By Rob Stanborough ~ PT, DPT, MHSc, MTC, CMTPT, FAAOMPT ~ First Coast Rehabilitation

I have written on Dry Needling (DN) before but continue to receive questions regarding this intervention. The purpose of this column is to answer as many of those questions in the space allowed (500 words or less) but more info can be found on our website or can be answered with a phone call at 904-829-3411 by any of our DN clinicians (see ad).
Is DN new?
No, DN is not new. It has been growing in popularity since the 1960’s when Janet Travell, MD coined the term Myofascial Pain Syndrome and used it to treat myofascial trigger points. It has been utilized for years by European physical therapists, which was my first exposure and was first approved in 1984 for use by US/Maryland physical therapists.
First Coast Rehabilitation (FCR) therapists have been teaching DN nationally and internationally since 2010, were approved in 2017 by the state PT Board to use in 2017, testified before the FL PT Board on behalf of all FL PT’s, which was approved in 2020, and have since trained many others in St. Augustine, Florida and across the nation (see myopainseminars.com).
Why utilize DN?
The benefit of DN is multifactorial and rooted in pain science research. At its root, a trigger point, or hyper-irritable nodule within a taut band of muscle, develops when the muscle is overloaded. This can happen in several ways, but poor posture or unaccustomed activities are two primary. When this happens, the basic contractile elements of the muscle lock up, causing compression of the vascularity, thereby depriving the tissues of oxygen, resulting in tissue damage and the release of noxious (pain stimulating) chemicals = pain.
When treating the trigger point with DN, a twitch response is elicited, which is protective response to the stimuli via a spinal reflex loop. The “twitch” is an indication the trigger point has been treated and the noxious stimuli have been flushed out. It may leave some muscle soreness but can result in an immediate analgesic effect, increase motion, strength and function. And because no medication is involved, there are not medicinal side-effects.
What kind of problems can be treated with DN?
Almost anyone. It can help with nearly all types of headaches, Ehlers-Danlos syndrome, shoulder, neck, back, hip, leg, foot, and hand pain, where trigger points are involved. TMJ, jaw pain, and ringing of the ears caused by trigger points can also be treated. It can be used for orthopaedic and neurological problems where pain, muscle inhibition and loss of range of motion are a result of trigger points. It can also be used to treat scar tissue, pelvic pain and more.
Is it safe?
Yes. All needles are sterile. In a 2013 multi-site study in Ireland, which included 39 PT’s in nearly 8,000 treatments, proved with proper training and practice, DN is safe. (Therapist at FCR have been trained in the same techniques used in this study.) The major side effects were soreness, fatigue, an occasional bruising.
There are many more questions but limited space. What to do after treatment? How may session will it require? Once the trigger points are treated, are they gone forever?
Please visit firstcoastrehab.com for more answers or call if you don’t find an answer to your question or to see if DN could work for you.
Rob Stanborough was one of the first PT’s to be permitted to use DN in FL and doing so since 2017. He has trained others in DN since 2010 both nationally and internationally as a Senior Instructor for Myopain Seminars (www.myopainseminars.com). He is a co-owner of First Coast Rehabilitation, est 2006 (www.firstcoastrehab.com), has presented and published regarding DN and co-authored Myofascial Manipulation: Theory & Application, 3rd ed by Proed Inc.