Dry Needling FAQ

Physical therapists at Wellilo have advanced post-degree education and credentials in order to perform dry needling, at minimum meeting the requirements of the District of Columbia.

What is dry needling?

Dry needling is highly effective, and quick treatment that can be (optionally) part of your physical therapy care at Wellilo.

Dry needling involves a thin, sterile (single-use) filament needle inserted into a muscle. The physical therapist aims the needle at a “myofascial trigger point”. A myofascial trigger point consists of multiple, hyperlocal muscle ongoing contractions (“knots”). For many patients, muscular trigger points are related to their ongoing or recurrent pain, balance issues or other body issues.

What should I expect after dry needling?

Many patients experience immediate improvement in their symptoms after dry needling.

After needling, you may also experience a muscle ache for up to 48 hours, similar to post-workout soreness, followed by an expected improvement in your overall symptoms. If you have significant post-needling soreness, applying heat over the area may help. Continuing to stay gently active and moving, just like after a workout, is recommended.

Can I work out after dry needling?

We do not recommend heavy use of the muscles (such lifting weights to fatigue) that are treated in the 24 hours after experiencing dry needling.

However, we highly recommend that you continue to move that body part frequently, gently and normally throughout the day and aim to avoid excessive sitting. Movements like walking, pilates, and gentle to moderate yoga are excellent.

If you were needled in your arm, you can do hard workouts involving legs, back or core.

What type of problems can be treated with dry needling?

Dry needling can be used for a variety of musculoskeletal problems (myofascial trigger points, muscle spasms, scars, or other areas with tightness). It is an appropriate treatment when muscles are thought to be a contributing factor to the symptoms.

Such conditions include, but are not limited to: neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache (including migraines and tension type), jaw pain, buttock pain and leg pain (sciatica, hamstrings strains, calf tightness/spasms).

Is dry needling the same as acupuncture?  

No, dry needling administered by a physical therapist is not the same as acupuncture. However, it is a technique that utilizes thin, solid sterile, single use needles that are very similar to acupuncture needles.

Dry needling focuses on local muscle twitch responses that may be visible and palpable, whereas most acupuncture operates on “energy lines” or “meridians”.

Dry needling is strictly based on contemporary evidence-based medicine principles and research. Physical therapists are not licensed acupuncturists (unless otherwise stated) and do not practice acupuncture within the scope of a physical therapy license.

How does dry needling work?

The exact mechanisms of why dry needling works are not known. There are, however, known biochemical, electrical and mechanical responses to the insertion of needles into muscular trigger points. In addition, there is substantial data that these techniques can reduce pain.

Research from the National Institutes of Health demonstrates that eliciting local “twitch responses” with dry needling leads to the greatest pain reduction.

Is it painful to receive dry needling?

Most patients do not feel the insertion of the needle. The local twitch response can elicit a brief, painful response and may be repeated as needed. Some patients describe this as a little electrical shock; others feel it more like a deep ache or cramping sensation. Research shows that the main therapeutic response occurs when a local twitch response happens. In other words, some short term discomfort (the twitch) is a good and desirable reaction.

Are the needles sterile?

Yes, we only use sterile, disposable needles. 

How long does it take for the procedure to work?

Dry needling may create changes immediately, or more typically, take a few visits for a positive reaction to take place. For those living with chronic pain, each successive procedure of dry needling may lead to a cumulative response, after which the pain cycle is disturbed.

Where does dry needling fit in the entire rehabilitation program?

Dry needling is one of many potential hands-on treatments that may be chosen during in-person sessions to treat pain. Hands-on treatments should always be coupled with a movement and exercise plan that the patient can continue at home. Dry needling may be needed more frequently in the beginning of a rehabilitation plan in order to break the pain cycle or it may be useful as a long term maintenance technique.

Once I am feeling better, how often do I need to come back to maintain my progress?

It depends!

If your pain, discomfort or tightness returns, “tune-ups” are recommended to treat and prevent serious injuries. Please speak with your physical therapist about when you should return for a follow-up.

We offer dry needling focused 30 minute follow up sessions exclusively to current physical therapy patients (not available for public scheduling, please inquire with ariele@wellilo.com).