By Dr. Adam M. Cramer, PT, DPT
In my physical therapy clinic, I often see patients whose whole quality of life has been put on hold while they wrestle with debilitating musculoskeletal pain. Sometimes the pain centers in their neck and back, or manifests itself with severe muscle spasms. Other times it appears as tendinitis, shoulder, hip or knee pain, muscle strains, and overuse injuries. In treating all of these patients, I have achieved some amazing results using a physical therapy treatment known as “dry needling.” The Doctor of Physical Therapy who delivers this form of manual therapy has to be specially trained and certified.
What is dry needling? Dry needling is a skilled intervention that a Doctor of Physical Therapy performs using a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments which leads to improved healing and activity performance.
When I initially recommend dry needling to patients, some of them confuse it with a traditional Chinese medicine known as acupuncture, where the same kind of needle is used. But that is where the similarity stops. Dry needling is different in that it is based on western neuroanatomy and modern scientific study of the musculoskeletal and nervous system.
Unlike acupuncture, the needles in dry needling therapy administered by a physical therapist are inserted into trigger points in the body to elicit a twitch response. In essence, the needles create a beneficial inflammatory response to release the trigger point and help to promote healing.
Speeds up recovery process. A study by James Dunning and a team of researchers concluded that several studies have demonstrated “immediate improvements in pain and/or disability by targeting trigger points.” The studies all demonstrate that dry needling speeds up the recovery process for patients. When you incorporate dry needling into a full physical therapy package, the patient’s function is restored much faster than if it is not included.
That reflects the findings we have observed case by case within our own clinic. We see every day that dry needling works. With low back pain impacting up to 80 percent of the adult population in the United States, we need to be open to engaging in therapies that work, even if they are different from what we have always done.
One of the studies3 that I found most enlightening was published in 2010 in the Journal of the American Board of Family Medicine concluded that dry needing is an effective means of managing musculoskeletal pain. Additional benefits were that it is minimally invasive and carries a very low risk.
How it feels for the client. When I discuss dry needling, clients often express concern that it will be painful. Actually, it can be quite comfortable to receive this therapy. Most of my clients cannot even tell when the needle has been inserted. When the twitch response happens, they may experience some minimal discomfort which they describe as a bit of pressure. These reactions are not bad in the sense that they clearly indicate the therapy is working.
Some clients report they feel a little bit of soreness after the therapy, but the majority do not. If there is soreness, it is usually gone within a couple of hours and at the most, a couple of days but are happy to find that their previously reported symptoms are gone. For most clients who have been burdened by chronic pain for a long time, it takes several treatments before they can report significant pain reduction. Remember that this therapy is trying to make a biomechanical and mechanical change in your body function without the use of any medication, and this requires some time in most people.
When pain relief does happen, it can be an emotional experience for the client. To finally be rid of a pain they have shouldered for months or even years leaves them with a feeling of incredulity and tremendous relief. After each treatment, we perform light massage, gentle stretches or light exercise, along with moist heat will also help increase the blood flow to promote healing.
Dr. Adam M. Cramer, PT, DPT, is a licensed physical therapist, pain specialist and owner of MyoFit Clinic, 14950 S. Springdale Ave. Middlefield (44062) 440-632-1007 and 11850 Mayfield Road, Chardon (44024) 440.286.1007.
1. Dunning, James et all. Dry Needling: A literature review with implications for clinical practice guidelines. Physical Therapy Reviews. 2014 Aug 19(4) 252-265
2. American Physical Therapy Association. Physical Therapists & amp; the Performance of Dry Needling. Http://www.apta.org/StateIssues/DryNeedling/ Published January 2012
3. Kalichman, Leonid K. and Vulfsons, Simon. Dry Needling in the Management of Musculoskeletal Pain. Journal of The American Board of Family Medicine. September-October 2010. Vol. 23, pp 640-646.