Dry Needling

​Dry Needling: An overview of benefits and risks for chronic pelvic pain patients

Dry needling, also called Intramuscular Manual Therapy, is a treatment technique recognized by the state licensing board in 33 states to be within the scope of practice for physical therapists. It was first cited over 25 years ago but has picked up in popularity in just the last 5 years. It involves a solid needle similar in diameter to an acupuncture needle that is inserted into tissues for the purposes of managing pain and/or dysfunction.  This is typically achieved through placing the needle in a muscle trigger point but could also include targeted areas of tendons, ligaments, scar tissue, and peripheral nerves.
 
Based on current research and clinical success, dry needling is generally thought to be effective in offering relief for a variety of neuromusculoskeletal conditions. There are several theories as to how exactly dry needling causes the relief of pain. It could be that several of these theories are interconnected and working together.
 
Though dry needling offers an avenue for pain management, several cautions should be noted if you are considering this line of treatment.
 

1. Research has documented adverse effects as a result of dry needling. Typically, these adverse effects are mild such as bleeding and pain, which do not require additional treatment. But there has been cited in the research rare cases of dry needling causing hematoma, peripheral nerve tissue damage, and impacts on the spinal cord.
2. Dry needling is an evidenced-based treatment modality when applied by a skilled professional. Inquire as to the professional’s training in this area. The clinician must have expert level knowledge in the understanding of the underlying anatomy. For instance, take the gluteus maximus, often used in entry level training programs because it is a large muscle and relatively safe for needle placement. Even as such, the clinician would need to know the course of the sciatic nerve underlying the muscle to avoid any potential risk of damage to this nerve.
3. The clinician (and you) should be aware of what’s called the vasovagal response. Certain stimulus that causes fear such as seeing the needle, seeing blood, or experiencing pain can cause on autonomic response leading to lightheadedness. The practitioner should be skilled in recognizing these symptoms and in patient positioning so that there isn’t a risk of falling and creating a harmful situation.
4. Keep in mind that dry needling is one among a variety of treatments available.  It shouldn’t be seen as a cure-all or stand-alone treatment but rather a complimentary treatment inside a holistic treatment approach that seeks to address the underlying, root cause issues.

  
 
*References:
1. Halle S John Halle J Rob Pertinent Dry Needling Considerations for Minimizing Adverse Effects – Part One. Intl J Sports Phys Ther. (2016); 11(4): 651-662
 
2. Halle S John Halle J Rob Pertinent Dry Needling Considerations for Minimizing Adverse Effects – Part Two. Intl J Sports Phys Ther. (2016); 11(5): 810-819

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