How Acupuncture Works

The scientific basis of Acupuncture is now well understood. There is no

longer a need to get lost in esoteric discussions of qi and meridians as they relates to
acupuncture. A summary of the science is given below, however, note that the physiology of
acupunture treatment can be a bit complex.

First off, we can start with debunking the basic history of Chinese Medicine and how we are
generally told that acupuncture works. The Western idea that Chinese medicine is an energetic,
metaphysical medicine was created by a French bank clerk named Georges Soulie de Morant in
the early 1900s. Unfortunately, de Morant lacked any training in medicine or Chinese language.
De Morants explanation of concepts like Qi and Meridians was neither historically accurate nor
consistent with science, even the science of the time.

It is a fact that more than 95 percent of all literature published in western languages on Chinese
medicine reflect western expectations rather than Chinese historical reality.

Paul Unschuld, historian of Chinese medicine

More on this topic can be found here.

Acupuncture has been shown to act on several mechanisms in the body,

and the details of these mechanisms are discussed below. These physiological mechanisms can
become complicated, however the basis of acupuncture is quite simple. Acupunctures effect is
dependent on the stimulation of the peripheral nervous system (PNS). This is confirmed by the
fact that when nerves innervating acupoints are blocked acupuncture has no effect.

Research suggests that acupuncture stimulates the central nervous system to release natural
chemicals that alter hormonal output, pain response, and other biological processes. In 2003, the
World Health Organization (WHO) conducted an extensive review and analysis of clinical trials
involving acupuncture. According to this report acupuncture impacts the body on multiple levels,
concluding it:

Stimulates conduction of electro-magnetic signals, which can promote immune system

cells or pain-killing chemicals.

Activates the bodys endogenous opioid system, which may help reduce pain and induce
better sleep quality.

Stimulates brain centers including the hypothalamus and pituitary gland, which modulate
numerous body systems.

Changes in the secretion of neurotransmitters and endocrine hormones, which may

positively effect brain chemistry.

In the World Health Organizations video, a team of researchers,

including an acupuncturist, conducted an experiment for the first time in history. Using MRI
imaging techniques, the research study visually demonstrated that acupuncture has a very real
and measurable effect on the brain. Acupuncture does something completely remarkable it
deactivates certain area of the brain, particularly in the limbic system. In this process there is
decreasing neuronal activity, which in turn suppresses pain and overactive nervous system
patterns (as opposed to having an activating neuronal impact). Their experiment also clearly
showed that fake (sham) needling did NOT have this effect. The limbic system is a deep brain
center associated with the experience of pain, adding further evidence that something very
unique happens during acupuncture treatment. Acupuncture fundamentally alters the experience
of pain by shutting down these deeper brain regions that are over-active in chronic pain
conditions and in chronic stress patterns.

In addition, scientific research on Acupuncture has shown measurable activity in specific body
systems including:

Acupuncture increases peripheral blood flow. An increase in blood flow is significant

because all tissues of the body need a rich supply of blood to heal and thrive. Blood
brings oxygen, nutrients, vitamins, immune complexes, hormones, and anti-inflammatory
substances. Restoring optimal blood flow is essential to promoting and maintaining
health. Blood flow can be impacted by injuries, certain diseases and general aging.
Acupuncture has been shown to increase blood flow and vasodilation in several regions
of the body.
 Acupuncture increases the neural pain threshold. This effect occurs through the release of
natural painkillers. Inserting an acupuncture needle sends a signal from the peripheral
nervous system to the brain and in response the brain releases chemicals such as
endorphins, norepinephrine and enkephalin. Some of these natural substances are 10-200
times more powerful than opioid drugs such as morphine.

Acupuncture releases neurochemicals similar to endorphins which as been shown to

reduce both the intensity and perception of chronic pain. It produces this effect through a
process termed descending control normalization, which involves the serotonergic
nervous system.

