Dry Needling

By: Drew Bechtel

What is Dry Needling?

• According to the APTA "Dry needling is a

skilled intervention that uses a thin filiform needle to
penetrate the skin and stimulate underlying myofascial
trigger points, muscular, and connective tissues for the
management of neuromusculoskeletal pain and movement
impairments. [It] is a technique used to treat dysfunctions in
skeletal muscle, fascia, and connective tissue, and to
diminish persistent peripheral nociceptive input, and reduce
or restore impairments in body structure and function,
leading to improved activity and participation."
Current Dry Needling
Regulations

• Currently 35 states have laws

permitting PT’s to be able to Dry needle
• 7 states prohibit dry needling from their
scope of practice
• Nine states are currently “silent” on the
matter (including Michigan)
Can you Dry needle in Michigan?
• Yes, although Michigan Legislative is currently silent. Trained certified
physical therapists can dry needle in the state of Michigan.
• In 2019, the MPTA stated “dry needling is within the
scope of practice for physical therapy as a rehabilitative procedure”
Why dry needling?
• Dry needling is a good adjunct treatment for treating myofascial pain and
musculoskeletal movement disorder.
• The concept behind dry needling is to disrupt and eliminate trigger points, by
promoting a healing response
• Trigger points are a common source of constant nociceptive input
• Trigger points can alter the muscle's ability to contract properly, which lead to movement
disorders
Common Target
Tissues/Diagnosis

• Myofascial pain/movement restrictions

• Active/Laten Trigger points

• Back pain/Deep Paraspinals

• Tendons/Tendinopathy
• Bursa/Bursitis
• Migraines and Tension Headaches
How Dry Needling works?
• The needle is gently inserted into the trigger point (typically not felt by
the patient)
• Depending on the technique and intent of treatment the needle may be moved in
and out, twisted or left in for a duration of time (<1 or up to 15mins).

• The goal is to elicit a local twitch response (involuntary muscle

contraction)
• Research states the dry needling efficacy is corelated directly to LTR’s
Techniques of Dry Needling
• Pistoning-”in and out” technique
• Most aggressive technique
• https://www.youtube.com/watch?v=G6UqM46uX6o

• Twisting/rotating/tenting
• Estim
Needle Sizes
• Needle length and width can vary
• Needle length can range from 1.5 cm to 6cm
• Needle width can range from 0.16mm to 0.3mm

• Needle size will vary depending on:

• Depth of target tissue
• Size of intended muscle or trigger point
• Size of patient (subcutaneous tissue)
Possible Benefits
• Reduce Pain
• Increase range of motion
• Restore Function
• Improve activity and participation
• Typically used as an adjunct treatment with traditional physical therapy
(ie: manual therapy, therapeutic strengthening, etc)
Resources
• On pins and needles: Just what is dry needling? Mayo Clinic Health System. https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-

.
health/on-pins-and-needles-just-what-is-dry-needling. Accessed March 25, 2021

• https://aptami.org/practice/Whitepaper%20-%20MPTA%20-%20Dry%
20Needling%20Feb%202020.pdf
• https://www.orthopt.org/uploads/content_files/2016_CSM_Handouts/D
ry_Needling_PMSIG.pdf