Dry needling - is it an effective form of therapy?
Each of us reacts to therapeutic stimuli in a very individual way. If pain complaints recur, in addition to the application of classical physiotherapeutic methods, one of the alternative but, according to research, effective forms of therapy - dry needling - may be the solution to our problems. As can be seen from systematic reviews and meta-analyses over the past five years (footnotes below), researchers are working very hard to assess the effectiveness and level of evidence for dry needling. It is an intriguing, innovative theme and shows quite a few elements of novelty.
What is dry needling?
Dry needling is a minimally invasive therapeutic method using needle puncture without injection of the therapeutic substance. In other words, it is a therapy that allows us to pierce the surface of our skin almost painlessly. Through the needles, we do not apply the therapeutic substance; the puncture serves only to reach deep into the tissue. The authors of numerous studies, pay particular attention to the analgesic effect of this technique and often also to the possibility of improving the patient's function. Clinical reports emphasise the significant advantages of the method over control groups and sham procedures, which is extremely important for practitioners and confirms the effectiveness of this therapy.
Historical background to needle therapy
Dry needling is often confused with the traditional Eastern form of Acupuncture. Traditional Chinese Medicine consisting of herbal medicine, massage, acupuncture and an exercise system was the inspiration for the development of the Western form of needling. The methods, purposes and locations of needle application are different in the modern and Far Eastern needling models.
A significant channel for the spread of needling in Western lands was the arrival of Asian immigrants, to the United States after World War II. During this time, many Asian medical practitioners came to America providing services such as chiropractic, massage, acupuncture and acupressure. They quickly gained recognition among Western patients. However, the world was in no hurry to popularise or legalise this form of therapy. The thesis that needling could be an effective alternative to pharmacology could not easily overcome the prevailing stereotypes. For this reason, rather late in Europe, associations were formed to study the effects of needling on the body.
Does dry needling help?
As therapists, we often hear this question. The effect of dry needling both locally and globally is confirmed by numerous scientific studies and the consensus opinion of patients who have been helped by the therapy to cope with recurrent pain. Clinical studies unequivocally and unanimously show significant analgesia over sham procedures. AThe nalgetic, or purely analgesic effect of needle puncture is explained by the release of endogenous opioids such as endorphins, enkephalins and dynorphins. During the treatment, the therapist performs a series of punctures and rotational manipulations, increasing the micro-damage of the treatment area. These techniques, cause micro-bleeding in the trigger point area, activating biochemical changes. Better nourishment of poorly supplied tissues stimulates regeneration processes and helps to eliminate inflammation.
When to use? Indications and contraindications for therapy needles
Among the indications for dry needling we can mention:
- headaches of various origins;
- neck and neck muscle pains, whether related to a sedentary lifestyle or post-traumatic problems;
- shoulder pain caused by restricted mobility of the upper limb, and pain that occurs with radiation to the upper limb;
- tendinopathies;
- back pain;
- Lower back pain, radiating to the lower limb, against a background of trauma, overload and chronic pain.
Contraindications to dry needling are:
- pathological skin lesions;
- wounds, abrasions, burns, frostbite;
- elevated body temperature;
- infectious diseases;
- tumours.
What does a dry needling treatment look like?
The therapist palpates the area in the patient's tissue where the trigger point is located. The needles remain in the patient's body for several to as long as 30 minutes. The physiotherapist moves the needles in different directions to deepen the penetrations and effectively break up the trigger point.
The second technique of using dry needling, treats the root cause of the pain in a more global way. Needles are not inserted directly into the painful area, but around the area. The method assumes that the cause of the pain is more complex and may involve the central nervous system.
Summary
In summary, in most cases dry needling has an analgesic effect
and improving the functional status of patients with overload and degenerative changes, although further clinical studies are still needed, as with other conservative treatment methods. Some publications indicate that dry needling brings with it a new quality and can replace the traditional therapeutic measures used for years as a more effective method, but results from some other works contradict the above claim and are critical of needle therapy. Therefore, the most balanced position, which, by the way, is supported by the majority of methodologically good randomised clinical studies of the last 25 three years in the present matter, is as follows treating dry needling as a highly effective analgesic method that also allows for functional improvement and selected quality of life indicators, being an important addition and a valuable complement to existing complex treatment.
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References
1.Griswold D, Wilhelm M, Donaldson M, Learman K, Cleland J. The effectiveness of superficial versus deep dry needling or acupuncture for reducing pain and disability in individuals with spine-related painful conditions: a systematic review with meta-analysis. J Man Manip Ther. 2019 Jul; 27 (3): 128-140. 8.
2.Boyles R, Fowler R, Ramsey D, Burrows E. Effectiveness of trigger point dry needling for multiple body regions: a systematic review. J Man Manip Ther. 2015 Dec; 23 (5): 276-293.
3.Rodríguez-Mansilla J, González-Sánchez B, De Toro García Á, Valera-Donoso E, Garrido-Ardila EM, Jiménez-Palomares M, González López-Arza MV. Effectiveness of dry needling on reducing pain intensity in patients with myofascial pain syndrome: a Meta-analysis. J Tradit Chin Med. 2016 Feb; 36 (1): 1-13.
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