Dry Needling Resources

Here are some resources you might find of interest if you use dry needling as part of your clinical practice. The first is broad-brush dry needling science presented by a researcher with a strong focus on the cervical spine. The second is a systematic review of the lumbar spine, and the final is an adverse events review specific to dry needling (so not including TCM events).

Exploring the Science Behind Dry Needling: A Comprehensive Overview

The interview discusses dry needling as a technique used primarily by physiotherapists to treat myofascial pain. It distinguishes dry needling from acupuncture, highlighting its basis in Western medicine and its focus on muscle trigger points rather than meridians. The physiological effects of dry needling are explored, including its impact on muscle relaxation, pain reduction through modulation of biochemicals, and potential central nervous system effects. The article also covers applications in neurological conditions, scar tissue treatment, musculoskeletal disorders, safety considerations, and comparisons with other therapies like manual pressure techniques.

You can listen to the interview with Barbara Cagniehere or read a transcript with associated reference articles here. Well done to the guys from Physiotutors for putting it all together, and thanks to Mark for bringing it to my attention.

You can read Barbara's article titled Physiologic Effects of Dry Needlinghere

Treating myofascial pain with dry needling: A systematic review for the best evidence-based practices in low back pain. Dach F, Ferreira KS. Treating myofascial pain with dry needling: a systematic review for the best evidence-based practices in low back pain. Arq Neuropsiquiatr. 2023 Dec;81(12):1169-1178. doi: 10.1055/s-0043-1777731.

After sifting through myofascial pain articles published between 2000 and 2023, the authors identified 4 RCTs and two meta-analyses. These studies compared dry needling efficacy to other treatments, such as acupuncture, sham dry needling, laser therapy, physical therapy, local anesthetic injection, ischemic compression, and neuroscience education.

Authors' conclusion: Dry needling is an effective procedure for treating myofascial pain in acute and chronic low back pain patients. Further high-quality studies are needed to clarify the long-term outcomes.

Adverse Events Associated with Therapeutic Dry Needling. Boyce D et al. Adverse Events Associated with Therapeutic Dry Needling. Int J Sports Phys Ther. 2020 Feb;15(1):103-113.

You can access the full PDF article here.

Four hundred and twenty physical therapists (USA) provided information over six weeks concerning minor (e.g., bleeding, bruising, aggravation of pain) and major adverse (e.g., pneumothorax, major bleeding, ongoing pain) events that occurred from 20,464 treatments.

Results: 7,531 minor adverse events (AE's) were reported, indicating that 36.7% of the reported treatments resulted in a minor AE. The top three minor AE's were bleeding (16%), bruising (7.7%), and pain during dry needling (5.9 %). The average ratio of minor AE's for all respondents across all weeks was approximately one event for every two patients. Twenty major AE's were reported out of the 20,494 treatments for a rate of <0.1% (1 per 1,024 treatments). No associations were noted between the frequency of adverse events and the level of training or months of experience with dry needling, which I find extraordinary based on my observations of dry needling skill acquisition as practitioners develop with training, anatomical knowledge and expertise.

Authors' conclusion: Expected minor AE's such as mild bleeding, bruising, and pain during dry needling treatment were common and major AE's were rare. Based on the findings of this study the overall risk of a major adverse event during dry needling treatment is small.