Dry Needling - What You Should Know

Dry needling sometimes is the best Physical Therapy in Cody Wyoming and the best physical therapy in the Big Horn Basin

The physical therapists at Advantage Rehab have advanced credentials in the technique of dry needling.

What is Dry Needling?

Dry needling is a procedure in which a solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point.

A myofascial trigger point is a very common cause of local muscle pain and tenderness. The pain associated with a myofascial trigger point comes from a hypersensitive nodule in a taut band of skeletal muscle. Myofascial trigger points are identified by physical examination, specifically by palpation. With the advancement of technology, more recent studies have found that trigger point taut bands can be visualized using sonographic and magnetic resonance elastography (Chen et al. 2007, 2008, Sikdar et al. 2009, Rha et al. 2011). The probable mechanism of their formation is thought to occur with muscle overload or overuse when the muscle cannot respond adequately, particularly following unusual or excessive eccentric or concentric loading (Gerwin et al. 2004, Gerwin 2008, Mense & Gerwin 2010). They have been identified with radiculopathies, joint dysfunction, disk pathology, tendonitis, craniomadibular dysfunction, migraines, tension-type headaches, carpal tunnel syndrome, computer-related disorders,

whiplash associated disorders, spinal dysfunction, pelvic pain and other urologic syndromes, most pain syndromes, post-herpetic neuralgia, complex regional pain syndrome, nocturnal cramps, phantom pain, etc. Thus, trigger point dry needling can be used for a variety of musculoskeletal problems. Such conditions include, but are not limited to neck, back, and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache to include migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstring strains, calf tightness/spasms). The treatment of muscles has an effect on reducing pain mechanisms in the nervous system.

The advantages of dry needling are increasingly documented and include an immediate reduction in local, referred, and widespread pain, restoration of range of motion and muscle activation patterns, and a normalization of the immediate chemical environment of active myofascial trigger points. Trigger point dry needling can reduce peripheral and central sensitization.


There are many similarities and differences between trigger point dry needling and acupuncture. Licensed physical therapists in a growing number of states can use trigger point dry needling under the scope of their practice. Dry needling also falls within the scope of acupuncture practice. The physical therapists at Advantage Rehab are not licensed acupuncturist and do not practice acupuncture. In contrast to most schools of acupuncture, trigger point dry needling is strictly based on Western medicine principles and research.
How does it work? The exact mechanism of trigger point dry needling is not known. There are mechanical and biochemical effects. Based on the pioneering studies of Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into a trigger point can cause biochemical changes, which assist in reducing pain. It is favorable to elicit so-called local twitch responses, which are spinal cord reflexes. Obtaining local twitch responses with dry needling is helpful in breaking the pain cycle. Most patients do not feel the insertion of the needle, if they do feel it, it is just a sharp sensation. The local twitch response elicits a very quick (less than a second) painful response. Some patients describe this as a little electrical shock, others describe it as a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses, which is a good and desirable reaction.

Are the needles sterile? Yes, we only use sterile disposable needles.

Occasional soreness after the procedure that is described as muscle soreness over the area treated and into the areas of referred symptoms. It can last a couple of minutes, hours or a day or so and just varies from person to person.

What should I do after I have the procedure done? Recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include stretching, heat or ice over the area.

How long does it take for the procedure to work? It can vary from person to person, sometimes one treatment, sometimes several visits. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means.

Once I am feeling better, how often do I need to come back to maintain my progress? The musculoskeletal system is under constant pressure from gravity, stress, work etc. A regular exercise program combined with good posture can prevent many problems. If the pain returns, “tune-ups” may help to treat and prevent further injuries. Your physical therapist can perform an evaluation to help determine if you are a good candidate for this possible treatment as part of your program in conjunction with other techniques including exercise designed to reduce your pain and improve your function.