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If you’re squeamish about needles, you may be tempted to skip this story. Don’t! Dry needling could be the key to reducing chronic pain, writes Laura Greaves.

When you’re in pain, the idea of sticking needles in your sore spots may seem counter-intuitive. But according to practitioners of dry needling – also known as myofascial trigger point dry needling – the technique can be beneficial in treating many painful conditions, such as tight muscles, non-specific low back pain, osteoarthrosis, headaches, and migraines.

In layman’s terms, dry needling works by stimulating trigger points – hyper-irritable spots in the connective tissue known as fascia. It involves inserting a fine needle into a tender or painful point, then rotating and/or pistoning the needle for therapeutic purposes. Dry needling is distinct from acupuncture in that it’s practised by physical therapists, such as osteopaths and physiotherapists. (For more about the differences between dry needling and acupuncture, see “Dry needling vs. acupuncture”.)

“The practitioner may try to elicit a ‘twitch response’, which is an involuntary contraction of the muscle that is used to help reduce muscle tone and nerve sensitivity,” says Dr Craig White, a Melbourne osteopath. “They may leave the needle in the muscle or tissue for a period of time to achieve the same outcome. Some practitioners also use electrical stimulation or a TENS machine to reduce pain and muscle tension.”

Fast results

Around 40 percent of osteopaths now offer dry needling, according to Osteopathy Australia. Dry needling can help to release tightened or shortened muscles, and White says research has shown that a twitch response can help relax a muscle, reduce the pull on adjacent areas, and reduce the irritation of a sensitive nerve.

He recalls treating a 40-year-old woman who suffered what appeared to be a calf strain just four days before a netball tournament she was desperate to play in. “In a normal situation she would be unlikely to be fit to play, so we decided to try two sessions of dry needling, combined with protective taping. After the two treatments, she played seven games of netball in three days. Her team won the grand final and she was named the Most Valuable Player (MVP) for the tournament. Had she not received dry needling, I doubt she would have been fit to play.”

Safety first

Dry needling is generally suitable for patients of all ages, however Osteopathy Australia does not recommend needle techniques for babies or children at pre-verbal stages of development. With the fear of needles extremely common, it’s also important that the patient fully grasps what the proposed needling treatment involves, and understands the potential side effects that can occur during or after a dry needling treatment; these include fatigue, light-headedness, bruising or temporary aggravation of symptoms.

“Some patients are more sensitive to needling and are ‘autonomically labile’ (prone to sudden drops in blood pressure that can lead to fainting). Fainting may be caused by anxiety, hunger, fatigue and excessive stimulation of the needles,” White says. “A small percentage of patients may feel excessively relaxed and sleepy after dry needling.”

Needle hygiene is also crucial, and patients should check that only sterile, single-use disposable needles are used. “A needle should be in its packet, in the patient or in the clinical waste receptacle,” he says.

Dry needling vs acupuncture

While the treatment of myofascial trigger points with needles is the basis of both acupuncture and dry needling, there are subtle differences between the two therapies.

In osteopathy and physiotherapy, it’s common to combine needling with a range of manual techniques, such as stretching, massage and gentle articulation and manipulation of specific joints and soft tissues. In acupuncture, however, the use of needles is more likely to be a standalone treatment, although traditional Chinese medicine (TCM) practitioners may also prescribe herbal formulations. Acupuncture also involves solid needles, while dry needling may involve either solid or hollow-core needles.

But the key difference between dry needling and acupuncture comes down to regulations, according to osteopath Dr Craig White. “The term ‘dry needling’ probably originated in the USA in the 1990s, (because) in many states licensing regulations for acupuncturists were such that it did not allow physical therapists to use the term acupuncture,” White explains. “Being an acupuncturist is a protected title under national law; only practitioners registered with the Chinese Medicine Board of Australia may use the title. There are potentially severe financial penalties for ‘holding out’ and misleading patients.”

“Dry needling cured my constant pain”

When a sports injury got too much, Brisbane event management consultant Samantha Horton, 25, overcame a needle phobia to try dry needling.

“I have a really tight neck and traps (the trapezius muscles at the back of the neck and shoulders), and I’d also injured my knee trail-running. My neck and knee were constantly painful, but when my physiotherapist suggested dry needling I was hesitant, because I hate needles. But after she told me it could speed my progress, I thought I might as well give it a try. It only took a few sessions for me to start noticing my muscles feeling looser, and now I have dry needling every two weeks. You just have to push past the fear of needles; honestly, the needles are so small I barely feel them. Once you start to see the benefits, it becomes a non-issue.
You can feel the muscles twitch beneath the needle, which is a strange feeling - but it’s far less painful than trigger point therapy, which I’ve also tried. I would recommend to anyone to give dry needling a go. It has honestly made such a difference for me.”