Acupuncture triggers the bodys innate healing mechanisms. Acu needles create micro
traumas that stimulate repair of local tissues, ultimately leading to a faster healing of
injuries. This involves stimulation to the tissues in the nervous, immune and endocrine
systems. As the body responds to the micro traumas induced by acupuncture, it also heals
any surrounding tissue damage left over from injuries.

Acupuncture relaxes shortened muscles. This in turn releases pressure on joint structures
and nerves, and promotes blood flow. Muscles often develop trigger points which can be
effectively be released through traditional acupuncture or trigger point dry needling.

Acupuncture reduces stress and subdues exaggerated stress responses. Suppressing the
sympathetic nervous system (SNS) and reducing stress is arguably the most important
system-wide effect of acupuncture. Research shows that acupuncture stimulates the
release of oxytocin, a hormone that up-regulates the parasympathetic nervous system
(PNS). The classic fight-or-flight state is governed by the SNS. In contrast, the PNS in
common terms is the rest-and-digest system, also called the calm-and-connect system.
Research has linked poor parasympathetic function (chronic stress) in a wide range of
diseases including: autoimmunity, arthritis, lupus and inflammatory bowel disease.

Acupuncture increases T-cells and other immune constituents.

Acupuncture increases activity at nerve gates. Thermal PET scans also show activity in
the regions of the brain responsible for pain messages.

And digging deeper into the science, acupuncture points appear to be

special in that they have denser sensory innervation and connective tissue. Along with this,
acupuncture points have higher density of TRPV1 receptors, which are important in pain
signaling. Insertion of a needle into traditional acupuncture points creates a physical stimulus
that activates mechanoreceptors and triggers afferent signals to the central nervous system
(CNS), to areas in the brain which handle pain processing and response. Neurochemically, pain
response is thereby down-regulated, and blood flow to the local area is increased, ultimately
inducing acupuncture analgesia.

Both laboratory research and clinical data demonstrate that the endogenous opioid system is
modulated in acupuncture analgesia. Consistently, studies show a reduced need for opioid drugs
and other pain-reducing medications in patients with chronic pain after acupuncture treatment. In
addition, the noradrenergic system has also been associated with acupuncture analgesia in
experimental studies. In this system, acupuncture can induce a decreased level of noradrenaline
in the brain was observed after acupuncture. Studies in animal models of inflammatory and
neuropathic pain have also found evidence for a role of serotonin and glutamate in acupuncture
analgesia. Other pain mediators that have been suggested to be modulated by acupuncture
include somatostatin, cannabinoids, and neurotrophic factors. However, clinical studies
supporting these additional theories are limited at this time.

Experimental models of pain have also indicated that acupuncture may have an
anti-inflammatory action by having a modulatory effect on the release of pro-
inflammatory mediators. These results have been supported by clinical findings
showing a reduction in the production of pro-inflammatory molecules after
acupuncture in patients with osteoarthritic pain and chronic pelvic pain syndrome.

Theories on the Mechanism of Acupuncture

-----------------

Multiple theories about the mechanism of acupuncture are available, but 3 that stand out for us at Best
Health Option connect Traditional Chinese Medicine (TCM) and Western Biomedicine

The connective tissue theory establishes a relationship with acupuncture points to connective tissue
planes. The growth control model identifies a relationship between bioelectrical transduction and cell
pathogenesis. The neuroimmune response incorporates afferent proprioceptive responses and the vagal
nerve.

