What is dry needling (DN) therapy?
(1) Local effects of needling
Dry needling lesions in the soft tissue is a therapeutic modality for soft tissue dysfunction. Soft tissue dysfunction involves soft tissue injuries including tissue inflammation, sensitized nerve tissue, scar tissue formation, tissue adhesion, and deficiency of blood and lymphatic circulation. The process of inserting a needle starts with puncturing the skin, and then involves physical stretching the tissues (down and up, and/or rotation movement of needle shaft), which creates lesions in the soft tissue. When the needle is removed, the lesions remain for a few days. Needling process thus provides both physical (tissue stretching) and biochemical (lesions) stimuli. This lesion-induced process activates physiological mechanisms of remodeling of injured and inflamed soft tissues in and around the needling site. The, tissue remodeling process includes (1) local physical stress reduction (tissue tension) and (2) normalizing local inflammation, and (3) replacement of injured tissues with fresh tissues of the same type.
(2) Systemic effects of needling
Each needling process is invasive and creates both local and systemic effects — the restoration of both local tissue homeostasis* (tissue remodeling of injured tissues) and systemic homeostasis. Restoration of systemic homeostasis involves reducing both physical and physiological stress. Physical stress means muscular , which creates biomechanical imbalance such as joint and posture imbalance. Physiological stress may include local physiological dysfunction (inflammation, tissue ischemia, etc.) and all body systems like immune, cardiovascular, endocrine, and all others. Simple insertion of an invasive needle creates both local and systemic therapeutic effects.
(3) Non-specific pathophysiologic feature of needling:
It is important to understand that needling itself does not treat any specific disease, but may restore tissue homeostasis, during which the process of biological self-healing and self-repair physiology-mechanisms are activated. After needling many pathological conditions can be improved, including joint biomechanics. Thus, needling is a non-specific therapy.