Dry Needling for Back Pain
Mainstream medicine is largely stumped when it comes to alleviating back pain, a condition that 80 percent of us can expect to suffer from at some point in our lives. After years of attempting expensive surgeries that fail to bring relief and prescribing pharmaceuticals that have contributed to an epidemic of opioid abuse, more clinicians are now recommending alternative medicine first.
One of these treatments is dry needling, an approach that may not sound appealing right off the bat. But for those suffering from chronic back issues, this alternative approach to pain relief and limited mobility has been a saving grace. It has also raised some interesting questions about the role of alternative treatments in mainstream medicine.
What Is Dry Needling?
Dry needling dates back to the 1940s when physician and muscular pain researcher Dr. Janet Travell introduced the concepts of myofascial pain and “trigger points” (or sensitive points on the muscle). Travell found that by inserting extremely thin needles into aggravated muscle tissues and moving them around, she could help reduce her patients’ musculoskeletal pain.
The movement of the needle is the key in dry needling. It allows the practitioner to elicit a visible local twitch response (LTR) in the problematic muscle. Patients often say the twitch feels like a “cramp” or “spasm,” but that it doesn’t hurt much, or for long.
The needles are called “dry” simply because they contain no anesthetic. They are the same tools used by acupuncturists, which has led to more than a little controversy about how original the technique really is. But despite its similarity to acupuncture at first glance, dry needling is a service offered by a subset of licensed physical therapists and chiropractors who have received specific training in the technique.
How Does Dry Needling Differ From Acupuncture?
According to Kara Johnson, a physical therapist at Mayo Clinic Health System in Eau Claire, Wisconsin, while both dry needling and acupuncture use a solid filament needle, “how they use the needle and where they place the needle are quite different.” But perhaps most importantly, Johnson notes, “dry needling is only one component of a comprehensive therapy program provided by a physical therapist with the ultimate goal of restoring function.”
The American Medical Association’s Current Procedural Terminology (CPT) recognizes dry needling as a treatment modality. And yet, there are laws prohibiting dry needling in six states: California, Hawaii, New Jersey, New York, Oregon, and Washington. Essentially, these states have prohibited the name rather than the practice, deeming the procedure “acupuncture,” which must be performed by a licensed acupuncturist—not a physical therapist or chiropractor.
People in pain care little about professional boundaries or the dividing lines between Eastern and Western medicine. It only becomes relevant because Western modalities are often covered by health insurance, while Eastern-based practices typically are not. Eastern medicine-based acupuncturists have a lot to lose when mainstream Western practitioners start to practice a similar technique.
The Piercing Psychological Toll of Back Pain
Perhaps one of the most disturbing parts of back pain is the psychological toll it can take on us. Seventy-two percent of chronic back pain sufferers report feelings of sadness, worthlessness, or hopelessness that have interfered with their lives. They experience other psychological distress as well, including anger and depression. As an added insult, depression can make chronic pain worse, creating a vicious cycle.
For roughly 85 percent of back pain sufferers, pain is “non-specific”—meaning the cause is unknown. The pain is real and frustrating, but there’s no obvious issue to repair. Finding a practitioner you trust to perform dry needling and possibly unlock the secrets that may be hidden deep in the muscles may be just what you need to finally move the needle on your back pain.
What You Need to Know About Dry Needling
If you’re ready to try dry needling for back pain, here are some things to keep in mind:
- There are multiple reported benefits. According to Johnson, the benefits of dry needling include “increased blood flow to treatment location, decreased tissue banding of treated tissue, biochemical changes to the treated tissue, and decreased spontaneous electrical activity of the treated tissue which is correlated to improved pain pressure thresholds in the tissue.” As with many treatments, your results will vary based on a number of personal factors.
- You’ll need to find a trained practitioner. In the U.S., dry needling is performed by physical therapists and chiropractors. You can call practices in your area and inquire about credentials, which typically require 54 hours of specialized training on top of a professional license in most states.
- Dry needling is minimally-invasive, but it’s not without risk. According to Johnson, dry needling is generally a safe and effective pain-reducing tool, but “there can be side effects, including needle insertion pain, muscle soreness, fatigue or bruising.”
- It’s hard to gauge the overall effectiveness of dry needling from a scientific perspective. Large, double-blind, placebo-controlled studies are required to determine if a treatment is truly effective. However, they require participants to be given a placebo or “sham” treatment without knowing it, which is hard to do when you’re dealing with needles that are designed to create an involuntary muscle movement. That’s hard to fake. The best we can say of dry needling is that evidence exists that suggests it may be better than no treatment, sham treatment, and other treatments in reducing pain.
- Dry needling for back pain will likely be part of a larger treatment regimen. While approaches to back pain treatment will differ by practitioner, Johnson says, “Dry needling is a small part of a comprehensive physical therapy program and when combined with other therapeutic techniques, including joint or soft tissue mobilization, stretching, and strengthening exercises.”
- by Jessica Baron