"Dry Needling”
offers relief to Physical Therapy Patients :
Andrea Blumenstein on
a little-known technique to treat chronic back and neck pain
By Andrea Blumenstein
From chronic pain to sports-related injuries, many issues
can lead to a physical therapy referral. Physical therapy includes multiple
modalities with decreased recovery time and longer-lasting improvements in
mobility, functionality and quality of life. Dry needling is one little-known
technique — and though it sounds intimidating, physical therapist Taryn Cohn
says she's used it with great results.
"[For patients presenting] with long-standing
conditions such as chronic low back and neck pain, as well as more acute
injuries like those that occur suddenly at work or during recreational sports
activities, I've had amazing success [using dry needling]," Cohn says.
During dry needling, solid, sterile filiform needles are
inserted into soft muscle tissue or connective tissue correlated with an
injured or painful area of the body. While the needles are the same type used
in acupuncture, dry needling is a distinct form of therapy.
Physical therapist
Randy Hernandez of the Movement Science Center says one of the biggest
differences between the two is that acupuncture uses meridians (invisible
energy pathways that are the basis of traditional Chinese medicine). In this
philosophy, needles might be placed in the hand to treat an ailment in another
part of the body. This is not the case for dry needling.
"The hand would only be needled, for example, if there
are symptoms in the hand itself or a neighboring joint that would be directly
affected by the location of the needling," Hernandez says.
Physical therapists use dry needling in conjunction with
other forms of manual therapy and corrective exercises. Therapists make the
decision about what treatments to recommend during an initial visit.
The technique is not new. For more than 25 years, therapists
have used dry needling to improve recovery time. "Pioneers in our state
have been practicing successfully for around 10 years," Hernandez says.
Dry needling is a treatment option for people with
musculoskeletal conditions such as muscle strain, tendonitis and bursitis,
along with back and neck pain.
"By eliminating trigger points in muscles, dry needling
also takes care of many referred pains, such as headaches and sciatica which
are often mistakenly blamed on more serious causes," says Ron Helwig, a
physical therapist and CEO of Magnolia Physical Therapy,
Patients can expect a physical therapy session to last 60
to 90 minutes, including both dry needling and therapeutic exercises. At
Magnolia, therapists provide approximately 30 minutes of manual therapy that may
or may not include dry needling, followed by 30 to 40 minutes of specific
therapeutic exercises.
"Incorporating dry needling has considerably cut down
treatment duration — meaning patients get well faster," Helwig says. The
results are more immediate, and the risk of complications (which include
infection and bruising) is low under the care of a trained professional.
Dry needling is gaining recognition as a first-option
treatment for many injuries. Cohn incorporates dry needling early in the rehabilitation
process if she finds the treatment appropriate and her patients are willing to
try it.
"The rapid improvement in the soft tissue mobility this
treat-ment provides allows us to move more quickly into a corrective exercise
and strengthening program," Cohn says.
This often shortens the duration of physical therapy
treatment. However, Cohn prefers not to perform dry needling on a patient more
than once a week in order to allow for the body to adapt to the changes.
Overall treatment success depends on whether an individual
patient complies with physical therapist-directed home programs. Hernandez sees
the greatest success rates when dry-needling patients follow through with both
manual physical therapy and therapeutic exercises.
"With dry needling, it is important to reinforce the
treated tissues with proper muscle re-education and supportive
interventions," Hernandez says.
Most people say the pain of dry needling ranges from minimal
to uncomfortable, depending on the muscle tissue and the patient's sensitivity.
It is not uncommon to feel muscle soreness after the treatment, similar to the
soreness that follows an intense workout. The majority of people receiving dry
needling feel pain relief within 48 hours, often much sooner.
The cost of the procedure varies based on insurance and
practitioner. Many therapists absorb the cost of the needles because insurance
companies do not, Hernandez says.
Dry Needling in Physical Therapy-American Physical Therapy
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