to bruise than others, including the shoulders, chest, face, and portions of the extremities. Use ice to help decrease the bruising, and if you feel concerned, please call your physical therapist.

• It is common to feel tired, fatigued, energized, emotional, giggly, or “out of it” after a treatment. This response can last up to an hour or two after treatment. If this lasts beyond a day, please contact your physical therapist.

• There are times when treatment may exacerbate your symptoms. This is normal and may indicate that you need a follow-up sooner than later to continue treatment. If this continues past the 48-hour window, please let your physical therapist know so they can adjust your treatment plan if needed based on your report. This does not mean dry needling cannot help your condition.

What should I do after my treatment?

We recommend increasing your water intake for the next 24 hours after treatment to help avoid or reduce soreness. We also recommend soaking in a hot bath or hot tub to help relieve post-treatment soreness and to soften the symptoms associated with the treatment you received. After dry needling therapy, you may do the following based on your comfort level: 

• Work out and/or stretch

• Drink water

• Participate in regular physical activity

• Massage the area

• Use heat or ice as preferred for post-treatment soreness

• If you have prescriptions medications, continue to take them as prescribed

Please note that if it hurts or exacerbates your symptoms, then discontinuing the activity is probably best.

You should avoid:

• Unfamiliar physical activities or sports

• Doing more than you usually do

• Excessive alcohol intake

If you feel lightheaded or experience difficulty breathing, chest pain, or any other concerning symptoms after treatment, call your physical therapist or physician immediately. 

Learn more about physical therapy treatments at Bull Dawg today.