Trigger Point Dry Needling

Dry NeendlingSteve Wowzynski, MPT, CMTPT/DN

Maybe your doctor suggested it or a friend said it helped them.  So, what is Trigger Point Dry Needling, and how can it help?  These burning questions and more will be discussed in this Q&A.

What is Trigger Point Dry Needling?

Trigger Point Dry Needling (TrP-DN) is an adjunct approach to manual therapy utilized in the clinic by a trained and certified physical therapist. There are several different dry needling techniques used by physical therapists.  While some philosophies might differ, all the approaches center around the use of the dry needle. 

What is a Dry Needle? 

A dry needle is a thin gauge filament needle with a solid core, meaning there is no injection of pain killers or steroid medications of any kind. Rather, the dry needle is used by a certified therapist to pass through the layer of skin tissue to address the fascial/connective tissue and/or muscle layers of the body. 

What is a Trigger Point?

A trigger point is a focal nodule of myofascial tissue within a taut band of tissue that leads to local or referred pain responses. Trigger points have been known to form due to an acute injury, traumatic event, chronic overuse, or stress related injuries. A patient will usually describe a Trigger Point as a “knot” that just will not relax.

What is the dry needling treatment approach?

A skilled physical therapy assessment identifies restrictions in movement, decreased strength, tension, and pain associated with impaired function.  During the assessment, a Trigger Point might be located and found to reproduce the local pain and/or referred pain response.   For example, when you experience a headache, you might find a “knot” in your neck.  As you touch that “knot” you notice some local pain where you are touching, but you also notice the pain travels upward into your head like your headache.  In conjunction with hands-on manual therapy, posture re-education, and strengthening, we may also suggest trigger point dry needling to further speed healing. Through this mechanical approach, the Dry Needle is manipulated in a skilled way to help change local blood flow, resulting in decreased inflammation and reduced pain signal at the local site.  

What will Trigger Point Dry Needling feel like?

Sensations vary from person to person. As a therapist, we are looking for a twitch response in the treatment area. The twitch response has been described as an involuntary muscle contraction (twitch), flushing warmth, tissue relaxation, or an electric wave. In most cases, patients experience local soreness in the treatment area, but generally the pain that brought you to therapy will diminish.  As with all medical interventions, there are some rare interactions that can occur such as bruising and/or bleeding from the treatment site, lightheadedness or feeling faint, electric shock nerve pain, sweating, and itching at the treatment site. Your therapist will discuss this treatment option, including all of the benefits, risks, and possible side effects, to make every effort to keep you feeling safe and comfortable.

What are some conditions for which Trigger Point Dry Needling (TrP-DN) might be helpful?

This list is not all inclusive, but TrP-DN has been used in muscle injuries throughout the body as well as  hand, elbow, shoulder, neck, jaw, back, thigh, buttock, leg, and foot pain conditions. TrP-DN can also help decrease scar adhesions after an injury or surgical intervention.

Is there anyone who should not receive TrP-DN?

The only absolute contraindication to using TrP-DN is a person with a true phobia to needles called trypanophobia. That said, caution is used for situations of cognitive impairment, local skin infection or lesions, blood infections, compromised immune systems, bleeding disorders, extreme varicose veins and spider veins, fresh surgical incisions, and pregnant women if they have not received TrP-DN prior to pregnancy. 

Will my insurance cover TrP-DN?

As mentioned, TrP-DN in Physical Therapy is not a stand-alone procedure, as it is an adjunct option within the scope of manual physical therapy. You can check with your insurance or have our insurance specialist find out if physical therapy at MotionWorks is a covered benefit of your health insurance.  

Is TrP-DN the same as acupuncture?

No, TrP-DN is not acupuncture. Though a physical therapist may use the same needles as an acupuncturist, an acupuncturist practice approach is based on traditional Chinese medicine and has its own set of education and certification options. 

Dommerholt J & Fernandez-de-las-Penas C. “Trigger Point Dry Needling: An Evidence and Clinical-Based Approach,” 2nd ed.