Connective Tissue Growth Control Model

Theory

Dr Charles Shang established the Growth Control model in which he

The relationship of determined nodal and vessel systems allocating electro-physiological
acupuncture points and characteristics with morphogenetic fields initiated cell pathogenesis which
meridians to connective occurs with non specific stimuli. In theory a small group of cells (organizers)
tissue planes researched control a larger region via morphogens.
by Dr. Helene Langevin
and Jason Yandow Morphogens (messenger molecules) form around the organizers.
suggest an attraction and Organizers are either the highest or lowest in concentration of morphogens
coupling between the which is a macroscopic singular point. The bioelectric field affects the
needle with the elastic morphogen and growth factor producing morphogenesis. When related to
and collagen fibers of the acupuncture, evidence connects acupoints and organizers in relationship to
subcutaneous connective distribution at extreme points in surface curvature, response to non specific
tissue. Manipulation of stimuli and an association with the bioelectric field. The suggestion is made
the needle facilitates an that acupoints originate from organizers and concentration of morphogens
electro-chemical signal and embryogenesis are at the extreme points of curvature in relationship to
via the connective tissue anatomy.
plane. As manipulation is
prolonged or intensified,
the needle- tissue torque
is intensified thus Traditionally, the high and low concentrations could be conceived as an area
propagating the of either excess or deficient qi at particular acupoints. The stimulation at a
response. Tissue particular curvature where there is a low concentration of morphogen
samples studied after surrounded organizers would experience tonification or bring more qi to that
manipulation suggest point which may be in fact embryogenesis.Acupoints as stimulating
prolonged architectural organizers cause transient change in neurotransmitters but will alter growth
changes in the tissue control signal transduction creating a long term
after withdrawal of the
needle (fig).The tissue
torque is defined as
needlegrasp.This type of
response though not
defined in this manner
traditionally is an
established response of
de qi, or arrival of qi

In 2002 Lengevin et al.

quantified needle
grasping by measuring
the pullout force of the
needle with manipulation.
This is a measurable
therapeutic response
associated with
acupuncture. Connective
tissue planes were also
associated with various
acupoint regions as well
as Yin and Yang
meridians of the arm. Yin
meridians and their
associated planes were
inward and deep,
compared to the Yang
meridians and their
associated planes which
were outward and
superficial corroborating
the external to internal
theory of needling.
Picture 1-7 shows the
connective tissue and
needle "whorl"

effect.
The Neuroimmune Response
Dr Donald E Kendells peer reviewed publication in 2002 and updated theory and research
establishes the neuroimmune response theory inclusive to neural, vascular, immunological and
endocrine systems. A local defensive inflammatory response (bradykin release) elicited by the
insertion of an acupuncture needle provokes afferent nociceptive neuron distribution to the dorsal
horn of the spinal cord. This triggers the gamma loop efferents of the ventral horn to stimulate
neurons to cross the spine and send transmissions to the sensory cortex (which are perceived by
the person being needled as needle sensation) and the brain stem. Nociceptive and proprioceptive
signals stimulate neurons which activate somatic and autonomic motor nerves to the periphery,
muscle and internal organ.These signals inhibit pain, relieve muscle contractions, normalize
vascular tone, and restore blood flow. Inhibition of autonomic motor fibers also normalizes organ
activity; internal organs also have afferent nociceptive neurons.
Ben Kavoussi and B Evan Ross expanded this theory confirming the brain and immune system
form a bidirectional network via the neurohumoral pathways expanding on the idea that when
unmyelinated C fibers are stimulated, pro- inflammatory tachykinins which induce vasodilation,
and increased vascular permeability ensue. This inflammatory event is transmitted along the
afferent vagus nerve and into the brain stem which in turn provoke a transmission pathway of
cytokines, causing a direct nerve to immune cell interaction or indirectly via the adrenal
neuroendocrine axis. This ultimately leads to a decrease in the pro inflammatory response and an
increase in the anti inflammatory cytokines as well as the release of ACTH via the dorsal vagal
complex. Both activate the humoral anti inflammatory pathway.
The interesting research that connects this biomedicine theory with traditional teachings is the
Vagus nerve and the Spleen. The parasympathetic nervous system (PNS) governs the down
regulation of pro inflammatory cytokines and containment of the somatic inflammatory response.
Efferent activity in the vagus nerve leads to acetylcholine (ACh) response which inhibits pro
inflammatory response only. Studies show that direct electrical stimulation of the efferent vagal
nerve blocks TNF synthesis. The Spleen/Stomach Meridians of traditional teaching nearly
correlate with the known and hypothetical pathway of the vagal nerve. The vagal nerve is one of
the longest cranial nerves and is crucial to the PNS; the Spleen and Stomach are essential to the
physiology and pathology in traditional teachings.
*Kavoussi, B. Ross B.E. The Neuroimmune Basis of Anti-inflammatory Acupuncture. Integrated
Cancer Therapies 6(3): 251-257. do: 10.1177/1534735407305892
*Carol Mattson Porth, Essentials of Pathophysiology: Concepts of Altered HealthStates
Philadelphia, Pennsylvania: Lippincott Williams and Wilkins, 2007
*Helene M. Langevin and Jason Yandow. Relationship of Acupuncture and Meridians to
Connective Tissue Planes.The Anatomical Record Review (New Anat) 269:257-265, 2002.
*Kendall, Dr. D.E. The Dao of Chinese medicine: Understanding an Ancient Healing Art.1 ed.
USA: Oxford University Press. 2002
*Shang, Dr. C. Basic Acupuncture Research has met the Gold Standard of Science. Department
of Medicine, Harvard Medical School. Boston 2009

