Dry needling is a skilled technique performed by remedial massage therapists and other health allied practitioners aimed at managing musculoskeletal injuries and pain while addressing movement dysfunction. Dry needling utilizes a thin filiform needle to penetrate the skin, fascia, and muscles to address adhesions, trigger points, and connective tissue. This speeds healing and relieves pain by decreasing muscle hypertonicity, increasing joint range of motion, and correcting movement dysfunction through releasing a trigger point adhesion.
Dry needling relies on the practitioners expanded knowledge of skeletal and neuroanatomy. This knowledge helps identify damaged and sensitive tissues, taut bands, and trigger points as well as injured and overused tissues.
The twitch response is a localized, reflexive response of a dysfunctional area of muscle to palpation, or in our case, a dry needle. When needling a trigger point, this is one of our goals as it leads to a rapid release of a taut muscle band, decreasing tightness and sensitivity of the surrounding area. A tight muscle or one with a trigger point will feel an achy discomfort with an occasional twitching or cramping sensation. This twitch response returns the muscle to a normal state by releasing inflammatory chemicals from the trigger point and restoring blood flow to the area. According to a recent study in the Journal of Orthopaedic & Sports Physical Therapy the twitch may be a sign that the treatment will be successful. A local twitch response is a spinal cord reflex that creates an involuntary contraction that can be triggered by palpitation or insertion with an acupuncture needle. When the patient has an involuntary twitch response, that suggests that the needle has hit the right spot.1
1 Kietrys, D. M., Palombaro, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., & Tucker, M. (2013). Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. Journal of orthopaedic & sports physical therapy, 43(9), 620-634.
Often, patients will experience a mild, dull ache during treatment and up to 24 hours post treatment. Some discomfort is experienced during the rapid twitch response, however this discomfort is minimal and lasts only a few seconds. It is normal to have mild to moderate muscle soreness after dry needling treatment. Drinking lots of water, stretching, moving your body and placing a heat pack on the sore muscles can reduce the duration of the soreness. Side effects may include mild muscle soreness and bruising in some patients.
Dry Needling is an extremely effective treatment for acute and chronic pain, decreased flexibility, joint dysfunction, and recovery from physical activity and competition. Patients who undergo dry needling therapy experience less pain quickly, with most finding relief after their first treatment. According to reports published by the Journal of Orthopaedic & Sports Physical Therapy, patient function is restored much more quickly when dry needling is incorporated as part of the care plan.
It is normal to take several dry needling therapy sessions before the muscle is fully functional again. This is because trigger points are located under deep layers of muscles, so it typically takes several sessions for the changes to take full effect. But patients will usually notice the difference right after each treatment.2
2Kietrys, David M., Kerstin M. Palombaro, Erica Azzaretto, Richard Hubler, Bret Schaller, J. Mathew Schlussel, and Mary Tucker. "Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis." Journal of orthopaedic & sports physical therapy 43, no. 9 (2013): 620-634.