Dry Needling

Integrative Dry Needling is a highly-effective treatment for a multitude of musculoskeletal and neuromuscular conditions. It is not appropriate for all conditions or pathologies, and the use of the technique will be at the discretion of your physical therapist. Not all medical or physical therapy professionals are trained to perform the Integrative Dry Needling treatment technique. The physical therapists at Rebound Physical Therapy have advanced training and have been certified through the Integrative Dry Needling Institute.

How will I feel after the dry needling treatment?

This will vary but many patients experience immediate relief of their symptoms and an increase in range of motion. Many patients feel relaxed and calm at the end of the treatment. Soreness can also be a common response from the needling but does not occur with all people. Some individuals may experience an immediate achiness or a delayed soreness the next day. The soreness, if present, will usually last 1-2 days, use of heat, light massage and movement will be beneficial. Mild bruising may occur at the needling sites and is more prevalent in certain parts of the body. Larger bruising may also occur but is rare. Application of ice on the bruise will help with the soreness, and the skin discoloration will last several days but is not harmful.

How does it work?

Integrative Dry Needling is not acupuncture (traditional Chinese medicine). Integrative Dry Needling is based on neuroanatomy and modern scientific study of the musculoskeletal and neuromuscular systems. A very fine filament needle is inserted through the skin and into the deeper tissues that are considered trigger points to your pain. Dry needling works by causing a micro lesion within the pathological tissue thus breaking up shortened tissues, inhibiting a reflex arc from the nervous system to the tissue, normalizing the inflammatory response, and centrally mediating the pain. This mechanical and neuromuscular effect provides an environment that enhances the body’s ability to heal which ultimately reduces pain. The benefits of this intervention can be felt in many patients immediately. The goal of a course of treatments is to have long-term pain relief.

What conditions can be treated?

Conditions include, but are not limited to, neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache (migraines, tension-type headaches), jaw pain, buttock/leg pain (sciatica, hamstrings strains, calf tightness/spasms), and foot/ankle pain (plantar faciatis). Arthritic pain of any joint often times is effectively treated.

Molecular mechanism of dry needling

Dry needling normalizes inflammation. This needling-induced anti-inflammatory process triggers regulatory mechanisms of blood and fluid circulation in inflamed tissues that includes microcirculatory vessels. The antiinflammatory process of dry needling involves balancing the sympathetic nervous system, thus balancing between vasodilators such as adenosine and nitric oxide (NO) and vasoconstrictors such as superoxide and many others.

Chronic inflammation is the result of inflamed microcirculatory vessels that causes tissue hypoxia. Needling creates acute inflammation as a mechanism to reduce chronic inflammation. The micro-physiological effect that occurs increases the local levels of NO, O2 , and adenosine. (Cagnie 2012, Takano 2012, Tsuchiya 2012)

Are the needles sterile?

Yes, we only use sterile disposable needles.

Is the procedure painful?

The fine filament needle is very thin, solid, and flexible which allows for the needle to be pushed through the skin versus cutting the skin. This helps reduce any discomfort that may occur with the procedure. We strive to make the treatment virtually painless, however, at times a local twitch response of the muscle may be felt. When the needle is inserted into the pathological tissue, the local twitch response sensation is normal and is felt only momentarily. Many patients describe this twitch response as a little electric shock, cramp or an ache sensation. These sensations are perfectly normal and even a desirable response. Your physical therapist will make every effort to make your experience comfortable and therapeutic.

It is uncommon but possible that the treatment may temporarily increase your symptoms. This is not unusual, but if this continues past the 1-2 day window, inform your physical therapist to allow adjustment of your program to enhance your comfort the next time. This does not mean that needling will not be beneficial to your condition.

Will I continue to do exercises or receive other treatments?

Yes, your personalized physical therapy program will still integrate traditional physical therapy methods including manual therapy, therapeutic exercise, endurance training, stabilization, balance and posture training.

How many treatments will I need?

This will depend on the category of your condition, which is determined by the state of the injury and your overall health. Remember, we are attempting to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to break the pain cycle. Your physical therapist will be able to give you more insight after your evaluation.

What should I do to prepare for the treatment?

  • Do not eat 30 minutes before the treatment.
  • Be well hydrated, but empty your bladder prior to treatment.
  • Wear lose fitting clothing, shorts, or bathing suit for easy access to your painful areas.

What should/can I do after treatment? What should I avoid?

Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include increasing your water intake, applying heat or ice over the area, gentle stretches and modifications of activities, but often times there are no restrictions after treatment.