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"Dry needling” offers relief to physical therapy patients

Andrea Blumenstein on a little-known technique to treat chronic back and neck pain



From chronic pain to sports-related injuries, many issues can lead to a physical therapy referral. Physical therapy includes multiple modalities with decreased recovery time and longer-lasting improvements in mobility, functionality and quality of life. Dry needling is one little-known technique — and though it sounds intimidating, physical therapist Taryn Cohn says she's used it with great results.

  "[For patients presenting] with long-standing conditions such as chronic low back and neck pain, as well as more acute injuries like those that occur suddenly at work or during recreational sports activities, I've had amazing success [using dry needling]," Cohn says.

  During dry needling, solid, sterile filiform needles are inserted into soft muscle tissue or connective tissue correlated with an injured or painful area of the body. While the needles are the same type used in acupuncture, dry needling is a distinct form of therapy. Physical therapist Randy Hernandez of the Movement Science Center says one of the biggest differences between the two is that acupuncture uses meridians (invisible energy pathways that are the basis of traditional Chinese medicine). In this philosophy, needles might be placed in the hand to treat an ailment in another part of the body. This is not the case for dry needling.

  "The hand would only be needled, for example, if there are symptoms in the hand itself or a neighboring joint that would be directly affected by the location of the needling," Hernandez says.

  Physical therapists use dry needling in conjunction with other forms of manual therapy and corrective exercises. Therapists make the decision about what treatments to recommend during an initial visit.

  The technique is not new. For more than 25 years, therapists have used dry needling to improve recovery time. "Pioneers in our state have been practicing successfully for around 10 years," Hernandez says.

  Dry needling is a treatment option for people with musculoskeletal conditions such as muscle strain, tendonitis and bursitis, along with back and neck pain.

  "By eliminating trigger points in muscles, dry needling also takes care of many referred pains, such as headaches and sciatica which are often mistakenly blamed on more serious causes," says Ron Helwig, a physical therapist and CEO of Magnolia Physical Therapy,

  Patients can expect a physical therapy session to last 60 to 90 minutes, including both dry needling and therapeutic exercises. At Magnolia, therapists provide approximately 30 minutes of manual therapy that may or may not include dry needling, followed by 30 to 40 minutes of specific therapeutic exercises.   

  "Incorporating dry needling has considerably cut down treatment duration — meaning patients get well faster," Helwig says. The results are more immediate, and the risk of complications (which include infection and bruising) is low under the care of a trained professional.

  Dry needling is gaining recognition as a first-option treatment for many injuries. Cohn incorporates dry needling early in the rehabilitation process if she finds the treatment appropriate and her patients are willing to try it.

  "The rapid improvement in the soft tissue mobility this treat-ment provides allows us to move more quickly into a corrective exercise and strengthening program," Cohn says.

  This often shortens the duration of physical therapy treatment. However, Cohn prefers not to perform dry needling on a patient more than once a week in order to allow for the body to adapt to the changes.

  Overall treatment success depends on whether an individual patient complies with physical therapist-directed home programs. Hernandez sees the greatest success rates when dry-needling patients follow through with both manual physical therapy and therapeutic exercises.

  "With dry needling, it is important to reinforce the treated tissues with proper muscle re-education and supportive interventions," Hernandez says.

  Most people say the pain of dry needling ranges from minimal to uncomfortable, depending on the muscle tissue and the patient's sensitivity. It is not uncommon to feel muscle soreness after the treatment, similar to the soreness that follows an intense workout. The majority of people receiving dry needling feel pain relief within 48 hours, often much sooner.

  The cost of the procedure varies based on insurance and practitioner. Many therapists absorb the cost of the needles because insurance companies do not, Hernandez says.

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