Dry needling has become a popular tool in the hands of many therapists including doctors and physiotherapists. So what is it and how does it work?
Why is dry needling ‘dry’?
The terminology ‘dry needling’ came about like this: A few very reputable physicians in the US spent decades studying myofascial pain. Myofascial pain is not describing pain in the face nor the eyeballs! Myofascial dysfunction describes pain and other symptoms that can arise from skeletal muscle and ‘fascia’. Fascia is most easily described as the white sinewy stuff that is interwoven through and around your eye filet steak. Yes red meat is basically ‘skeletal muscle’ like ours and most of us can picture the white tough bits laced through meat. That stuff is part of the fascial web throughout the body.
Anyway, myofascial pain is a bit of a newcomer on the block in the medical world. God knows it has been there forever but we have been slow to figure it out. We have always known about pain from inflammation and pain from a pinched nerve but pain referred from muscle and fascia is a bit of a new concept. Pity that most headaches and chronic lower back pain is this type of pain! For about 40 years now, myofascial pain has received serious study but only in the last 15 years has there been a real mainstream awareness of myofascial pain.
Now where was I . . .
Yes, I was explaining why dry needling is ‘dry’.
Okay, so physicians studying myofascial pain figured out that if they inject the muscle that is referring the pain with a saline solution they could reproduce and chart the pain pattern. Great for research, not great for the guinea pig/patient. They also found that if they injected the offending muscle with an anaesthetic solution and stretched it, they could resolve the referred pain. Much better for the guinea pig/patient.
But then somehow they discovered that if they stuck a needle into the muscle without any injection – thus ‘dry’ – the referred pain from the muscle would often resolve! Cool huh?! And dry needling is born.
The bottom line is this: The body responds in incredible ways to the skilful application of inserting fine needles into the tissues and the science is simply catching up on the ‘why’.
So what is the difference between dry needling and acupuncture?
At face value, dry needling and acupuncture appear to be the same thing. They use the same kind of needles after all. The difference lies in why you put the needle where you do.
Acupuncture is an ancient Chinese medicine thousands of years old. Over the millennia, Chinese men have studied and charted what effects placing needles in different locations has. As such they have come up with points all over the body. The theory behind Chinese medicine is that the body has ‘meridian lines’ or ‘energy pathways’ throughout. When the flow of this energy is blocked then illness of one type or another is the result. The needles are inserted at key locations along these pathways to unblock the flow of energy and enable healing. This means that often the location of the needles appears to have little correlation to where the symptom is. Now this theory may or may not be true but either way Chinese acupuncture gets some amazing results.
Dry needling on the other hand does not observe Chinese medicine or its theories at all. Where the needles are placed in dry needling has everything to do with the fascial and skeletal muscle connections in the body. So the research done by the western physicians (mentioned near the start of the article) has charted referred pain patterns from skeletal muscle and fascia all over the body. These pain patterns, studied by injecting a saline into key points and seeing where the pain goes, have established the charts that undergird where dry needles are placed for certain complaints.
So how does it work?
Good question.
The effectiveness of dry needling is basically widely accepted now. So much so that physiotherapists, many GPs and medical specialists use it regularly. The evidence-based research that explains exactly what those needles are doing – and what is going on physiologically in the tissues when they are inserted – is growing but not complete. There are fascinating papers written regularly now observing the intriguing chemical, mechanical and cellular reactions that occur when the needles are used. But ask for a clear explanation on exactly why it works and you won’t get one. We are simply not there yet.
What I can say is this . . .
Whatever those Chinese men thousands of years ago figured out, it seems to work. And although the ‘real scientists’ in the west will argue that their evidence-based rationale for ‘why dry needling works’ has nothing to do with meridians, energy pathways and hocus pocus, the fact is that 80 per cent of the western needle point locations are within three centimetres of the eastern Chinese meridian points.
The bottom line is this: The body responds in incredible ways to the skilful application of inserting fine needles into the tissues and the science is simply catching up on the ‘why’.
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Happy camping!
– Tim
