Dry Needling: What Is It and How Does It Work?

17 hours ago

4 min read

by Carien Boshoff

Heard dry needling can be used during an osteopathy appointment and wondered what it actually does.

Dry needling is one technique that an appropriately trained osteopath may consider as part of managing some muscle and joint-related presentations. It uses thin needles inserted into selected muscles and other soft tissues.

In osteopathy, dry needling is generally not used as a treatment on its own. Instead, it may form one part of your overall management alongside approaches such as exercise, education, activity advice and hands on osteopathic treatment.

What is dry needling?

Dry needling involves inserting a very fine, sterile, single use needle through the skin and into selected soft tissue, such as a muscle. The word “dry” simply means that nothing is injected through the needle. There is no medication or other substance involved. Your osteopath will consider your symptoms, anatomy, medical history, and assessment findings when deciding whether dry needling may be appropriate and where it may be used.

Is dry needling the same as acupuncture?

Not quite. Dry needling and acupuncture can use similar types of needles, but they come from different approaches to healthcare. Within osteopathy, dry needling is generally used from a Western anatomical and musculoskeletal perspective. Your osteopath considers factors such as your anatomy, symptoms, movement and assessment findings when deciding whether and where to use dry needling. Acupuncture has its origins in traditional Chinese medicine, although there are different approaches to acupuncture used today.

What does dry needling feel like?

Everyone experiences dry needling a little differently. You may barely notice the needle going in. At other times, you might feel a brief ache, cramp or muscle twitch. Sometimes a muscle may briefly contract or “twitch” when the needle is used. This is known as a local twitch response. You may also notice some temporary soreness afterwards, a little like the feeling you can get after exercise. Your osteopath should communicate with you throughout treatment, so if anything feels uncomfortable, let them know.

Why might an osteopath use dry needling?

An osteopath may consider dry needling for some people experiencing muscle or joint related pain, tightness or muscle sensitivity. Depending on the individual presentation, dry needling might be considered around areas such as the:

• Neck and shoulders

• Back

• Hips and glutes

• Thighs

• Calves

• Forearms

However, dry needling isn't suitable or necessary for everyone. As osteopaths, we don't decide to use dry needling simply because a particular area feels tight or sore. We first consider the bigger picture, including your symptoms, medical history, movement, activity levels, assessment findings, goals and personal preferences. From there, we can discuss whether dry needling may have a place within your management plan.

What happens during dry needling?

Before dry needling, your osteopath should explain why they are considering the technique and how it fits into your overall treatment. They should also discuss:

• What you might feel

• Possible risks and side effects

• Other treatment options available

• Any questions or concerns you have

You will be asked for your consent before treatment begins. A sterile, single use needle is then inserted into the selected area. The number of needles, their location and how they are used will depend on your individual presentation and your osteopath's clinical reasoning. And remember, dry needling is always optional.

Are there any risks?

Like any treatment involving a needle, dry needling can have side effects. More common and usually temporary effects can include:

• Soreness or aching

• Minor bleeding

• Bruising

• Discomfort during treatment

There are also less common risks associated with needling, which your osteopath should consider and discuss with you where relevant based on the area being treated and your individual circumstances.

Before treatment, it is important to tell your osteopath about any medical conditions, medications, pregnancy or possible pregnancy, previous reactions to needles, or anything else you are concerned about.

How does dry needling fit into an osteopathy appointment?

One of the important things to understand about dry needling is that the needle itself isn't the whole treatment.

When you see an osteopath, we assess more than just the area that feels sore. Depending on your presentation, we may look at your movement, strength, activity or training loads, medical history, lifestyle factors and what you want to get back to doing. Your management plan may then include a combination of:

• Education and advice

• Exercise and rehabilitation

• Changes to activity or training

• Hands-on osteopathic treatment

• Dry needling where appropriate

• Referral for further assessment if needed

Dry needling may therefore be one tool we use within a broader management approach rather than a standalone or “quick fix.”

Do I have to have dry needling?

No.

You do not need to have dry needling to receive osteopathic treatment.

If your osteopath thinks dry needling may be appropriate, they should explain why they are recommending it and give you an opportunity to ask questions before you decide.

If you don't like needles, have had a bad experience with them before, or simply don't want dry needling, let your osteopath know. We can discuss other management options with you.

Take home message

Dry needling is one of several techniques an appropriately trained osteopath may consider when managing some muscle and joint related presentations.

Ultimately, whether dry needling is appropriate depends on you, your presentation and your goals. If you're curious about dry needling or wondering whether it may be appropriate for you, speak with your osteopath. We can assess your presentation, explain the available options and work with you to determine an appropriate management approach.

References

Boyce, D., Wempe, H., Campbell, C., Fuehne, S., Zylstra, E., Smith, G., Wingard, C., & Jones, R. (2020). Adverse events associated with therapeutic dry needling. International Journal of Sports Physical Therapy, 15(1), 103–113.

Gattie, E., Cleland, J. A., & Snodgrass, S. (2017). The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: A systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 47(3), 133–149. https://doi.org/10.2519/jospt.2017.7096

Navarro-Santana, M. J., Sanchez-Infante, J., Fernández-de-las-Peñas, C., Cleland, J. A., Martín-Casas, P., & Plaza-Manzano, G. (2020). Effectiveness of dry needling for myofascial trigger points associated with neck pain symptoms: An updated systematic review and meta-analysis. Journal of Clinical Medicine, 9(10), 3300. https://doi.org/10.3390/jcm9103300