Ultimate Guide to Dry Needling
Dry needling - the technique that athletes from all around the world know and love as part of their physical therapy treatment plan.
If you live in Washington state, there’s been a major change (for the better) in the scope of physical therapy practice. Physical therapists are now allowed to offer dry needling treatment as a part of our services, as long as we are certified and endorsed by the State of Washington.
This one is a game changer for athletes because it gives them access to a safe and effective treatment for their pain, which allows them to get back in the game faster and feeling better than before. When combined with other manual therapy techniques and exercises for strengthening, dry needling is a helpful tool in creating a more comprehensive recovery plan.
What is dry needling?
Dry needling, also known as intramuscular needling, is a technique used by physical therapists to help alleviate pain and increase mobility, as well as to stimulate tissue healing and repair. It involves the use of a thin, sterile, single-use monofilament needle inserted into a muscle, connective tissue, or myofascial trigger point. The needle is then stimulated during treatment for best results.
It’s called “dry” needling because we are not injecting any substances (ex. Cortisone, PRP, stem cells, or medication) into the treatment site during treatment. “Wet” needling uses hollow-bore needles to deliver an injectate into the site.
Dry needling is a skilled physical therapy treatment technique that should only be performed by a certified provider with an endorsement in Washington state.
How does dry needling work?
Dry needling is not a standalone treatment option in Washington state. It is combined with other manual therapy interventions, such as soft tissue or joint mobilizations, and therapeutic exercises to achieve optimal results during your therapy session.
The needle is inserted into muscles, trigger points, or connective tissues that just need a little extra TLC for support and recovery. The needle is stimulated during your treatment session to help send the signal for the muscles to relax and increases circulation to promote tissue healing in the exact area where you need it.
The dry needling part of the treatment session lasts for up to 20-30 minutes and may involve as few as 2 needles or as many as 20 needles, depending on treatment area, purpose, and target tissue. The needles are continually adjusted or stimulated throughout the treatment session.
Afterwards, you may be a little sore or feel like the muscles are tight in the area where the needles were inserted. However, most patients notice improvement with decreased pain or increased mobility as soon as the same day, or typically, the next day following treatment.
What are the benefits of dry needling?
There are a lot of benefits to receiving dry needling treatment, which include:
Decreased pain
Increased circulation for tissue healing and repair
Decreased muscle tension (achieves muscle relaxation)
Increased range of motion
Dry needling is a low cost, effective technique that pairs well with traditional physical therapy treatments, such as manual therapy and therapeutic exercise, to accelerate healing and promote a quicker recovery.
Is dry needling safe?
Yes, dry needling is a safe treatment technique to manage pain and increase mobility, as long as you are seeing a provider who is certified in dry needling.
I even wrote an entire blog post about it here (link). Check it out!
With the proper equipment and education, physical therapists are able to offer dry needling as a safe treatment option in outpatient clinics. Continuing education courses to achieve the certification in dry needling ensures that a physical therapist is aware of any potential contraindications, risks, and has been trained in the proper techniques to use for dry needling. All needles are sterile and single-use to mitigate risk of infection or transmission of blood-borne pathogens.
In Washington state, providers must go through even more extensive training to be able to offer dry needling services to patients. In addition to being a licensed physical therapist and obtaining a certification in dry needling, providers also need to complete a clinical review of 150 treatment hours and sessions and apply for a state endorsement before being able to offer dry needling in the clinic.
What are the risks and potential side effects of dry needling?
There are always risks associated with any treatment and dry needling is no exception. Always communicate with your therapist if you have any specific concerns.
Here are a few of the most common risks and side effects with dry needling:
Temporary pain during or after treatment
Soreness
Bruising
Infection
Bleeding
Fatigue
Fainting or dizziness
Nausea
Adverse reactions (allergic response)
Serious side effects are extremely rare with dry needling, but may include:
Pneumothorax (symptoms may be several hours after dry needling treatment)
Nerve or blood vessel damage resulting in temporary numbness or tingling
Infection
Damage to internal organs
What is dry needling used for?
