The Safety and Effectiveness of Dry Needling: Poking Fun at Our Favorite Technique (With Minimal and Unavoidable Needle Puns)
Alright, healthcare warriors, let's talk about dry needling. Yes, that treatment we all love to defend at dinner parties when our non-medical friends look at us like we've lost our marbles. “You stick needles where?” they gasp. And we, the calm, collected professionals, nod sagely and say, “Yes, and it works wonders.” But let's be real: we need to ensure that we're not just championing a medieval torture technique in disguise. Today, we're diving into the nitty-gritty of the safety and effectiveness of dry needling, armed with some solid research to back us up.
Safety First: Because Nobody Wants to Explain a Lawsuit
We all know that with great power comes great responsibility. And with great needles comes the need for great caution. Dry needling, while a fantastic tool, isn't without its risks. Thankfully, our trusty researchers have done some heavy lifting to help us understand these better.
Boyce et al. took a deep dive into adverse events associated with dry needling in their 2020 study published in the International Journal of Sports Physical Therapy. Their research showed that while most adverse events are minor—think bruising, bleeding, and temporary pain—there are rare but serious risks too. Pneumothorax, for example, is the big scary monster under the bed we all worry about. Thankfully, it's rare-very rare, but it's a reminder to always be cautious and precise with our techniques and choose a dry needling education company who puts safety first by having tried and true safe techniques and a low instructor to participant ratio (Boyce D, Wempe H, Campbell C, et al. Int J Sports Phys Ther. 2020;15(1):103-113).
In another enlightening piece of research, Valdes (2019) in the International Journal of Physical Therapy and Rehabilitation discussed adverse events in the context of physical therapy practice. Valdes emphasized the importance of thorough training and adherence to safety protocols to minimize risks. Again, the adverse events are usually minor, but the take-home message is clear: keep your training sharp (Valdes VR. Int J Phys Ther Rehab 2019;5:157. doi: https://doi.org/10.15344/2455-7498/2019/157).
Effectiveness: Why We Stick to Our Guns (and Needles)
Now, let's talk effectiveness. We're not just poking people for the fun of it (promise!). Dry needling has shown significant benefits, particularly for musculoskeletal pain and dysfunction. The magic lies in the way it can be seamlessly integrated into your current practice. In fact, dry needling is most effective when combined with other treatment modalities (think corrective exercise) that reenforce the changes you are trying to make with dry needling.
Research has consistently demonstrated that dry needling can decrease pain and improve function. Patients with chronic conditions like lower back pain, neck pain, and shoulder issues often report significant improvements after a few sessions. This isn't just placebo effect; it's the real deal. When done correctly, dry needling can make positive changes for managing pain on our cerebral cortex and spinal cord, reduce muscle tension, improve blood flow, improve muscle contractility and promote healing—making it a powerful tool in our therapeutic arsenal.
Practical Tips: Sharpening Your Skills
Alright, we’ve got the research to back us up, but what about the practical side of things? How do we ensure we’re maximizing the benefits of dry needling while minimizing the risks? Here are some tips to keep you on point (sorry, couldn’t resist).
Get Proper Training: This might seem like a no-brainer, but thorough, hands-on training is crucial. It’s not just about knowing where to stick the needle; it’s about understanding anatomy, being able to FIND the specific structures you’re targeting, and understanding how to apply dry needling clinically to get the most out of your treatment.
Follow Safety Guideline: Pick a course that emphasizes safety and teaches you how to keep you and your patients safe. Stick to the guidelines established by OSHA and the CDC. They’re there for a reason, and adhering to them can save you a lot of trouble.
Communicate with Your Patients: Neutral language is key. Explain the procedure, discuss potential risks, and set realistic expectations. A well-informed patient is more likely to have a positive experience and less likely to panic if they experience minor side effects.
Prove your effectiveness to yourself and your patients: Are you doing a test/retest every session? How do you know if what you are doing is making a difference? One of the most exciting aspects of dry needling is the immediate changes you see after removing the needles. If you are not seeing a change in your key objective tests and measures, you know you need to reassess (or review your anatomy to get to your target better!). This gets you to the underlying causes of dysfunction much faster and is way more effective than chasing pain.
Stay Updated: The field of dry needling, like all medical fields, is constantly evolving. Keep abreast of the latest research, attend multiple dry needling (and other!) courses, discuss outcomes and techniques with your colleagues, follow reputable sources (ahem…. DNA has a Facebook and Instagram presence!) and stay engaged with the evolution of the tools you use.
Myth-Busting: Addressing Common Misconceptions
Let’s tackle some common misconceptions about dry needling, because there are plenty floating around out there.
“It’s Just Acupuncture!” – While dry needling and acupuncture both use thin needles, they’re based on different principles. Acupuncture is rooted in traditional Chinese medicine and focuses on energy flow (Qi) and meridians. Dry needling, on the other hand, is based on modern Western medicine principles, targeting specific neuromusculoskeletal structures with an intent to change input to the nervous system and change how we move.
“It’s Painful!” – Remember to use neutral language when speaking to your patient. Despite our “pointed” puns in this blog, it’s best practice to avoid using words that will elevate anxiety with your patients. For example, instead of saying “When I stick the needle in you will feel a poke”, you could say “As the needle enters the skin you will feel a tap”. And when your patient asks: “Is it painful?” you can describe the procedure as “an achy sensation sometimes associated with a twitch response in the muscle”.
“It’s Dangerous!” – As with any medical procedure, there are risks. However, with proper training and adherence to safety protocols, dry needling is generally safe. Be sure to consent your patients appropriately. This includes reviewing the technique, the risks, and how you will mitigate the risks. The incidence of serious adverse events is very low, but not zero. Patients should be made aware of the risks and assured you are well trained and will always do your best to avoid any adverse events.
Conclusion: Sticking to Our Principles - Dry needling is a powerful technique that can offer significant benefits to our patients. Like any medical intervention, it comes with risks, but with proper training and careful practice, these can be minimized. The research, as highlighted by Boyce et al. and Valdes, supports the safety and effectiveness of dry needling, reassuring us that we’re on the right track.
So, next time someone questions your use of dry needling, you can stand tall (with or without a needle in hand) and explain the science and success behind it. Remember, our goal is to alleviate pain and improve function, one patient at a time. Keep your needles sharp, your skills sharper, and your sense of humor intact. You’re doing great work out there.
References
Boyce D, Wempe H, Campbell C, et al. Adverse events associated with therapeutic dry needling. Int J Sports Phys Ther. 2020;15(1):103-113.
Valdes VR. Dry needling in physical therapy practice: Adverse events. Int J Phys Ther Rehab. 2019;5:157. doi: https://doi.org/10.15344/2455-7498/2019/157.
