Dry Needling

As part of a comprehensive physical therapy program, dry needling offers stimulation for muscular and connective tissue that can bring blood flow and relieve pain. This passive intervention is used at PT Solutions by highly trained physical therapists, along with other evidence-based treatments, in order to achieve a successful outcome for each patient. While dry needling is often confused with acupuncture, the practice is very different and fits the model of scientifically-based physical therapy that PT Solutions offers.

Dry needling is a physical therapy technique that is used alongside other treatments, like exercise and manual therapy, to improve function in the body and reduce pain. The treatment is most effective when used in conjunction with active interventions.

What Is Physical Therapy? 

Physical therapy is a type of care that is used to ease pain and improve functioning and movement in a patient. These outcomes can be achieved through a range of techniques, including manual therapy, exercise routines, and additional treatments such as dry needling. Physical therapy is usually recommended when someone sustains an injury or illness that makes it difficult to move and perform daily tasks.

How Does Dry Needling Improve Physical Therapy? 

The primary benefit of dry needling is the relief of pain and stiffness in the muscles. In cases where these muscles are impacting movement or causing pain that prevents movement, dry needling can be used during physical therapy. The relief brought about through dry needling may allow a patient to better perform exercises or practice movement as recommended by their therapist.

Dry Needling vs. Acupuncture 

Dry needling is very often confused for acupuncture, as both use very thin needles inserted throughout the body and therefore evoke the same image. However, the intent of both practices, as well as the origins, differ greatly.

Acupuncture is an ancient Asian practice that is still used today. The underlying belief in acupuncture is that illness results from a blocked or interrupted Chi. The Chi provides your body with healing energy, and acupuncture removes these blockages to restore your energy flow to the balanced state necessary for health. Each needle is placed along the meridian line of the body meticulously in order to achieve this.

In contrast, dry needling is based on scientific principles. Each needle is placed within a knot or trigger point in order to stimulate the muscles and release tension. Dry needling is used specifically to treat pain and other musculoskeletal problems rather than overall health.

Who Benefits from Dry Needling? 

Not every person undergoing physical therapy will benefit from dry needling. However, a large number of conditions can be effectively treated with the practice. These include:

• Headaches
• Muscle spasms
• Tendonitis/tendinopathy
• Fibromyalgia
• Patellofemoral Pain Syndrome (PFPS)
• Sciatica
• TMJ
• Carpal Tunnel Syndrome
• Tennis or Golf Elbow
• Frozen Shoulder
• Acute and chronic injuries
• Athletic and overuse injuries
• Edema (swelling)
• Poor circulation

Who May Not Benefit from Dry Needling

Dry needling is specifically used to address pain and stiffness related to the muscles, joints, the spine, and nervous system. However, there are some reasons people seek physical therapy and benefit from the practice without benefitting from dry needling. Certain precautions include having impaired sensation, a fear of needles, history of fainting, and/or being pregnant.

Who Can Perform Dry Needling? 

There are several courses and organizations that certify Licensed Physical Therapists to perform Dry Needling. Some techniques are different than others, so it may be beneficial to talk to your provider about the specific training they had.

Most reputable providers of dry needling are also physical therapists who use the treatment as a part of their practice. You can use the directory from the American Physical Therapy Association to begin a search.

Average Cost of Dry Needling vs. Acupuncture 

The cost of both acupuncture and dry needling will vary based on your location, provider, and insurance coverage. You should also consider whether the session is part of a package of services, is a single session, or requires a follow-up.

The average cost of dry needling is about $60 per session, and most physical therapists will recommend 3 to 6 sessions. However, this will usually be part of a treatment plan and used in conjunction with other services, so it may not be itemized in this way.

Acupuncture more commonly costs between $100 and $300 per session. Many times, a single session is all that is recommended, but follow-up may be needed.

Is Dry Needling Worth the Cost? 

