Over the past decade, a strange practice has worked its way into physical therapy offices. It\u2019s not exactly acupuncture but still involves a therapist sticking tiny needles under your skin and letting you suffer for a short time. <\/p>\n
Dry needling \u2014 the insertion of ultrathin needles into trigger points to loosen them<\/a> \u2014 was codified by the American Medical Association as an acceptable form<\/a> of therapy in 2016. Since then, it has become a standard part of orthopedic care, with superstar athletes like Travis Kelce and Caitlin Clark using the treatment for recovery and maintenance.<\/p>\n Fans of the procedure say it can offer near instant relief, describing a melting of pain or a feeling of release at the needling site. Others say at best it\u2019s a temporary fix.<\/p>\n And while the therapy is largely considered safe, sticking needles in the body does carry some risk. In December, T.J. Watt, a linebacker for the Pittsburgh Steelers, suffered a collapsed lung<\/a> after a session of dry needling. (He eventually recovered and finished out the season.)<\/p>\n So what do you need to know about dry needling? Is it a clinical breakthrough for chronic pain or just another overhyped wellness trend?<\/p>\n What is dry needling?<\/p>\n The basic idea behind dry needling is to create a tiny injury in a painful part of the body in hopes of increasing blood flow and loosening tight muscles, tendons and other tissue. The needles don\u2019t inject anything \u2014 hence they are \u201cdry.\u201d The treatment is most often used to treat overuse or stress injuries tied to \u201ctrigger points,\u201d or muscle knots.<\/p>\n Generally, practitioners will either leave the needles in place or gently slide them up and down under the skin (called pistoning). Other times, they may run electricity through the needles to further relax the muscle. Either way, the sensation can be strange.<\/p>\n \u201cI saw the muscles on my arm dancing while it was being done,\u201d said Caroline Miller, a 64-year-old competitive swimmer from Maryland, of her experience with standard dry needling. But, she added, \u201cthe next day all the pain went away.\u201d<\/p>\n Though dry needling has generally been used to target muscles, over the last decade the treatment has expanded<\/a> to tendons, scar tissue, fascia and bone surfaces. Some evidence even suggests that it may improve headaches<\/a>. But despite their similarities, dry needling is not the same as acupuncture.<\/p>\n \u201cDry needling focuses solely on musculoskeletal targets, like trigger points,\u201d said Melissa Monroe, an acupuncturist in Los Angeles. By contrast, she added, acupuncture incorporates traditional Chinese medicine principles around energy and fascia pathways in the body.<\/p>\n Does it work?<\/p>\n The answer, as with many physical therapy procedures, is: It depends.<\/p>\n While evidence of long-term benefits of dry needling are low-quality<\/a>, many studies have found it\u2019s is more effective than a placebo and at least as effective as traditional physical therapy techniques<\/a>, like exercise and massage, in the short term.<\/p>\n Many patients report an immediate sense of relief after a session, as well as an increase in muscle strength and range of movement, said Jan Dommerholt, a physical therapist in Maryland who runs a certification program.<\/p>\n Oddly enough, it\u2019s still not clear exactly how needling works. While experts agree that muscle knots exist, not all agree they are the cause of myofascial pain<\/a> or whether needles are the best way to release them.<\/p>\n \u201cDry needling at best is a short-term solution that ignores the root cause of the issue,\u201d said Rhett Polka, a physical therapist in Loveland, Colo. He argues that dry needling only temporarily calms symptoms like tightness or spasms and bypasses deeper physiological issues.<\/p>\n \u201cThere are therapies like heat and gentle massage that are just as effective for loosening muscles,\u201d said Nelin Krull, a physical therapist in Toronto.<\/p>\n Even those who promote needling say it\u2019s not a panacea, and that it should be administered by a qualified professional, often alongside other treatments, like joint mobilization, soft tissue work<\/a>, therapeutic exercise<\/a> or gait training.<\/p>\n Some studies have found that electro-stimulation can deliver faster pain relief<\/a>, but again, only in the short term. When used for headaches, randomized trials have found<\/a> that needling can help, but no more than other therapies<\/a>.<\/p>\n While Medicare does cover the treatment<\/a> for lower back pain, many insurance companies do not<\/a>.<\/p>\n Is it safe?<\/p>\n Studies show that when practiced correctly, dry needling rarely leads to significant complications, though the risk is not zero. Minor side effects, like bruising, bleeding or temporary pain after treatment are common, according to one 2020 study<\/a>.<\/p>\n More serious events, like worsening symptoms or forgotten needles were exceedingly rare, appearing in less than 0.1 percent of cases. The risk of a collapsed lung, as Mr. Watt experienced, is even rarer<\/a>.<\/p>\n