What is Functional Dry Needling?
Functional Dry Needling is an amazing tool I use in my practice to resolve muscle tension and pain. When I’m explaining the technique to a patient, the first question I often get is “Is it acupuncture?” While there are some similarities and both have advantages, the techniques are based on different philosophies, so I want to outline those differences and similarities here.
Dry Needling is a general term that includes any treatment that includes inserting a needle without fluid or medication, hence the ‘dry’ portion of dry needling. Both functional dry needling and acupuncture fall into this category.
According to Mayo Clinic, acupuncture is based on “balancing the flow of energy or life force - known as chi or qi (chee) -- believed to flow through pathways (meridians) in your body”. Needles are inserted into specific points along the meridians in order to rebalance the chi.
Many Western practitioners view these acupuncture points as “places to stimulate nerves, muscles and connective tissue”. Depending on the state, an acupuncturist may or may not be licensed. More information about certification and state requirements for practice can be found at https://www.nccaom.org/state-licensure/.
Functional Dry Needling is based on anatomy and physiology with the needles being inserted into neuromuscular junctions and motor points to affect the nervous system and muscles. Functional Dry Needling is regulated differently in each state. In some states, any medical provider who has completed the proper training and testing can provide this type of dry needling. In other states, only acupuncturists can perform any treatment using a dry needle.
While it may seem that you could get either treatment done by a Physical Therapist (PT) or Acupuncturist, that is not entirely true. The training and experience the provider has will greatly affect the treatment they will provide. Both, or either may be beneficial for you, depending on the reason you are seeking treatment. Acupuncture may be a better resource for inducing labor (though I haven’t seen research to support this claim) but functional dry needling would be better to address sciatica. Many acupuncturists do not have the medical training to fully assess muscular and neurological function in order to perform the appropriate treatment or refer you to the right provider who can help. Acupuncturists do have some anatomy training in order to correctly and safely place the needles. Another difference is that acupuncture follows a set path so every person trying to induce labor will get the same treatment. Physical Therapists are trained in assessing the whole physical body and developing a treatment plan based on that assessment, of which one part may include functional dry needling.
A typical session of dry needling includes a review of your symptoms or changes that have occurred since the last visit. A physical assessment will be conducted which may include observing your movement, muscle and fascial tension, joint and nerve mobility. During any movement, pay attention to any places you feel tension, restriction, or pain. The PT will then determine a location or multiple locations for dry needling. This may be one or multiple needles for various lengths of time. Depending on the goals of the needle session, your therapist may move the needles around 1 at a time, leave them in without movement or attach electrical stimulation to the needle causing a muscle twitch or thumping sensation. At the end of the session, after all needles have been removed, the therapist will ask you to repeat a couple of the movements you performed at the beginning. This is called a re-test. Here, we are looking to see if your movement has improved. You should notice the tension, restrictions or pain you felt at the beginning of the session are reduced or gone! This is a successful dry needling session.
Side effects of dry needling include soreness for 24-36 hours which occurs in almost all cases and bruising which is less common. Excessive bleeding, infection, lung puncture can occur but are extremely rare and the risk is reduced by asking about your medical history and medications, using clean needles and gloves and safe needling positions and locations around the lungs.
Most people with musculoskeletal pain can benefit from dry needling, but you must be comfortable with the idea of being stuck with a needle and be aware of and understand the possible effects. I typically do not perform dry needling the first time I see a patient in order to get a better understanding of their response to hands-on treatment. I also want patients to have some strength and motor control of the impaired muscles in order to have better long-term benefits from needling. We don’t want the tense muscle to get tense again quickly after dry needling, thus addressing the cause of the tension is the way to lasting results.