The Need for Needling

By: Caleigh Burkley

Academic, 2019

Imagine a young college student similar to Lexi, a star volleyball player, who has recently struggled with knee problems. Lexi attends physical therapy regularly to help strengthen and heal the muscles around her knee that continually get pushed to their physical limits during her volleyball season. However, the therapy is long, extensive, and Lexi’s pain has not seen improvement at the rate needed for an athlete of her caliber. She has heard of a new therapy method, called dry needling, that has helped many athletes overcome injuries and setbacks quickly. She does not want to miss out on her volleyball season, so she looks into the newly popular procedure to see if she could try it out. However, Lexi discovers that dry needling is not legal in her state and therefore has no other option but to continue with her regular therapy and push through her pain, elongating her healing process. Many people similar to Lexi, athlete or not, have been deprived of the opportunity for a faster and more effective recovery because dry needling is currently only legal in certain states. Dry needling should be a legal method of therapy in all states because it provides a safe, immediate and effective way of relieving pain.

Although many have not heard of it, dry needling has been around for decades; however, it recently has become increasingly popular in the world of physical therapy. To the surprise of many, dry needling is not a recent discovery, with loads of history and science standing behind the procedure. Dry needling dates back to the nineteen-forties with Dr. Janet Travell. It also takes on the names of IMS, IMT, and FDN, which stand for intramuscular stimulation, intramuscular manual therapy, and functional dry needling (Spencer). The process of dry needling is the simple procedure of inserting multiple extremely thin needles through the skin in order to stimulate a specific area of the muscles, called a trigger point, in order to relieve pain. Trigger points are most easily explained as hard “knot-like” balls in the muscles that cause pain in the surrounding area (Babcock). A specific type of needle called a monofilament needle is primarily used during this procedure. This specific type of needle is extremely thin, causing little to no pain within the procedure (Johnson). Many advancements have taken place in recent years for dry needling procedures, including the trigger point model, the radiculopathy model, and the spinal segmental model, all which are used to help treat pain and dysfunction (Spencer). Methods of dry needling continue to constantly improve as more research accumulates and new methods of performing the procedure develop.

It is true of course, as with any procedure, that there stands the potential risk of injury, specifically to blood vessels, nerves, and muscles when referring to dry needling. However, the procedure of dry needling has a minimally invasive process that greatly reduces the risk for any injuries. Physical therapist, Matt Briggs, from The Ohio State University Wexner Medical Center stated, “Needling can produce minor bleeding and some soreness, but in trained hands and with the use of sterile needles and gloves, it’s a very safe procedure” (qtd. in Painter). In rare instances, injuries to nerves and blood vessels can take place. Perhaps the greatest risk stands as that of a punctured lung, however this rarely, if ever, has taken place. These injuries typically only take place when performed by those untrained and unspecialized in dry needling (Painter). Most complications can be avoided by the person performing the procedure simply just knowing the anatomy of the human body, undergoing extensive training, and gaining valuable experience in the field.

Undoubtedly, many still shine light on the concept of dry needling closely resembling acupuncture, which has been deemed dangerous in many cases. Although the two appear very similar, they have completely different histories and methods behind them. In terms of history, acupuncture has foundations based on traditional Chinese medicine and customs. It is intended to help with the ‘flow of energy’ throughout the body. However, dry needling has a foundation based on Western medicine, primarily anatomical and neurophysiological principles (Babcock). In other words, acupuncture basically stemmed from Chinese tradition, while dry needling has stemmed from modern science and extensive research. The methods and procedures also differ greatly between the two. Acupuncture needles have the goal of redirecting the energy flow of the body; this means the needles are left in the body for a fairly decent amount of time. Acupuncture needles also get inserted relatively deep in the skin. Contrasting, dry needling needles slowly get inserted in to the body at the most minimal depth possible and get removed after a short period of time. The process then gets repeated multiple times. Also, dry needling targets specific areas of the body that appear as the source of the pain. Acupuncture tends to cover a broader span of the body and is not specialized to a certain area (Babcock). The similarities between acupuncture and dry needling stop at the simple fact of both procedures inserting needles into the body. Otherwise, the methods of dry needling share no resemblance to those of acupuncture.

