The discussion and use of dry needling in physical therapy practice has increased substantially within the last year. I graduated from PT school three years ago, and we rarely, if ever, heard or discussed dry needling as a treatment option. Reading through my JOSPT issue this morning, I came across two ads for dry needling certification within the first three pages. So what is dry needling? And what do our patients need to know about dry needling?
Dry needling is a technique including a dry needle, without medications, that is inserted into a trigger point to release the trigger point and relieve pain. It is minimally invasive, cheap and carries a relatively low risk of complications.1 Dry needling is a neurophysiological evidence-based treatment technique that requires effective manual assessment of the neuromuscular system, which differs from the Chinese medicine channel-based acupuncture practice model.
Evidence supporting dry needling as an effective intervention is quite overwhelming. Searching for "trigger point dry needling" or "dry needling physical therapy" yields pages of results, most of which support the use of dry needling for a variety of conditions.
Contraindications to dry needling include patients with needle phobia, unwilling patients or those unable to give consent, into a limb with lymphedema, patients on anticoagulant therapy or patients with a compromised immune system. The APTA lists pages of other relative considerations in addition to the list of absolute contraindications.2
Each state's regulatory board determines the performance of dry needling by a physical therapist. I searched through a few websites to find the training requirements to practice dry needling. Certification for dry needling includes a minimum of one introductory course (30 hours) through multiple education sponsors. After completion of the introductory course, therapists can begin utilizing the treatment immediately. Some states require a level II course to be completed within six months of the first course. Level I courses (from the Kinetacore website) start at $1,250.
What do you think? Do you practice dry needling or are you interested in becoming trained? Do you think dry needling is simply a "fad" that will eventually fade away?
1. Kalichman, L., & Vulfsons, S. Dry Needling in the Management of Musculoskeletal Pain. (http://www.jabfm.org/content/23/5/640.long). Journal of the American Board of Family Medicine.