For more information, articles, other websites that promote science based literature, studies, and
educational pieces on Acupuncture visit our Articles and Interest page
Acupuncture for Chronic Pain
by Joseph Alban, L.Ac. October 28, 2011

Chronic pain is mysterious. It can come and go. It can get worse, or get better. Often without
explanation.

Chronic pain is serious. It interferes with work, school, and relationships. Chronic pain is the
most common issue that comes into my acupuncture clinic. Pain can effect almost any place in
the body: headaches, back pain, shoulder pain, neck pain, knee pain, and any other location.

Acupuncture for Chronic Pain

Acupuncture is a complex therapy and works in a combination of ways to reduce pain and
inflammation.

Acupuncture works to reduce pain and

inflammation through regulating neural pain pathways, stimulating the release of natural pain
relieves in the body, such as opioids, as well as regulating pain relieving opioid receptors.

Many studies have also shown acupuncture to have a anti-inflammatory effect, reducing the
circulating inflammatory hormones in the blood, such as cortisol. Interestingly, many of the
hormonal and neural effects last long after the acupuncture treatment has finished, suggesting
that acupuncture has both immediate and long term regulatory effective in reducing pain.

What is the acupuncture needle doing?

We also can think about what the acupuncture needle itself is doing. When inserting a needle, the
muscles near the acupuncture needle or along the acupuncture channel will often twitch. Many
scientists have looked at this twitch response which can change the inflammatory mediators in
the area of the acupuncture point. This could point to a mechanism related to local pain
reduction.
Connective tissue stimulation is another possible mechanisms for pain relief that the acupuncture
needle site.

Acupuncturists will twirl the needle many times during the treatment. Researchers have shown
that this stimulates subcutaneous loose connective tissue. Helene Langevin, the remarkable
researcher who discovered this, writes, Fibroblasts (the cells) within the loose connective tissue
respond to the mechanical stimulation with active cytoskeletal remodeling that may have
important downstream effects within connective tissue.

We do not know the specific clinical effects of the connective tissue responses. But Langevin
believes these results may eventually lead to an explanation of the acupuncture channel
circulation and connecting the body.

The next steps in acupuncture research will look to understand how these complex mechanisms
work together for long lasting pain relief.

References

Napadow V, Ahn A, Longhurst J, et.al. The Status and Future of Acupuncture Mechanism
Research. J Altern Complement Med. 2008 September; 14(7): 861869.

Langevin HM, Churchill DL, Wu J. Et. al. Evidence of Connective Tissue Involvement in
Acupuncture. FASEB Journal. April 10, 2002. Published Online.

National Center for Complementary and Alternative Medicine Website. Acupuncture for Pain.
Accessed 4/30/2013.

photo: Wikipedia
.

