Integrative Dry Needling Q&A

Integrative Dry Needling is a highly effective form of Physical Therapy for the treatment of a multitude of musculoskeletal and neuromuscular conditions. It is not appropriate for all conditions or pathologies and the use of the technique will be at the discretion of your physical therapist.

*Not all medical or physical therapy professionals are trained to perform the Integrated Dry Needling treatment technique. Jamie Morse, PT, DPT at Altitude Physical Therapy, PLLC has advanced training and has been certified through Dr. Ma’s Integrative Dry Needling Institute.

Questions & Answers

How does it work?

Integrative dry needling is not acupuncture (traditional Chinese medicine), it is based on neuro-anatomy and modern scientific study of the musculoskeletal and neuromuscular systems. A very fine filament needle is inserted through the skin and into the deeper tissues that are considered trigger points to your pain. Dry needling works by causing a microlesion within the pathological tissue thus breaking up shortened tissues, inhibiting a reflex arc from the nervous system to the tissue, normalizing the inflammatory response, and centrally mediating the pain. This mechanical and neuromuscular effect provides an environment than enhances the body’s ability to heal which ultimately reduces pain.

What conditions can be treated?

Conditions include, but are not limited to: neck, mid and low back pain, shoulder, arm/elbow pain (shoulder impingement, tennis elbow, golfer’s elbow, wrist pain, carpal tunnel), headache (migraines and tension type), jaw pain (TMJ), buttock, hip and leg pain (sciatica, hamstring strains, hip flexor and quad strains, IT Band tendonitis), lower leg, foot and ankle pain (calf strains, achilles tendonitis, ankle sprains, plantar fasciitis).

Are the needles sterile?

Yes, we only use sterile disposable needles.

Is the procedure painful?

The fine filament needle is very thin, solid, and flexible, which allows for the needle to be pushed through the skin versus cutting the skin. This helps reduce any discomfort that may occur with the procedure. We strive to make the treatment virtually painless however at times a local twitch response of the muscle may be felt. When the needle is inserted into the pathological tissue the local twitch response is normal and is felt only momentarily. Many clients describe this twitch response as a little electric shock, cramp or an ache sensation. These sensations are perfectly normal and even a desirable response. Your physical therapist will make every effort to make your experience comfortable and therapeutic.

How will I feel after the Dry Needling treatment?

This will vary but many clients experience immediate relief of their symptoms and an increase in range of movement. Soreness can also be a common response from the needling but does not occur with all people. Some individuals may experience an immediate achiness or a delayed soreness the next day. The soreness, if present will usually last 1-2 days, use of heat and light massage and movement will be beneficial. Mild bruising may occur at the needling sites and is more prevalent in certain parts of the body. Larger bruising may also occur, but it is rare. Application of ice on the bruise will help with the soreness and the skin discoloration may last several days but is not harmful.

It is uncommon but possible that the treatment may temporarily increase your symptoms. This is not unusual but if this continues past the 1-2 day window, inform your PT to allow adjustment of your program to enhance your comfort the next time. This does not mean that needling will not be beneficial to your condition.

How many treatments will I need?

This will depend on the category you fit in which is determined by the state of the injury and your overall health. Remember we are attempting to cause mechanical and biomechanical changes without any pharmacological means. Therefore, we are looking for a cumulative response to break the pain cycle. Your PT will be able to give you more insight after your evaluation.

What should I do to prepare for the treatment?

  • Do not eat 30 minutes before the treatment
  • Be well hydrated but empty your bladder prior to treatment
  • Wear loose fitting clothing, shorts or a bathing suit for easy access to your pain area(s)

What should/can I do after treatment, what should I avoid?

Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Recommendations may include increasing your water intake, applying heat or ice over the area, specific mobility exercises and/or modifications of activities.


Reference: Dr. Ma’s Integrated Dry Needling Handbook for Pain Management & Sports Medicine, 2016