Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Aug;11(4):651-62.

PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS - PART ONE

John S Halle  1 , Rob J Halle  2
Affiliations

PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS - PART ONE

John S Halle et al. Int J Sports Phys Ther. 2016 Aug.

Abstract

Background: Dry needling is an evidence-based treatment technique that is accepted and used by physical therapists in the United States. This treatment approach focuses on releasing or inactivating muscular trigger points to decrease pain, reduce muscle tension, and assist patients with an accelerated return to active rehabilitation.

Issue: While commonly used, the technique has some patient risk and value of the treatment should be based on benefit compared to the potential risk. Adverse effects (AEs) with dry needling can be mild or severe, with overall incidence rates varying from zero to rates of approximately 10 percent. While mild AEs are the rule, any procedure that involves a needle insertion has the potential for an AE, with select regions and the underlying anatomy increasing the risk. Known significant AEs from small diameter needle insertion include pneumothorax, cardiac tamponade, hematoma, infection, central nervous system injury, and other complications.

Purpose/objective: Underlying anatomy across individuals has variability, requiring an in-depth knowledge of anatomy prior to any needle placement. This commentary is an overview of pertinent anatomy in the region of the thorax, with a 'part two' that addresses the abdomen, pelvis, back, vasovagal response, informed consent and other pertinent issues. The purpose of the commentary is to minimize the risk of a dry needling AE.

Conclusions/implications: Dry needling is an effective adjunct treatment procedure that is within the recognized scope of physical therapy practice. Physical therapy education and training provides practitioners with the anatomy, basic sciences, and clinical foundation to use this intervention safely and effectively. A safe and evidenced-based implementation of the procedure is based on a thorough understanding of the underlying anatomy and the potential risks, with risks coordinated with patients via informed consent.

Levels of evidence: Level 5.

Keywords: Adverse effect; anatomy; dry needling; informed consent; pneumothorax.

PubMed Disclaimer

References

    1. Guide to Physical Therapist Practice. 3.0. Alexandria, VA: American Physical Therapy Association; 2014.
    1. Volz D. Treating soft-tissue pain. Adv Phys Ther Rehab Med. 2015:1-3.
    1. Lewit K. The needle effect in the relief of myofascial pain. Pain. 1979;6(1):83-90. - PubMed
    1. Ingber RS. Shoulder impingement in tennis/racquetball players treated with subscapularis myofascial treatments. Arch Phys Med Rehabil. 2000;81(5):679-682. - PubMed
    1. Dommerholt J Mayoral-del Moral O Gröbli C. Trigger Point Dry Needling. J Man Manip Ther. 2006;14(4):70E - 87E. - PMC - PubMed

LinkOut - more resources