Furthermore, dry needling stands as an extremely advanced method of rehabilitation and/ or therapy. As mentioned earlier, dry needling targets the problem pain areas of the body, called trigger points. Trigger points are the points that tend to disrupt function, cause tenderness, restrict range of motion. By inserting the needles, the goal is to desensitize the trigger points, relieving pain almost immediately, and help induce a healing response to the tissue itself (Johnson). However, it rarely gets used as a stand-alone method. Dry needling normally is combined with traditional therapy as well, to get a fuller and more sound result (Dommerholt). Typically, the functions are restored to the body much faster when other methods of therapy become combined with dry needling. Consequently, dry needling stands as one of the only methods of theory that provides an immediate relief of pain (Ries).

Moreover, dry needling improves movement in the targeted areas and helps speed up the recovery process. Dry needling is used for numerous problems, including neuromuscular dysfunctions and disorders, migraines, carpal tunnel, spinal dysfunction, complex regional pain, phantom pain, tendonitis, joint dysfunction, and countless other conditions (Babcock). People from many different backgrounds have benefitted from dry needling, but perhaps one of the largest groups of benefiters has been that of athletes. Many athletes frequently take advantage of the procedure to help reduce pain in area affected by their activities. The most common areas include the elbow, knee, back and neck. Athletes not only use dry needling to relieve pain and speed up their recovery process, but they also use it to prevent further injuries from taking place. Dry needling is also used to help treat musculoskeletal disease, which shockingly affects ½ of people over the age of 18 (Spencer). Dry needling again and again proves to be beneficial in numerous situations and could potentially change the lives of millions of people.

Because dry needling has continually proved to stand as a beneficial procedure in the field of therapy and rehabilitation, it has been predicted to spread greatly in the near future. “In the U.S., approximately 20 states and D.C. have approved dry needling by physical therapists” (qtd. in Dommerholt). Less than 50% of our country has access to dry needling therapy, which essentially deprives over half of our country from receiving the benefits of this procedure. Dry needling has showed repeated positive results, with numerous patient cases of different backgrounds. Some countries that lack proper training have not showed successful results when dealing with this procedure, but this has not appeared with the majority of U.S. procedures. Those who perform the procedures come with a variety of background information and extensive training in anatomy, biomechanics, physiology and patient facts. Dry needling is predicted to be a requirement for most, if not all, physical therapists in the next few years (Ries). Currently, only about 6,000 of 200,000 PTs have received a license for dry needling, due to the legality issue of the procedure. Charges range from $10-75 per treatment, however this is relatively cheap when compared to other medical costs. Currently not all insurance companies will cover this cost, but the cause is due to the procedure only having approval in 20 states. If legalized, insurance companies would be willing to pay for the procedure just as if it was a regular method of therapy (Painter). The simple fact remains that dry needling is quickly becoming a hot new method of therapy that cannot be disputed much longer.

Overall, it rings clear that dry needling should be legalized in all states due to the simple fact that it provides a better method of therapy that can be more effective than other traditional methods. Strong science, case experience, and patient results stand behind dry needling, yet it continues to be ignored. It has proved to help improve and treat multiple conditions, such as neuromuscular disorders and musculoskeletal disease. From athletes, to the elderly, to the average person, everyone in the United States should have access to this cutting-edge treatment in rehabilitation and therapy. It is becoming applauded more and more as time goes on, so why should those in need get deprived of this opportunity? The truth remains that there stand a “need for needling” and it cannot be ignored much longer. Dry needling is a miraculous method of therapy that can essentially change the life of millions of people across the United States.