Dry Needling, often referred to as Intramuscular Technique (IMT), is a medical procedure where a physical therapist, M.D. or D.O. inserts a full filament needle into muscle tissue to relieve trigger points in a muscle and fascia (connective tissue under the skin and between muscles and organs).
Dry Needling provides 3 major benefits:
Sensory: It relieves muscle pain and releases painful neurochemicals in the trigger points. It also gives an anesthetic effect in your brain and stimulates pain-relieving chemicals in the brain.
Motor: Dry needling a trigger point, triggers a therapeutic twitch response in the muscle that allows the involuntary contracture in the muscle to relax. Trigger points are microscopic contractures within a muscle band. Contracture by definition is the involuntary (no voluntary ability to relax) sustained constriction of a muscle fiber.
Autonomic: Dry needling changes the muscle activation pattern of the muscles, decreasing sympathetic tone (auto-pilot nervous system) and allows more coordinated muscles. Relieving the contractures with the muscles allows the muscles to relax and get blood supply to the muscle fibers so they can shorten and lengthen more freely. The area feels lighter and more free, because movements are better coordinated.
To fully understand how dry needling works, we need to understand muscle pain. Muscle pain is its own pain science. It is not skin, nerve, disk, or biomechanical and it is especially not neuropathic pain. Muscle pain has both a peripheral and central (meaning connect to pain processing centers at the spinal cord/brainstem) level. Peripheral sensitization means that muscle pain can spread and refer pain to other body areas, different than that of a nerve root. Muscle pain also has a central sensitization component which means the cortex is involved. In the cortex our brain remembers muscle memory and learns movement by habit.
Habit is doing the same thing the same way. Our signature is an example. Our brains are blind to this muscle memory/habit. Our brain learns by doing (the somatosensory kinesthetic brain). Dry needling allows the brain to change muscle activation patterns, which lends itself, if done properly, to relaxation and movement efficiency without pain. Another benefit of dry needling is that it can decrease pain sensitization (elevates pain threshold). For example, a person with a high pain threshold will feel less pain for the same painful stimuli such as a pinch, then someone with a lower pain threshold.
Dry needling is clinically tested to provide faster and greater improvement. Learn more here.
How is it different when Dry Needling is performed by a physician or acupuncturist?
- Dry needling by a physical therapist is done in conjunction with manual therapy/myofascial release, neuromuscular techniques.
- Patients are provided with key exercises and neuromuscular re-education to balance the movements in pain free range.
Other benefits of dry needling include:
- Immediate results because the nervous system participates more and results are more sustained than passive techniques. “You keep what you do,” says Carol Cote, NJPTA President and Director.
- Based on our practice, dry needling is 70-80% faster than traditional physical therapy.