Dry needling is an effective technique that can be used to help treat tendonitis, muscle aches, joint pain, headaches, nerve pain, and arthritis. It is commonly used to help alleviate:
Knee pain (and knee osteoarthritis)
Shin splints
Patellar tendonitis
Ankle sprains
Achilles tendonitis
Plantar fasciitis
Low back pain
Sciatica
Hip pain
Piriformis syndrome
Pulled hip flexor or hamstring
Groin pull
Quadriceps strains
Shoulder impingement
Whiplash
TMJ disorders
Tennis elbow (lateral epicondylitis)
Golfer’s elbow (medial epicondylitis)
Carpal tunnel syndrome
How many dry needling sessions do you need to see results?
You may start to see improvement in your symptoms in less than a day, but more commonly, you’ll see improvement within a couple of days.
Initially after treatment, even if the muscle tissue feels more relaxed to the touch, many patients report feeling sore and tight in the area where the needles were inserted. Most patients feel improved mobility and decreased pain the following day. For others, it takes several days to see results.
The number of dry needling sessions that you may need depends on several factors including:
The treatment area (or number of treatment areas)
Acuity of pain (acute vs chronic conditions)
Nature of the injury
Your body’s response
Some patients need as few as 1-2 sessions, where others may benefit from receiving treatment 1-2 times per week for several weeks, depending on the injury.
How is dry needling different from acupuncture?
Dry needling is based in Western medicine to treat musculoskeletal pain - directly inserting the needles into muscles, trigger points, and connective tissues for targeted healing and pain relief.
Let me preface this by stating that physical therapists practicing dry needling are NOT trained in the traditional Chinese medicine practice of acupuncture or moving qi along energy meridians in the body (unless that therapist holds a separate acupuncture license).
Acupuncture is an Eastern medicine practice that promotes healing by improving energy flow in the body. Needles are typically inserted into certain points along energy meridians in the body, which is different than dry needling where it targets a specific tissue (ex. Upper traps muscle or quadriceps). Basically, it comes down to a different intention with treatment and a different target tissue.
There’s a few similarities with acupuncture and dry needling. Both may use the same type of needles (thin, sterile, and single use) for treatment, these needles do puncture the skin during the treatment session, and both may be used to treat pain in different ways. But that’s about the extent of the similarities.
Acupuncture is further defined in RCW 18.06.010 as "'Acupuncture and Eastern medicine' means a health care service utilizing acupuncture or Eastern medicine diagnosis and treatment to promote health and treat organic or functional disorders, which includes a variety of traditional and modern acupuncture and Eastern medicine therapeutic treatments, such as the practice of acupuncture techniques and herbal medicine to maintain and promote wellness, prevent, manage, and reduce pain, and treat substance use disorder."
If you are currently working with an acupuncturist or eastern medicine provider, then I will make an effort to coordinate care with that provider to prevent conflict or duplication of services (with your permission, of course)
Does dry needling hurt?
No, it doesn’t “hurt” but dry needling can be a bit uncomfortable depending on how sensitive the tissues are that we’re treating and your individual response. It’s also common to experience a little soreness after treatment, especially after the first one.
With dry needling, we are trying to reproduce some of your symptoms in the area where you feel them. Most patients report that it feels more like a radiating ache or tightness, rather than pain. Some feel no pain at all
Sometimes we will get a twitch response from the muscle with needle stimulation and adjustment, which has potential to make you a bit sore for a day or two after treatment.
How to find a physical therapist who practices dry needling?
I recommend starting with a Google search using the phrase “dry needling near me” to learn if physical therapy clinics near you offer the service. When you call to make the appointment, make sure that you request to see the provider who has a certification in dry needling.
First of all, make sure that the provider you’re seeing is certified in dry needling and has extensive training and coursework in dry needling. I chose to get my Certification in Dry Needling from the American Academy of Manipulative Therapy, which I completed in December 2023.
If you’re local to the Tri-Cities, WA area, contact Game Changer Physical Therapy located in Kennewick, WA.
I’m Kacie Shively, PT, DPT, Cert. DN, a physical therapist for athletes who is Certified in Dry Needling and endorsed in the State of Washington. As a result, I use dry needling to help athletes recover quickly from injuries.
Find out more information and determine if physical therapy would be beneficial for you by booking a free 15-minute discovery call via the button below. I’m always happy to help!
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