Functional Dry Needling

Functonal Dry Needling

Functional Dry Needling (FDN) is a technique physical therapists use (where allowed by state law) to treat myofascial pain. The technique uses a “dry” needle, one without medication or injection, inserted through the skin into areas of the muscle, known as trigger points.

FDN is not acupuncture, a practice based on traditional Chinese medicine and performed by acupuncturists. Dry needling is a part of modern Western Medicine principles, and supported by research 1.

FDN involves multiple advances of a filament needle into the muscle in the region of a “Trigger Point’. The aim of FDN is to achieve a local twitch response to release muscle tension and pain. FDN is an effective treatment for chronic pain of neuropathic origin with very few side effects.

This technique is unequaled in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits. The needle used is very thin and most subjects do not even feel it penetrate the skin. A healthy muscle feels very little discomfort with insertion of this needle. However if the muscle is sensitive and shortened or has active trigger points within it, the subject will feel a sensation like a muscle cramp -‘the twitch response’.

The patient also may feel a reproduction of “their” pain which is a helpful diagnostic indicator for the practitioner attempting to diagnose the cause of the patients symptoms. Patients soon learn to recognize and even welcome this sensation as it results in deactivating the trigger point, reducing pain and restoring normal length and function to the involved muscle.

What is a ``trigger point``?

A myofascial “trigger point” is a hyperirritable point in skeletal muscle that is associated with a hypersensitive palpable nodule, or “knot”. This area becomes painful at the site and can also “radiate” in predictable patterns.

What is Functional Dry Needling?

FDN involves the insertion of a thin filament needle to stimulate the healing process of soft tissues (muscle “trigger points”, fascia, tendons and ligaments, etc) resulting in pain relief and restoration of healthy physiology.

Research supports that dry needling improves pain control, reduces muscle tension, normalizes biochemical and electrical dysfunction of motor endplates, and facilitates an accelerated return to active rehabilitation.

What is the difference between Functional Dry Needling and Acupuncture?

The objectives and philosophy behind the use of FDN by physical therapists is not based on ancient theories or tenets of traditional Chinese medicine. The performance of modern dry needling by physical therapists is based on western neuroanatomy and modern scientific study of the musculoskeletal and nervous systems.

Both FDN and Acupuncture do, however, use the same tool; a solid needle filament.

Does it hurt?

Generally, the insertion of the needle is not felt or just slight prick is noted. The local “twitch response” may provoke a brief pain sensation that has been described as a tingling, aching or cramping sensation and resolves quickly.

Who can benefit from Functional Dry Needling?

FDN may be used for acute and chronic sport-related injuries such as:

  • Muscular hematomas
  • Muscle tears
  • Compartment syndrome
  • Medial tibial stress syndrome (shin splints)
  • Rotator cuff injuries
  • Tennis/golfers elbow

FDN can also be used for spinal conditions in which the underlying pathology may have triggered a movement disorder. This can result in the presence of reduced ROM or pain due to abnormal muscle tone or spasms. Such conditions may include:

  • Piriformis syndrome
  • Cervico-genic headaches
  • Sciatica
  • Hamstring issues

Common lower extremity conditions treated with FDN include:

  • Patellar Femoral Syndrome
  • Patellar tendonitis
  • Hamstring Strain
  • Groin Strain
  • Shin-splints, Compartment Syndrome
  • Achilles tendonopathies

Common upper extremity conditions treated with FDN include:

  • Thoracic Outlet Syndrome
  • Carpal Tunnel Syndrome
  • Lateral Epicondylitis (tennis elbow)
  • Medial Epicondylitis (golfers elbow)
  • Impingement syndrome
References

1. Cummings MT, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review. Arch Phys Med Rehabil. 2001;82(7):986–992. Free Article.