Dry needling is gaining popularity amongst patients and physical therapists alike. It the midst of the opioid epidemic, it is gaining national attention in the United States due to articles like the segment by NPR in 2018 which featured an Emergency Room that reduced their opioid prescription by 58% using strategies like dry needling (1). Dry needling is rapidly moving from being considered alternative medicine like acupuncture to a mainstream treatment option. The Cleveland Clinic, Mayo Hospital, and WebMD all have informational webpages on dry needling. This post is dedicated to answering some frequently asked questions, and giving you a provider's perspective on dry needling so you can make informed decisions about your healthcare treatment options. We'll discuss:
What is dry needling?
Dry needling involves the insertion of a thin monofilament needle into the body. Dry needling is believed to influence blood flow an inflammation in the body. When a new, micro tissue injury is created by the needle, the body naturally directs blood flow and inflammation accordingly to heal the injury and protect the body.
How is dry needling different than acupuncture?
To practice acupuncture, a provider must be a licensed acupuncturist and meet the requirements of their respective state governing accrediting body. Acupuncture is based on traditional Chinese medicine (though Japanese methods and influences from other nations also exist). Generally speaking acupuncturists seek to utilize their needles to influence chi, a type of energy in traditional Chinese medicine, to improve various components of health. Acupuncturists choose the locations for needle placement in consideration of meridian lines along which energy is believed to flow. This system is based on hundreds of years of eastern medical tradition.
Dry needling is based in a more western approach. Needle placement locations and sizes are chosen based on nerve anatomy, as well as our understanding of blood flow and the inflammatory system. Therapists typically place needles locally in the area the patient is experiencing symptoms, or along the nerve distribution that supplies that region. E.g. needles may be place near the spine to address pain that is radiating down the leg from the back. Dry needling methods are based on available evidence in research, and the experience of the clinician providing the treatment. The providers that are legally permitted to administer dry needling can vary by state.
How is dry needling different than injections?
Dry needling involves the use of a thin monofilament needle. Dry needling is called dry because there is no medication being used like in "wet needling" more commonly called injections. Unlike needles used for injections which are larger, and hollow to allow medication to pass through them into the body, dry needles are smaller, thin and solid.
Is dry needling safe?
While all medical procedures carry some degree of risk, dry needling is relatively safe. The needles come in sterile packaging, and are discarded after use. Needles are not re-used between patients. The size of the needle is also so small that the risk of infection is even lower than with other common place medical procedures like getting a blood draw or taking an insulin shot. For individuals with metal allergies (e.g. nickel), stainless steel needles are available that reduce the likelihood of allergic reactions.
Your therapist should have a form about informed consent that will discuss risks and benefits to dry needling. You should have an opportunity to ask questions before signing to consent and receiving the treatment.
Who can benefit from dry needling?
If the condition is associated with nerve pain, or inflammatory problems, dry needling may be a potential treatment option. Dry needling can be beneficial for a variety of conditions including:
Low back and pelvic pain
Chronic nerve pain
Inflammatory conditions like tendonitis, or arthritis
Where can I get dry needling?
Ally Total Physical Therapy offers dry needling services with the convenience of concierge care in your own home. If you're looking to be evaluated by a therapist to determine if dry needling is right for you, click the book online option above.
If you are not in the Toledo area and are looking for a provider, reputable companies like Integrative Dry Needling that educate therapists on dry needling and provide continuing education specialty coursework typically have practitioner directories on their websites. You can search for a certified provider here: Practitioner Directory - Integrative Dry Needling (2)
Is dry needling covered by insurance?
This can vary widely from one state to another and from one insurer to another. As of 2023 federal insurance plans like Medicare and VA insurance plans do not cover dry needling. It is always best to check with your insurance provider regarding your plan's coverage. If dry needling is not covered by your insurance most clinics will offer dry needling on a cash pay basis.
Patients should be aware that due to frequent changes in insurance billing requirements therapists may attempt to bill for dry needling under different treatment codes. Some therapists will bill for dry needling under the manual therapy code, or another code for surgical needle insertion that some insurers consider only appropriate for use during surgeries. This may or may not be allowed by an individual insurance company. You may want to ask how your insurance company wants to be billed so you don't get a surprise bill at the end of your treatment.
If you have more questions about dry needling, post them in the comments below, or send us a message and we'll do our best to help you find answers. As a general disclaimer, the content in this article is not intended to replace individualized medical advice. You are advised to schedule an evaluation with your healthcare provider to discuss if this is the right treatment for you.