What is Dry Needling?

Dry needling is a general term for a therapeutic treatment that involves multiple advances of a (very thin) monofilament needle into a muscle in an area of the body which produces pain and typically contains a ‘Trigger Point’ (there is some debate about whether ‘trigger points’ exist in muscles, but either way the needle is inserted into a tender/tense point that can be felt in the muscle). There is no injectable solution. Most patients will not even feel the needle penetrate the skin, but once it is advanced into the muscle, the intensity of the discomfort can vary from patient to patient. A healthy muscle usually feels very little discomfort. However, if the muscle is sensitive and shortened or has active “trigger points” within it, the patient may feel a sensation much like a muscle cramp, which is often referred to as a ‘twitch response’. The patient may only feel the cramping sensation locally or they may feel a referral of pain or a reproduction of the pain for which they are seeking treatment. This can be a very helpful diagnostic indicator.

Dry needling acts as a reset to the muscle, thereby reducing pain and restoring normal length and function of the involved muscle. Typically, positive results are apparent within 2-4 treatment sessions, but can vary depending on the cause and duration of the symptoms, overall health of the patient, and experience level of the practitioner. Dry needling is an effective treatment for acute and chronic pain, rehabilitation from injury, and even injury prevention, with very few side effects.

In British Columbia, all physiotherapists who perform dry needling must complete an accredited course and then apply for special permission to perform dry needling with patients (called rostering) from the College of Physical Therapists of British Columbia. Many physiotherapists in BC use dry needling daily as part of their practice.

Sometimes this dry needling technique is referred to as IMS (Intramuscular Stimulation).

Dry needling is only performed on external (e.g. hip, back) muscles, not internally on pelvic floor muscles. It is a useful treatment option for larger muscle groups that affect or are affected by pelvic floor dysfunction. This is unique to the individual and can be discussed with your therapist.

Risks of the procedure:

The most serious risk associated with dry needling is accidental puncture of a lung (pneumothorax) when needling in the thorax. If this were to occur, it may require a chest x-ray and no further treatment. The symptoms of shortness of breath may last for several days to weeks. A more severe lung puncture, while rare, may require hospitalization. Physiotherapists are well trained in anatomical landmarking to minimize the risk of a pneumothorax.

Other risks may include bruising, infection or nerve injury. It should be noted that bruising is a common occurrence and should not be a concern. Physiotherapists are trained to avoid important anatomical structures (e.g. large nerves), but occasionally contact with a small superficial nerve may provide a “zinging” sensation. This is not of concern beyond slight discomfort. You may also experience any of the following during treatment: A feeling of relaxation, an increase in energy level, dizziness, nausea, sweating, or irritation at the site of needle insertion. These sensation are usually transient, lasting only a very short time.

Please let your therapist know if you are taking blood thinners, are immunocompromised, are taking immune-suppressing medications, have an active disease or infection that could be transmitted through bodily fluids, or are pregnant.