Dry Needling (FAQs)
The attorney General of NJ rendered his opinion on February 9, 2017 stating, “under the current statute, physical therapists are not authorized to engage in dry needling”. As determined by the NJ Board of Physical Therapy Examiners, Spine & Orthopaedic Physical Therapy cannot provide dry needling to any new patients which commence therapy after July 1. Patients who are currently receiving physical therapy including dry needling can continue receiving dry needling with an end date of September 1, 2017. After September 1, 2017 Spine & Orthopedic Physical Therapy will no longer provide dry needling to any current or new patients. Stay tuned for changes. Dry needling information provided on this web-site is currently for educational purposes only.
Frank Previte, PT has earned Dry Needling Certification upon completing course requirements of the MYOPAIN Janet G. Travell, MD Seminar Series and successfully passing theoretical and practical examinations in the identification, examination, and treatment of Myofascial Trigger Points.
What is dry needling? – Dry needling is an invasive procedure in which a solid filament needle is inserted into the skin and muscle directly at the myofascial trigger point. A myofascial trigger point consists of multiple contraction knots, which are related to the production and maintenance of the pain cycle.
Is dry needling similar to acupuncture? – There are many similarities and differences between dry needling and acupuncture. Licensed physical therapists in a growing number of states can use dry needling under the scope of their practice. Dry needling also falls within the scope of acupuncture practice. PT’s at Spine & Orthopaedic PT are not licensed acupuncturists and do not practice acupuncture. In contrast to most schools of acupuncture, dry needling is strictly based on Western medicine principles and research.
How does dry needling work? – The exact mechanisms of dry needling are not known. There are mechanical and biomechanical effects. Based on the works of Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into trigger points can cause favorable biochemical responses, which assist in reducing pain. It is essential to elicit so-called local twitch responses, which are spinal cord reflexes. Getting local twitch responses with dry needling is the first step in breaking the pain cycle.
What type of problems can be treated with dry needling? – Dry needling can be used for a variety of musculoskeletal problems. Muscles are thought to be the primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back and shoulder pain, arm pain (tennis/golfer’s elbow, carpal tunnel), migraines and tension type headaches, jaw pain, buttock and leg pain (sciatica, hamstring strains, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system.
Is the procedure painful? – Most patients do not feel the insertion of the needle. The local twitch response elicits a brief (less than a second) painful response. Some patients describe this as a little electrical shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the local twitch responses and that is a good and desirable reaction.
Are the needles sterile? – Yes, we only use sterile disposable needles.
Can I do dry needling myself as part of my home program? – No, dry needling requires extensive training and should never be tried at home.
What side effects can I expect after treatment? – Most patients report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred pain. Typically the soreness lasts between a few hours and two days.
What should I do after the treatment is done? – Our recommendations vary depending on the amount of soreness you have and the individual response to treatment. Recommendations may include applying heat or ice over the area, gentle stretches and modifications of activities.
How long does it take for the procedure to work? – Typically, it takes several visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.
Why is my doctor not familiar with dry needling? – In the US, dry needling is a relatively new method for treating myofascial pain and not everyone is already aware of this effective modality. Feel free to inform your doctor about this treatment option. It is upon us all to educate others about new and innovative ways to treat pain.
Where does dry needling fit in the entire rehabilitation program? – Generally speaking, dry needling is the modality of choice when comes to treating patients in the clinic. More frequently, dry needling is needed in the beginning in order to break the pain cycle. Once that is achieved, other treatment options are introduced.
Once I am feeling better, how often do I have to come back to maintain my progress? – The musculoskeletal system is under constant pressure from gravity, stress, work, etc. A regular exercise program combined with good posture can prevent many problems. If the pain comes back, “tune-ups” are recommended to treat and prevent serious injuries.