Guest Blog: Dry Needling in the Physical Therapy Tool Box -

Practically Perfect Physical Therapy aims to provide its clients with a variety of effective, evidence-based treatment approaches. Today, we are joined with a local practitioner who has her own practice that focuses on the athlete and active person to improve function and decrease pain. Here is what she has to tell us!

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Hello!! My name is Christina Juliano. I am a physical therapist and dry needling specialist. I have 15 years experience treating as a physical therapist, and over 100 hours of training in the field of dry needling. I am dual certified in dry needling, with certifications from Intricate Art Spine and Body Solutions and Evidence in Motion.

For more on my bio and certifications, check out https://www.renascentpt.com/bio

About 5 years into treating as a physical therapist, I moved to Delaware. It wasn’t until then that I got to experience first hand dry needling and what it can do. I am an avid runner with the typical runner injuries. I was suffering with constant calf muscle tension, causing me to have searing nerve pain into my heel. I was disrupting my sleep. More importantly, it was limiting me from running! Lucky enough, I just worked with one of the most skilled dry needling clinicians of the PA/DE region, JJ Thomas. After one treatment of dry needling to my calf, the searing pain was gone, and I was able to return to running with less discomfort. Dry needling can be such a game changer as opposed to traditional treatments in PT (which I did). I wish I had experienced the effects of dry needling sooner so I didn’t have to limit my activities. After that experience, I knew I needed to bring dry needling into my bag of tricks for treatment to help my patients get the quick results I experienced.

I became certified in dry needling in 2017. Since I started dry needling, I usually get hit with similar questions about what it is, how it works, etc. So to help inform you, here are the most common questions asked in regards to dry needling.

Dry Needling FAQs

What is Dry Needling?

Dry needling is a form of treatment used by physical therapists to help with neuromuscular conditions. It involves the use of a thin solid needle that is inserted through the skin. There is no fluid that is injected, hence the term “dry needle.”

History of Dry Needling

Dry needling dates back to the 1940s with Dr. Janet Travell. In her studies of utilizing wet needles to identify trigger points and referral patterns, Dr. Travel found that dry needles offered some of the same results as “wet” needles (hollow fluid filled needles).

Later in the 1970’s Dr. C Gunn contributed to the technique of dry needling with intramuscular stimulation (IMS). IMS focused more on the nervous system contributing to the cause of pathology.

What does the needle look like/needle type?

Dry needling utilizes a thin, stainless steel filiform needle. It is solid, not hollow. There is no medication injected. The diameter of the needle is typically 0.25mm and the length is dependent on the individual and body part being treated.

What does it do

Dry needling helps to regulate the autonomic nervous system (ANS) by elevating parasympathetics and decreasing sympathetics. It allows the body to bring itself closer to homeostasis, and amplifies its ability to heal itself without the use of medication. For the musculoskeletal system, dry needling reduces trigger points (taut bands of muscle tissue), and improves the muscle’s ability to contract and relax,helping with pain and muscle tension.

How fast can I see results?

Patients can experience results after the first session with both the pistoning and in-situ dry needling techniques. Often, changes can be seen in pain level, mobility or strength.

How many sessions?

The amount of sessions needed will be dependent on the diagnosis and overall health of the client. (Generally, healthier individuals heal with better and faster results.)

Does it hurt

Upon insertion of the needle, you may feel little to no pain. A dull cramping ache typically occurs in dysfunctional muscle tissue. However, symptoms will often dissipate as the needle stays in the tissue.

How long does it take

The time of treatment may vary from 10 seconds to 30 min depending on the technique used. The two most common techniques are the pistoning technique and In situ dry needling with or without electric stimulation.

The pistoning technique is relatively quick.The needle is inserted into the muscle trigger point and quickly moved up and down (pistoning). During the pistoning of the needle, a twitch response of the muscle may occur causing it to contract. This technique offers a quick reset of the muscle tissue

In-Situ dry needling involves the needles being placed and left in the muscle for at least 15 minutes to help stimulate the autonomic nervous system. This technique helps restore balance of the muscular and nervous system.

Is it Acupuncture

Dry needling is not the same as Acupuncture. Sure there are some similarities: use of the same tool (needles), penetrating the skin, as well the ultimate goal of reducing symptoms and restoring the body to homeostasis.

Acupuncturists will perform dry needling techniques. However, that is where the similarities end.

When it comes down to it the differences are:

Education Background
Treatment Approach

I like to say “same tool different methodology”

Physical Therapists are movement specialists. They are educated in the evaluation and treatment of pain patterns, postures, and faulty movement patterns. They utilize orthopedic testing to determine the root cause of the symptoms.

Dry needling performed by a Physical Therapist focuses on the treatment of neurological and musculoskeletal conditions as it relates to pain, movement and function. A Physical Therapist will also utilize dry needling as an adjunct to other treatment modalities such as joint mobilization, postural education, strengthening and mobility exercises.

An Acupuncturist may or may not use a movement assessment depending on their background. Their evaluation may utilize Traditional Chinese Medicine, energy field and meridians. Therefore the treatment plan of the Acupuncturist will differ from that of a Physical Therapist as it may not typically involve a mechanical evaluation on how your body moves. Acupuncture also encompassess a broader range of diagnoses outside of the musculoskeletal world including pain management, fatigue,gastrointestinal, infertility, headache, insomnia, anxiety and depression.

Side effects

Side effects of dry needling do not always occur; however the most common side effect of dry needling is soreness during or after the treatment. Other minor side effects include redness of the skin, stiffness, bruising, fainting or fatigue.

Although extremely rare, other side effects include infection and collapsed lung( only if the treating area occurs in the thoracic region)

Can it help me

Dry needling can help a host of musculoskeletal conditions however there are a few individuals that it may be contraindicated.

Dry needling can help: