Dry needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissue for the management of neuromusculoskeletal pain and movement impairments. It is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue; to diminish persistent peripheral nociceptive input; and to reduce or restore impairments in body structure and function, leading to improved activity and participation.
The dry needle used is very thin and there is no injectable solution. Inserting the needle can cause some pain, although this seldom occurs when done by well-trained practitioners. Proper dry needling of a myofascial trigger point will elicit a local twitch response (LTR), which is an involuntary spinal cord reflex in which fibers of the affected muscle contract. The LTR indicates the proper placement of the needle in the affected area. Dry needling that elicits LTRs improves treatment outcomes.
Dry needling is different than acupuncture
Acupuncture practiced by acupuncturists and dry needling performed by physical therapists differ in terms of historical, philosophical, indicative, and practical context. Dry needling performed by physical therapists is based on Western neuroanatomy and scientific studies of the musculoskeletal and nervous system. Physical therapists who perform dry needling do not use traditional acupuncture theories or acupuncture terminology. See this comparison overview between dry needling and acupuncture.
Why choose dry needling?
Musculoskeletal pains are not often explained from a muscle perspective. However, referred pain from muscle parts can mimic other musculoskeletal pains as shown in the image. These so called ‘myofascial trigger points’ are sources of persistent peripheral nociceptive input and their inactivation is consistent with current pain management insights.
Trigger points of the gluteus medius muscle and its possible referred pain patterns. Note the potential overlap with 'hip', 'SIJ’, ‘sacrum' or 'low back' pains.
In clinical practice, dry needling is performed once the physical therapy examination and evaluation are completed and clear therapeutic goals and objectives are established. Dry needling may be incorporated into a treatment plan when myofascial trigger points are present, which may lead to impairments in body structure, pain, and functional limitations. Dry needling also is indicated with restrictions in range of motion due to contractured muscle fibers or taut bands, or other soft tissue restrictions, such as fascial adhesions or scar tissue. The solid filament needle allows the therapist to target tissues that are not manually palpable.
Myofascial trigger points have been identified in numerous diagnoses, such as radiculopathies, joint dysfunction, disk pathology, tendonitis, craniomandibular dysfunction, migraines, tension-type headaches, carpal tunnel syndrome, computer-related disorders, whiplash-associated disorders, spinal dysfunction, pelvic pain and other urologic syndromes, post-herpetic neuralgia, complex regional pain syndrome, nocturnal cramps, and phantom pain.
Learning dry needling from quality instructors
There is worldwide interest in dry needling supported by increasing scientific evidence. Dry needling is practiced around the world by Medical Doctors, Doctors of Osteopathy, Naturopaths, and Physical Therapists (PTs). The PTs account for the largest growth in recent years. Frank Timmermans is the main instructor and has 40 years of experience as a Physical and Manual Therapist and has been dry needling since 2002. He has published several articles on myofascial pain and dry needling and has, together with his team, instructed many physical therapists. He is joined by other experienced instructors to obtain a 1:4 teacher student ratio for optimal safety and didactics in the courses offered by Uplands Physio Clinic.
Three dry needling course levels
Three dry needling course levels are offered and reflect increasing levels of dry needling skill. The introductory 3-day course on ‘Extremities’ covers the muscles in the arm and leg and teaches the basic knowledge and skills required to perform the technique. Precourse materials, such as articles and links for anatomy and referred pain patterns, will be emailed beforehand. You will receive a 185-page course manual, a Trail Guide anatomy/palpation book, and a trigger point poster. The advanced 3-day course ‘Spine’ is about one month after completion of the first course. Please note: practitioners must pass all theoretical and practical exams in both course levels and demonstrate safety and competency in order to receive a full certificate of completion. Afterwards, one can apply with the CPTBC to be listed on the dry needling roster. The 2-day third dry needling course is about 'headaches' and 'temporomandibular disorders' and meant for registrants that are already listed on CPTBC's dry needling roster.
Feedback from participants level 1 course 'Extremities'
The focus on safety was very good.
Great course. I appreciated the thoroughness of the safety taught and justification for said safety always well explained.
I really gained valuable knowledge and skill from the seminar. Looking forward to the next!
You brought in an excellent team of knowledgeable physiotherapists that were great to help us with the techniques.
I really appreciated your attention to detail, the small group & hands on time, and the general environment of the class.
It was super well done and I feel really confident about palpating appropriately and being able to safely needle my patients.
Apprciated the constant feedback throughout the whole course. One of the most practical and well laid out courses I have taken.
Feedback from participants level 2 course 'Spine'
This was a fabulous level 2 course. It supports the first one so much.
I understand that you need to do the 2 courses in this order. There is no way I could have grasped it all in one course.
I am loving finding tightness and decreased ROM and then dry needling and then re checking. It is very satisfying.
I learned a more rounded approach to needling treatments and how it fits into an overall assessment and treatment plan.
I felt the courses had a great emphasis on safety, which makes me feel better about starting to dry needle in the clinic.
Ongoing support after the courses
After completing the first two courses, you will be registered on the website as a certified dry needling practitioner. Through the 'members only' section of the website, you will have access to a consent form, clinic brochures, safety overviews, and order forms for dry needles and other clinic supplies, as well as relevant publications. After the courses, you are encouraged to stay in contact with your instructors in case you have any questions. Regular ‘refresher days’ will be organized to allow you to stay up to date with any new developments in this technique.
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There is a worldwide interest in 'dry needling' with increasing scientic evidence. It is practiced mainly by Physical Therapists and also some Medical Doctors, Doctors of Osteopathy, Chiropractors and Naturopaths.
Frank Timmermans is the main instructor and has 33 years of experience as a Physical and Manual Therapist and 15 years in dry needling. He has published ten articles on 'myofascial pain and dryneedling' and has instructed over 4,000 students.