Dry Needling

Our bodies are no strangers to pain, especially as we place demands on our muscles through daily life activities, exercises, work, and more.

As we continually place stress on our muscles, our muscles tend to tighten up to the point of movement restriction, function disruption, tenderness, and pain. These painful areas become known as trigger points that develop into myofascial pain syndrome when the pain persists longer and worsens (Fernández-de-Las-Peñas & Nijs, 2019).

This is where the technique of dry needling comes in. Dry needling is an intramuscular, invasive procedure that consists of inserting a thin monofilament needle into a trigger point in order to elicit a local twitch response when the needle is manually moved around the area in miniscule motions after insertion (Fernández-de-Las-Peñas & Nijs, 2019). According to the American Physical Therapy Association, dry needling is becoming an increasingly common method of intervention to supplement standard physical therapy ("Dry Needling," n.d.).

While there are some similarities to acupuncture, dry needling differs in that it stems from a Western approach and is done by physical therapists and other health care practitioners who carry a particular certification specific to dry needling. This is not a standalone procedure as this modality usually supplements standard physical therapy interventions (Dunning et al., 2014).

So, how effective is dry needling in terms of alleviating pain? Does it actually have an effect on treating myofascial pain syndrome, or are patients better off just using standard physical therapy practices and/or other modalities?

Perhaps, these questions were answered by a group of researchers.

In a single-blind randomized controlled trial conducted in 2016, a group of researchers recruited participants from orthopedic, neurologic, and neurosurgery departments who reported with low back pain (Mahmoudzadeh et al., 2016). These participants ranged from 20 to 50 years of age and had radiating pain manifesting into one or both legs (Mahmoudzadeh et al., 2016). In a sample size of 58 participants, the participants were split into the control group and experimental group through a coin toss conducted by a hospital staff that was blind to the study (Mahmoudzadeh et al., 2016).

The control group received standard physical therapy interventions.
The experimental group received standard physical therapy interventions along with dry needling.
- In the experimental group, the patients received five sessions of dry needling at the end of the second, fourth, sixth, eighth, and tenth sessions, which required an additional 15 minutes in each session.
Both the control group and experimental group started with a baseline pain intensity and disability scores.

The physical therapists assigned to deliver care to both the control group and experimental group were unaware of or blinded as to which group each patient was assigned to. Standard physical therapy consisted of a 45-minute session, which included the use of hot or cold packs, transcutaneous electrical nerve stimulation (TENS), ultrasound, and exercise therapy (Mahmoudzadeh et al., 2016). Patients received 10 standard physical therapy sessions every other day.

The participants were periodically assessed in the first session, in the last session, and two months after the last session by a blinded physical therapist (Mahmoudzadeh et al., 2016).

While dry needling is an effective technique to mitigating pain, we shouldn’t forget that it is merely an addition to exercise!

After the follow-up session, the researchers discovered that both groups experienced a decrease in pain intensity, which continued to decline even in the follow-up period (Mahmoudzadeh et al., 2016). However, there was a more significant decrease in pain levels and disability score in the experimental group at the follow-up period (Mahmoudzadeh et al., 2016). In terms of the experimental group, the participants experienced an enhanced effect of the standard physical therapy treatment protocol when combined with dry needling (Mahmoudzadeh et al., 2016). Thus, dry needling was an effective supplement to standard physical therapy interventions when addressing discogenic low back pain.

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