Dry Needling

At Persist PT, I sometimes use dry needling as an adjunct technique to address muscle and nerve-related discomfort. Dry needling may be used with or without electric stimulation (e-stim) to reach the desired tissue - many patients report that the use of e-stim reduces post-treatment soreness and increases the effects.

Dry needling is a technique where a thin, solid filament needle (similar to ana acupuncture needle) is inserted into muscle tissue, connective tissue, or trigger points to address pain, movement dysfunction, and tissue sensitivity. Unlike acupuncture, which operates within a traditional Chinese medicine framework, dry needling is grounded in western neurophysiology and musculoskeletal anatomy. The mechanism isn't fully settled in the literature, but current evidence points to local and systemic effects: a reduction in peripheral sensitization at the muscle spindle level, modulation of pain processing in the dorsal horn of the spinal cord, and improvements in local blood flow and tissue extensibility (Dommerholt, 2011; Gattie et al., 2017).

In practice, dry needling fits into a broader treatment picture rather than serving as a standalone fix. Research supports its use as an adjunct to exercise and manual therapy for conditions like plantar fasciitis, rotator cuff tendinopathy, hip impingement, and chronic neck pain (Gattie et al., 2017; Liu et al., 2018). For athletes receiving physical therapy for runners and physical therapy for triathletes, dry needling can be a useful tool when stubborn trigger points or regional muscle guarding are limiting progress with exercise. The goal is never to "treat" the trigger point in isolation, but to reduce the noise in the system enough that the meaningful work of movement and load can take effect.

What dry needling is not is a passive, one-sided treatment you simply receive. Patients who respond best are those who pair it with active engagement in their rehabilitation. A brief window of reduced sensitivity following needling is an opportunity to move better, load more effectively, and reinforce the patterns that support long-term recovery. That's the framework within which dry needling is used at Persist Physical Therapy: not as a magic reset button, but as one lever among several, used thoughtfully and with clear purpose.

Dommerholt, J. (2011). Dry needling: Peripheral and central considerations. Journal of Manual & Manipulative Therapy, 19(4), 223-227.

Gattie, E., Cleland, J. A., & Snodgrass, S. (2017). The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: A systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 47(3), 133-149.

Liu, L., Huang, Q. M., Liu, Q. G., Thitham, N., Li, L. H., Ma, Y. T., & Zhao, J. M. (2018). Evidence for dry needling in the management of myofascial trigger points associated with low back pain: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 99(1), 144-152.