Dry needling is a moderately invasive procedure supported by dozens of peer-reviewed studies. Trained therapists use dry needling to eliminate musculoskeletal pain stemming from myofascial trigger points. While generally regarded as a safe treatment for healthy people, there are some inherent trigger point dry needling risks that you should be aware of, prior to scheduling a dry needling session.
Understanding more about the mechanisms behind dry needling will help you make informed decisions about whether to undergo dry needling, and where to find a qualified dry needling specialist to ensure the best results.
What Are Myofascial Trigger Points?
“Myofascial” is a compound word meaning muscle (myo) and connective tissue (fascia). In physical therapy, it refers to the thin sheathes of connective tissue that enclose, surrounds and separates the soft tissues in your body, compartmentalizing them so they can move independently of one another and glide freely around bones, nerves and vital organs.
Trigger points are tightly contracted groups of myofascial fibers that form tiny hard knots, often near the joints where muscles and tendons connect with bones. A trigger point is fundamentally a mini muscle spasm that does not release its contraction when unloaded. Trigger points frequently appear in physically active people, often occurring when muscles are highly challenged during sports and exercise.
Superficial trigger points form in soft tissues just below the skin’s surface, and the knots can often be felt with your fingertips. They are easily located by your clinician and relatively easy to treat. But sometimes trigger points can be hidden in muscles and connective tissues deep within the body. Deep tissue trigger points cannot be detected through the skin, posing a challenge for both diagnosis and treatment.
What is Dry Needling?
Dry needling is a form of injection therapy that uses long thin needles similar to those used for acupuncture. The needles are “dry”, meaning they do not deliver medication. But while acupuncture is an ages-old Chinese procedure that targets the body’s energy meridians, the goal of dry needling is to stimulate a twitch response in trigger points, causing the fibers to release their tight contraction and restoring their normal contractile function.
Dry needling is fairly straightforward when it comes to treating superficial trigger points. The nodules are easy to locate, enabling the clinician to accurately insert the needle with minimal risk and high prospects for success. But when trigger points are buried in deep tissues, they are much more difficult to diagnose and treat, since the nodes are neither visible nor palpable.
Trigger Point Dry Needling Risks
Before you can successfully treat deep tissue trigger points, you need to identify and locate them. Detection of deep trigger points is impossible without deep tissue imaging. If a practitioner recommends dry needling for deep tissue pain without tangible evidence of the existence of trigger points or their exact location, you should find another doctor.
Dry needling dangers include:
- Needle Insertion without visual confirmation of trigger points
- “Blind” dry needling, where needles are inserted without ultrasound guidance
- Multiple insertions in the same location, supposedly to find and target hypothetical trigger points
- Infections from poorly sanitized needles
- Pain and infections from multiple same-site insertions
- Procedures performed by unqualified or underqualified practitioners that put your health at risk
Unless active trigger points are easy to locate near the skin’s surface, dry needling should not be performed without ultrasound imaging.
Avoiding Dry Needling Risks
To ensure accuracy and precision and avoid dry needling risks and complications, look for a practitioner who uses diagnostic ultrasonography to accurately locate and identify deep tissue trigger points.
Diagnostic ultrasound offers several advantages for detecting deep tissue trigger points:
- It allows the clinician to look deep below the surface and examine the musculotendinous junction where trigger points are likely to form.
- It allows the diagnosis to take place in real time, with no extended wait period for results, accelerating treatment.
- It allows both clinician and patient to view the body’s structures while the patient moves the affected area, enabling the clinician to reposition the patient for optimal visual imaging.
- Ultrasound equipment is compact and mobile, meaning diagnosis can take place in small or remote spaces.
After the clinician has successfully diagnosed the presence of trigger points, ultrasound guidance can be used to accurately pinpoint active trigger points, dramatically increasing the procedure’s precision, while sparing the patient the discomfort and risks of blind needling procedures that often fail to relieve pain, and may worsen the patient’s condition.
When precisely targeted, ultrasound guided dry needling is able to successfully evoke a twitch response with a single needle insertion, providing the patient with immediate relief from trigger point induced pain.
Dry Needling Physical Therapy in NYC
To get the best outcomes from dry needling, look for a clinician with bona fide credentials and training in ultrasound guided needling procedures. You should be able to find a list of certifications, degrees and licenses on the practitioner’s website, on the “About” page.
If you live or work in New York, you can get the best dry needling physical therapy at NYDNRehab in Manhattan. Dr. Kalika, NYDNRehab’s clinical director, is a trained expert in ultrasound guided dry needling who has conducted and published multiple peer reviewed research studies on the procedure.