What Does Dry Needling Say About Pain Management?

Dry Needling is a practice adopted by physical therapists, acupuncturists, and chiropractors that uses needles to jab trigger points. Even the concept of trigger points is evolving into something more fleshed out, and Dry Needling is more of a pseudoscience that may make the patient feel like they are taking action against pain with little to back it up. On his site painscience.com, David Ingraham brings to light we don't have a lot of concrete knowledge about trigger points: Trigger points ("muscle knots") are an easy problem to like. We are happy to blame our pain on clusters of tiny patches of cramped muscle tissue because it's a powerful mental image that sounds like it feels and suggests an easy cure: just rub them out! Myofascial pain syndrome — chronic pain attributed to excessive trigger points — is a tempting underdog diagnosis that most doctors are oblivious to, so it's also got a bit of that secret knowledge vibe. And it's a great answer to questions almost everyone asks sooner or later: Why do I feel so stiff? Why do my muscles ache? Why does my pain go on and on? In short, trigger points are the gods of major gaps in medicine. It seems like they are the answer to many things. Take trigger point therapy one step further, and you have Dry Needling. Dry Needling overlaps with acupuncture, although the only true similarity is needles. Acupuncture is a Traditional Chinese Medicine practice that works with energies and meridians through the body, so generally, the very thin needles aren't placed directly into a sore spot. Although often practiced by acupuncturists, Dry Needling is a departure from the practice that puts a needle directly into a "trigger point" or knot. Acupuncture needles don't go past the dermis, while Dry Needling goes deep. Unlike acupuncture, Dry Needling was developed relatively recently by Dr. Janet Travell, JFK's personal physician, who assisted him with chronic back pain. She was a pioneer in myofascial, trigger point, and Dry Needling. Even though Dr. Travell had access to acupuncture needles (now commonly used), she chose conventional hypodermic needles. The "dry" refers to a needle that's not injecting anything. While most practitioners report minimal risk in Dry Needling, they are asked to self-report, meaning they rely on patient reporting and is highly subjective. Proper research hasn't been conducted because it's a practice that lives outside of conventional medicine. What studies have been conducted don't show improvements after Dry Needling. Because Dry Needling is condoned by physical therapists in a clinical setting, it may appear to be more scientifically backed than it is; and more medical than acupuncture. It falls in line with a handful of mainstream physical therapist tools like ultrasound, e-stim, and even applying ice have been recently shown to be ineffective at best. Dry Needling as a popularized practice may also fit in with a cultural tendency to associate pain or more extreme measures with effectiveness. "No pain, no gain" often seems to show itself ironically in pain management treatments. All and all, trying Dry Needling could be worth a shot for someone ready to throw spaghetti against a wall, but one would probably be in better hands sticking with traditional acupuncture.