How Acupuncture Works

The simple explanation
Acupuncture stimulates certain points on or near the surface of the body by the insertion of
needles to prevent or modify the perception of pain or to normalize physiological functions.
- Kaiser Permanente
Biochemical explanation
Acupuncture as a treatment method affects the human body in a variety of ways that make it an
effective treatment solution for a wide variety of conditions, most commonly pain. Scientists are
still uncovering the subtle and widespread changes that occur when a medical professional
inserts an inert needle into the body's tissues. On the more general level, acupuncture regulates
the delivery of blood to tissues and organs, thereby improving the function and health of the
tissues and organ systems. When the tissues/cells have increased access to oxygen, nutrition
(enzymes, anti-oxidants, ions, etc.) and pain-relieving hormones, the pain and injury can more
readily be resolved.

Acupuncture helps increase vascular function, i.e. improves blood-flow and vascular health
(heart and vessel health). It also have more specific effects on the nervous system and its effects
on other tissues (e.g. muscles, connective tissues, organs, gland, etc,). In Chinese medicine we
say that it "moves Qi and Blood." In biochemical terms, the acupuncture needling:

Stimulates the blood coagulation Kinin-kallikrein system to produce/release

bradykinin and plasmin, inflammatory mediators

Bradykinin triggers local pain sensory fibers and the corresponding

proprioceptive nerves

Plasmin activates C3, triggering the immune complement system to sustain

vasodilatory phase by histamine, leukotrienes, prostaglandins and kinin
protease which sustains the needling response

Inactivation phase breaks down histamine, releases cortisol, stimulates opioid

receptors and promotes tissue healing through increased circulation

Acupuncture creates a strong stimulation and reboots the proprioceptive nerve pathway.
Because acupuncture is only a jumpstart for the brain to release endorphins, it is common for
the signal to become weak. This is also why we recommend repeated acupuncture treatment in
Campbell: to continue needling and "jumping the threshold" until the body remembers and re-
establishes the normal threshold to signal the brain.

It should be noted that over 90% of Trigger points are Acupuncture Points:
In 1983, Janet Travell et al. described trigger point locations as 92% in correspondence with
known acupuncture points. In 2006, Peter T. Dorsher, acupuncturist at the Mayo Clinic,
concludes that the two point systems are in over 90% agreement. In 2009, Dorsher and
Fleckenstein conclude that the strong (up to 91%) consistency of the distributions of trigger point
regions referred pain patterns to acupuncture meridians provides evidence that trigger points
most likely represent the same physiological phenomenon as acupuncture points in the treatment
of pain disorders. An article in Acupuncture Today (May 2011, p. 3, Scope and Standards for
Acupuncture: Dry Needling?) further corroborates the 92% correspondence of trigger points to
acupuncture points. These points are areas of the body with a high convergence of blood vessels,
nervous tissue, connective tissue, and lymphatic tissue, making them especially effective in
treating a wide variety of conditions.

New research has allowed for better understanding of the physiology that is involved in the
seemingly broad effects of acupuncture. The article below, titled "Classic and Modern Meridian
Studies: A Review of Low Hydraulic Resistance Channels along Meridians and Their Relevance
for Therapeutic Effects in Traditional Chinese Medicine," explains Chinese acupuncture
'meridian' theory by way of newly understood "low resistance fluid channels where various
chemical and physical transports take place." There are many technical aspects to this research
but it essentially lays forth a better biomechanical and physiological understanding of fluid
dynamics and interstitial flow through tissues as regulated by acupuncture and other treatment
methods used in Chinese medicine. Read below for more information and the full report with
links and references:

A Review of Low Hydraulic Resistance Channels along Meridians and Their Relevance for
Therapeutic Effects in Traditional Chinese Medicine
http://www.slideshare.net/cortesevelyn/pain-management-by-acupuncture-42236326
http://www.slideshare.net/cortesevelyn/pain-management-by-acupuncture-42236326

5 by Jamie Clough 14 Comments

Your Top 6 Dry Needling Questions Answered (Western

Musculoskeletal Acupuncture)

Dr
y needling is a technique that is fast gaining appreciation within the physiotherapy world, with
many practitioners throughout Australia now trained in the use of acupuncture needles to assist
with their clients pain and rehabilitation. I found myself interested in dry needling and its
application from an early stage in my physiotherapy career, and have undertaken dry needling
courses and have also undertaken formal postgraduate training in musculoskeletal acupuncture.

