Explanation of each Dry Needling Technique


Written on
May 15, 2024
Dr. Don C. Dequine Jr. PT, DPT, CSCS

Dry Needling is opposite to that of “Wet Needling” in that a “Dry” needle is thin whereas a “Wet” needle is large. The “Wet” needle passes synthetic (*now, non-synthetic: PRP, BMC, Etc.) pain reducing liquids, hence the need for a larger gauge. “Dry” needles are much less invasive and promote endogenous (from the inside) pain reducers and tissue healing. Before invasive, try less invasive ways to reduce pain and promote tissue healing. Here are a few Dry Needling Techniques that can be administered by a physical therapist or chiropractor, certified in Dry Needling:  

  1. Trigger Point - We all have them! “Active” trigger points are muscles producing pain locally or somewhere else “down the chain.” “Latent” trigger points are in muscles and found when pushed on, not otherwise apparent. Pistoning, threading, and fanning are varying techniques that help release active and latent trigger points. The next time you wish someone would stick their thumb into your muscle, consider trigger point dry needling! Best for individuals experiencing insidious (out of nowhere) pain, headaches, or muscle aches.  
  2. Deep - This can be a form of Trigger Point but also includes bone, ligament, tendon, and cartilage. Simply, the needle goes deeper than the skin.
  3. Superficial - This technique is used to alter the signals sent to the brain. The needles are inserted extremely shallowly into the skin and not into muscle or bone. Literature suggests that the sensation of the needle drowns out the pain in the area, similar to a TENS unit or E-stim.
  4. Perineural - Multiple needles are inserted into the area of peripheral nerves and are often connected to an E-stim unit. Substance-P and CGRG are released to reduce pain and promote tissue healing and remodeling. It is used often in chronic pain and headaches.
  5. Periosteal Pecking - The needle will “peck” at the bone to promote healing. It is often used for headaches, tennis elbow, plantar fasciitis, and knee arthritis.

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