Dry needling
The American Physical Therapy Association defines dry needling as a technique used to treat dysfunction of skeletal muscle and connective tissue, minimize pain, and improve or regulate structural or functional damage.
[5][6][7] Currently, dry needling is being practiced in the United States, Canada, Europe, Australia, and other parts of the world.
Ma states, "Although ISDN originated in traditional Chinese methods, it has developed from the ancient empirical approach to become modern medical art rooted in evidence-based thinking and practice.
"[15] Ma also states that, "Dry needling technique is a modern Western medical modality that is not related to traditional Chinese acupuncture in any way.
Research supports that dry needling improves pain control, reduces muscle tension, normalizes biochemical and electrical dysfunction of motor end plates, and facilitates an accelerated return to active rehabilitation.Dry needling for the treatment of myofascial (muscular) trigger points is based on theories similar, but not exclusive, to traditional acupuncture; both acupuncture and dry needling target the trigger points, which is a direct and palpable source of patient pain.
[1] A high degree of correspondence is reported between myofascial trigger point dry needling and traditional western acupuncture[clarification needed].
[18] However, dry needling theory only begins to describe the complex sensation referral patterns that have been documented as "channels" or "meridians" in Chinese Medicine.
[19] Lewit had noticed that the success of injections into trigger points in relieving pain was apparently unconnected to the analgesic used.
Dry needling that elicits LTRs improves treatment outcomes,[7] and may work by activating endogenous opioids.
[8] In addition, deep dry may also decrease pain, increase range of motion, and minimize myofascial trigger point irritability.
[4] The APTA also disclaims that dry needling should not be used as a standalone procedure, but should be used in conjunction with other treatment methods, including manual soft tissue mobilization, neuromuscular re-education, functional retraining, and therapeutic exercises.
Many studies published about dry needling are not randomized, contain small sample sizes, and have high dropout rates.
[18] Three more recent reviews reached similar conclusions: little evidence supporting the use of trigger point dry needling to treat upper shoulder pain and dysfunction,[5] evidence not robust enough to draw a clear conclusion about safety and efficacy,[6] and that dry needling for the treatment of myofascial pain syndrome in the lower back appeared to be a useful addition to standard therapies, but stated clear recommendations could not be made because the published studies were small and of low quality.
Severe adverse effects include pneumothorax, injury to the central nervous system and spine, and blood-borne infection transmission.
[15] The American Medical Association made a press release in 2016 that said physical therapists and other non-physicians practicing dry needling should – at a minimum – have standards that are similar to the ones for training, certification, and continuing education that exist for acupuncture.
AMA board member Russell W. H. Kridel, MD: "Lax regulation and nonexistent standards surround this invasive practice.
[22] Because dry needling sometimes involves blood and other bodily fluids, there are sometimes risk of transmission of multiple forms of hepatitis as well as HIV.
[23] The debated distinction between dry needling and acupuncture has become a controversy because it relates to an issue of scope of practice of various professions.
Acupuncturists claim that dry needling is a form of acupuncture that does not fall in the scope of physical therapists, chiropractors, or the majority of other healthcare professionals; whereas those healthcare professionals claim dry needling is not acupuncture, but rather a procedure that is rooted in biomedical modern sciences.
[1] To become a certified acupuncturist requires hundred of hours spent in educational programs, national level exams, and good professional standings.