In this blog article I wanted to answer common questions about dry needling, including:

1. What is dry needling?

2. What is the difference between acupuncture and dry needling?
3. How does dry needling acupuncture work?
4. What will I feel during my dry needling session?
5. Is dry needling safe?
6. Where does dry needling fit into my rehabilitation plan?

So

1. What is dry needling?

Dry needling, sometimes referred to as clinical or Western acupuncture, is an invasive method
whereby solid filament (acupuncture) needles are introduced into the skin and tissues below, with
the term dry needling coined to differentiate it from injection needling where something is
injected into tissue with a hyperdermic syringe.

Dry needling is a unique procedure intended to specifically target and restore muscle function,
with an emphasis on improving tissue healing and restoring normal tissue function. This is
important as continued activity with poor muscle function may lead to further tissue damage and
increased pain. Dry needling is not meant to replace conventional medical procedures such as
physiotherapy or surgery. However, when combined with conventional treatment options, dry
needling can be an influential method to accelerate pain reduction, healing and the restoration of
normal tissue function.

The exact mechanisms of dry needling are complex and not fully known. However, there is a
growing body of scientific evidence that supports the positive effect inserting a needle has on the
electrical and chemical communications that take place in our nervous system. These include
inhibiting the transmission of pain signals in our spinal cord and increasing the release of our
own pain relieving chemicals within our brains. The pain relieving effect of dry needling is
gaining strong support in mainstream Western medicine, with public hospital systems now
directly funding its use.
2. What is the difference between acupuncture and dry needling?

There are obvious

similarities between dry needling and acupuncture and the needles used are identical. Generally
dry needling is based on Western anatomical and neurophysiological principles, which are not to
be confused with the Traditional Chinese Medicine (TCM) technique of acupuncture.

TCM is based on the use of pulses, coatings and meridians (or channels) derived from
ancient Chinese philosophy and culture, with traditional acupuncture needles inserted into
defined acupoints, intended to unblock energy meridians and help create balance within bodily
systems. Advocates of traditional acupuncture promote its use for treating a range of physical
and psychological problems.

Unlike the specific tissue targets used in dry needling, acupoints do not necessarily match our
understanding of anatomy and the proposed treatment mechanism is largely inconsistent with
modern medical science.

Modern dry needling is based on current medical science and research known and accepted by
todays primary care, orthopaedic, neurologic and pain management physicians. However, the
positive effect on pain of inserting a needle is likely to be similar, whether administered as part
of a dry needling or acupuncture treatment.
3. How does dry needling acupuncture work?

As I mentioned previously, the exact mechanisms of dry needling are complex and not fully
known. However, there is a growing body of scientific evidence that supports the positive effect
inserting a needle has on the electrical and chemical communications that take place in our
nervous system. These include inhibiting the transmission of pain signals in our spinal cord and
increasing the release of our own pain relieving chemicals within our brains.

Dry needling uses a very fine, solid filament needle to cause a small, precise injury or lesion in
the tissue when it enters the body. The tiny needle induces injury signals the brain uses to initiate
a sequence of events to replace or repair the damaged tissue with new, healthy tissue. Needling in
a painful trigger point or muscular knot frequently provokes a twitch response from the
muscle. This is both diagnostic as well as therapeutic, because healthy muscle tissue will not
twitch when stimulated by the needle. Once a twitch response has been elicited, the muscle
fibers in that area relax, inflammation is reduced and circulation improves. As a result of these
physiologic processes, dry needling can purposely address muscle, tendon and myofascial pain
and dysfunction.

