The 6 Most Common Questions I Get About Dry Needling
Here are the 6 most common questions I get about dry needling:
What is dry needling and how does it differ from acupuncture?
Is dry needling safe? What are the risks?
Why would you use dry needling for pelvic floor dysfunction?
What is e-stim and why would you use e-stim versus not use it?
Is dry needling safe during pregnancy?
What if I’m not a “needles” person?
What is dry needling and how does it differ from acupuncture?
Dry needling is the westernized version of acupuncture.
Please keep in mind, I am not an acupuncturist. To best understand acupuncture, I always recommend talking to a local acupuncturist! We at Lady Bird Physical Therapy are big fans of acupuncturists – I have referred patients with a variety of medical diagnoses to acupuncture alongside seeing a physical therapist to better manage their symptoms. Check out acupuncturists local to central Texas on our resource page.
However, my understanding is the following: Acupuncture is a beautiful, thousands of years old technique that’s rooted in traditional Chinese medicine. It affects qi flow through the various meridian channels in the body. When those meridian channels are opened, this directly affects the body by affecting the central nervous system, initiating change in your symptoms. In my experience with acupuncture, you may go in reporting various problems/symptoms you’d like to address, and your acupuncturist will determine which acupoints are going to best serve your needs. Typically, several needles are placed along the relevant meridian channel(s), which means needles may or may not be placed directly at or around the problem area. For example, when I’ve had acupuncture done in the past, I had needles in my back, hands, and feet! Needles typically go just below the level of the dermis, the deepest layer of the skin where your skin cells are produced. When I had acupuncture, the only real pain was the initial prick of some of the needles, but some of them I couldn’t feel at all.
Dry needling, on the other hand, is the westernized version which uses the same tool in a different way. It is based on pathoanatomy, meaning the needles are placed at or around the symptoms you are having, with the goal of directly affecting your irritated/inflamed tissues and causing higher up responses in the central nervous system to help reduce stress in your body that pain can cause. Different techniques cause different physiological responses at the level of the muscle cells, and your therapist will determine which technique is best for you!
Is dry needling safe? What are the risks?
Dry needling is very safe. This is the way I explain it to patients: As long as you don’t meet any of the contraindications (your therapist will rule this out with you), dry needling will either help or it won’t. I’ve never had someone’s symptoms worsen after dry needling.
Dry needling poses extremely low risk of infection as the needles are sterile, and the therapists use proper universal precautions for cleanliness, bloodborne risk protocols and sharps disposal protocols.
What if the needle punctures something it shouldn’t? This is a great question. First and foremost, our protocols teach us how to avoid those structures (nerves, blood vessels, etc.) Secondly, the size of a microneedle used for dry needling is around 0.25 – 0.30 mm in diameter. An average sewing needle is just over 1 mm (1.02 mm) in diameter. An average medical syringe for a vaccine or injection is 28.5 mm in diameter. Think about when you’ve had blood drawn – if a nurse can just take that syringe out and press/hold and you stop bleeding, these microneedles used in dry needling won’t make a dent in your blood vessels!
Fun fact: your larger blood vessels have such power pushing blood through them, that if a needle ever were to puncture one, it would likely just come shooting back out!
Common side effects include pain/discomfort, and more rarely, sympathetic nervous system responses such as nausea, lightheadedness, vomiting, or fainting.
Why would you use dry needling for pelvic floor dysfunction?
Dry needling is simply a tool in the toolbox. Often, I use dry needling as a way to reduce pain and discomfort to allow patients (hello, busy parents!) to be able to get through their daily activities with less pain. I see dry needling as a short-term treatment option for pain management – that doesn’t require medication – while we continue to progress toward long-term goals. Oftentimes, long-term therapy goals are written around building strength and retraining movement patterns to reduce pain with a specific movement pattern. But for many of our patients, they can’t stop doing the thing that causes them pain entirely (i.e. lifting up your toddler, bending over to put baby in a crib, lifting a carseat into the car, breastfeeding). Cue, dry needling!
I’ve used dry needling for all sorts of things related to pelvic health. The most common is, of course, musculoskeletal pain. We have protocols to reduce overactivity in the pelvic floor for those tense, hyperactive muscles that can cause urge, frequency incontinence, or pain with intercourse. We also have protocols to address underactivity in the pelvic floor which can cause leakage. It can even be used to help improve cesarean section scar mobility (in the right patient)! Here at Lady Bird, we treat the whole patient – and dry needling can help us address many aspects of the postpartum body.
Learn more about dry needling for the pelvic floor here.
What is e-stim and why would you use e-stim versus not use it?
E-stim, or electrical stimulation, is an additive we could use to enhance your dry needling experience and efficacy. Placing a needle and attaching it to e-stim is the typical protocol I use (patient-dependent, of course). While the needle itself is shown to affect local tissue, the use of e-stim increases central nervous system response by means of hormonal changes, blood flow changes, and sets off a chain reaction to encourage the body’s natural healing response to take over that injured tissue. It creates a bigger, better response!
E-stim is effective in certain spots of the body, but it is contraindicated in other spots of the body. E-stim is also contraindicated in pregnancy.
Is dry needling safe during pregnancy?
Excellent question. First and foremost, you’d need to be cleared by your OB/GYN or midwife. After that, it becomes the clinician’s decision of whether or not they feel comfortable, and of course, your decision as the patient. There is no evidence to show that there is an increased risk of miscarriage during the first, second, or third trimesters as a result of dry needling. However, as I’m sure many pregnant people have found out, it’s difficult to find research to support ANYTHING during pregnancy. Why? Simply put – it’s difficult to get a good quality trial while minding the ethical implications that pregnancy brings into a study. That being said, I have had good success after physician clearance working with pregnant patients for migraines, hip pain, and SIJ dysfunction.
What if I’m not a “needles” person?
If you really want to try dry needling, or you and your therapist think it could help you, and there are no contraindications, then it’s worth a try! Though typically, I find if you’re not a “needles” person, dry needling probably isn’t the best fit for you!
If you’re interested in learning more about how dry needling can help your pelvic health or chronic pain, contact us for a free phone consultation here or call us directly at 512-766-2649.