For most people, dry needling is a part of an overall physical therapy practice and not a standalone treatment. This may mean it’s covered by insurance as well. The benefits of reduced pain, improved function, and increased mobility are usually worth even the out-of-pocket cost for dry needling sessions. Because it can increase the effectiveness of physical therapy, adding sessions may also increase the value derived from overall treatment plans as well.

The primary benefits of dry needling are the relief it provides for muscle pain and stiffness. Along with this, the easing of trigger points can improve flexibility and increase range of motion. This means it is helpful for treating a range of injuries and aiding in physical therapy.

Is Dry Needling Essential?

Dry needling is not a “cure all” for pain or dysfunction. It can be a useful adjunct to treatment if symptoms are persisting, however should never be a stand-alone treatment.  If someone visits PT Solutions with severe shoulder pain, a therapist may recommend a series of exercises and manual therapy as a part of their treatment. If the pain is severe enough that they are unable to perform certain exercises that are necessary to improve functioning, dry needling can be a useful addition to decrease pain enough that the patient is able to complete the rest of their care plan.

With physical therapy, there is usually not a single technique that is essential. Instead, the correct combination of methods and variety over the course of treatment is what makes it effective.

How Often Do You Need Dry Needling?

During a course of physical therapy treatment, the number of sessions may vary. In most cases, 2 to 3 sessions overall are needed, spread out over a week or two. Rarely will more than 6 sessions be given. Acute pain may only need one session. Dry needling is not an ongoing treatment but is used to address a given problem and facilitate further treatments in other areas.

What Other Ailments Does Dry Needling Treat?

 Dry needling is used to treat musculoskeletal problems or any instances of muscle tightness that limits the range of motion. Common reasons to use dry needling may include:

• Excessive scar tissue
• Neck pain
• Joint problems, including arthritis
• Disc problems
• Whiplash
• Spinal problems
• Pelvic pain
• Phantom pain after an amputation

Generally, you should be okay to get dry needling even if you are feeling under the weather. But keep in mind that side effects can include temporary nausea, tiredness, or a “loopy” feeling which may exacerbate any symptoms of other illnesses. If you are unsure whether it is wise to get dry needling done, call your physical therapist before your appointment and tell them how you are feeling.

Dry Needling and Your Range of Motion 

One of the primary goals of dry needling is to reduce pain stemming from tight muscles. But by releasing the knots that these muscles have formed, patients are usually also able to increase their range of motion. Range of motion is the ability of a joint to move through its complete spectrum of possible movements. For example, if you are suffering from elbow pain, it may be difficult to extend your forearm all the way or to bend it. Dry needling, along with other physical therapy practices, can allow you to move your arm more freely.

Everyone’s insurance plan is slightly different, and some may cover dry needling while others won’t. If you are unsure about your plan, it is best to contact your insurance company or ask the staff at PT Solutions to walk you through your coverage.

When Is Dry Needling Covered by Insurance and When Is It Not?

Each insurance provider has the right to determine if they will cover dry needling or not. Some private companies will not cover it under any circumstances, while others may cover it sometimes. Usually, they will need evidence that it is linked to a condition and a referral from a physician or a note from your physical therapist. If your services are not covered, you may also be able to appeal the decision with private insurers.

Federal healthcare plans like Medicare do not cover dry needling, and Medicaid may vary by state.

What States Allow Dry Needling? 

In the United States, dry needling is prohibited in six states: California, Hawaii, New Jersey, New York, and Oregon. Eight other states have no policy allowing or prohibiting the practice. The other 36 states, and Washington D.C., all allow the practice.

How Long After Dry Needling Can I Exercise? 

It is recommended to wait at least 24 to 48 hours after dry needling to perform any strenuous exercise, as the muscles and soft tissues may be sore and need time to return to a healthy state. You should always speak with your physical therapist about exercising after dry needling.

How Long Does Dry Needling Last? 

Dry needling should be done as part of a treatment session, and not as a stand alone treatment. The length of time the needles are in place can vary, but at most 15 minutes is beneficial.