Personally, I feel dry needling has a complex effect on the bodys fascial make-up: with fascia
being the connective tissue that surrounds muscles and joints, and keeps everything together.
Originally fascia was thought to be an innate substance with minimal neural input/output, but on-
going research has found that fascia is a highly innervated tissue (lots of nerves), and therefore
would have a strong response to a slightly invasive treatment technique such as dry needling.
 Papers written by Helene
Langevin propose that the root effect of acupuncture/dry needling could be through its effect on
connective tissue. Read this excellent article by Helen about dry needling. Youll find links to
some more great information about dry needling.

A lot of the literature focuses on trigger points, and dry needlings effect on these, but
unfortunately there is not really a general consensus on what a trigger point is! Some well
established theories on the effect of needling trigger points include:

Theory A
1. Something causes pain, if it happens often enough or if the trauma is great enough, the pain
signal may return and activate special pain receptors, which will feedback to the spinal cord. This
will cause pain to continue instead of fade and is called a Reflex Arc.

2. At the same time motor neurones may become stuck in a feedback loop/reflex arc, facilitating
muscle spasm. In some cases the reflex arc continues for years, even decades.

3. Introducing a new stimulus (i.e. the needle) impedes the reflex arc and has the effect of
relaxing the muscle.

Theory B
1. A muscle in constant spasm becomes a damaged muscle. Spasm reduces blood flow in the
muscle. This means less oxygen and nutrients to the muscle. Muscle fibres die off and get
replaced by fibrous scar tissue. This in turn holds the muscle tense, prevents muscle metabolites
from leaving the muscle and causes continued spasm and pain.

2. Putting a needle into an active trigger point within the muscle causes the muscle to relax; this
can be seen with an electromyogram (EMG).

4. What will I feel during my dry needling session?

Generally, needle insertion is not felt; the local twitch response or sudden slight contraction of
the muscle may provoke a very brief pain response. This has been described as an electric shock
or a cramping sensation. A therapeutic response occurs with the elicitation of local twitch
responses and that is a good and desirable reaction.
During treatment, and depending on the dry needling technique used, patients commonly
experience heaviness in the limbs or a pleasant feeling or relaxation. Following this technique
some muscle soreness may be felt up to 24-48 hrs. The application of heat or ice depending of
the needling site and drinking plenty of fluids usually reduces the soreness.

5. Is dry needling safe?

Dr
y needling is a very safe treatment. In the clinic we are trained in using a clean technique, and
only individually packaged, single use, sterile needles are used. The needles are very fine
(.16-.30mm), and very rarely does any bleeding or bruising occur at the insertion site.

Many clients report some soreness in the treated area and referral zone lasting from a few hours
to two days. Side effects are very rare but when they occur, the most frequent and the most
serious is that of a pneumothorax. This is where a needle pierces the lung leading to a full or
partial collapse. This happens mostly when a needle is inserted into the Trapezius muscle in a
certain way and too deeply generally due to poor practitioner technique. Many physiotherapists
will not dry needle muscles of the thorax that may be deep and close to the inflated lung, but
most physios have a deep understanding of the relevant anatomy and dry needling technique so
the practice is very safe.
6. Where does dry needling fit into my rehabilitation plan?
Dry needling is the modality of choice when it comes to treating acute injuries, muscle spasms or
muscle pattern imbalances. It is very common to initiate dry needling at the beginning of your
treatment program in order to break the pain cycle. Once that is achieved, other treatment options
are introduced.

Typically, it takes several visits for a positive reaction to take place, as the needling is looking to
cause mechanical and biochemical changes without any pharmacological means. Therefore, we
are looking for a cumulative response to achieve a certain threshold after which the pain cycle is
disturbed.

While dry needling can be very useful in relieving pain it does not necessarily address the source
of the pain. For example, someone with advanced osteoarthritis of the hip or knee may have
associated secondary muscular pain as the muscles compensate to avoid movement related with
pain. Dry needling can be valuable in relieving the pain but it will not reverse the osteoarthritic
alterations in the hip that are the source of the muscular pain.

The benefits of Dry Needling frequently include more than just relief from a particular condition.
Many people find that it can also lead to increased energy levels, better appetite and sleep as well
as an enhanced sense of overall wellbeing.