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The Irish Society of Chartered Physiotherapists

Does Dry Needling Work?

I get asked the above questions on a weekly basis and short answer to the first question, “does dry needling work?” is YES!! It does work. How do we know it works? When carrying out our assessments and treatments we apply a test re-test philosophy. This means that on an initial examination we will take a measurement which we can re-test after we have carried out out treatment to see how it has changed.

This is usually the range of movement of a joint or of your spine eg. how close can you get to touch your toes which is an easy way to measure you spinal flexion. If we measure a significant difference in range of movement, muscle power, pain on movement or otherwise then we can be very confident that the treatment has worked. Dry needling works extremely well for muscular injuries. If it does not work there may be reasons for this, perhaps the injury is not muscular in nature or a different area needs to be targeted. In more difficult cases the treatment needs to be backed up with the exercise programme to gain the full effect and the measurement of the joint/power/pain will change over the course of a few days rather than a few minutes.

From time to time people will read something on the internet or be ‘told by somebody’ that there is no evidence or research to justify certain treatments. To this I would stress that just because the research into the area hasn’t been completed or is flawed, does not mean the treatment is not effective!!! There is limited evidence to suggest that ice is effective in reducing inflammation and yet it is used instinctively and almost every person who uses it to help treat an inflammatory condition will tell you that it helps pain and swelling.

In the case of dry needling however there has been extensive research which has concluded that it is effective and safe for use for mukuloskeletal injuries. If you have the time you can read this article which is one of many articles and papers which support it’s continued use as an effective and safe treatment.

How does it work?

This question is a little more difficult to answer and there is much debate over this. There is ongoing research into the mechanism by which dry needling (and other treatments such as massage) help pain and function. There are mechanical and biochemical effects. Based on the pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into trigger points can cause favourable biochemical changes, which assist in reducing pain. It is essential to elicit so-called local twitch responses, which are spinal cord reflexes. Local twitch response with dry needling is the first step in breaking the pain cycle.

Dry needling is used commonly all around the world at the highest level of sport and rehabilitation for a good reason. It does work. And if the treatment is safe and it works, does it matter exactly why? We can leave those questions to the academics!!

By Emmett Hartigan MISCP

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