Dry needling has become a common modality used in physiotherapy and osteopathy clinics and for good reason. When it is used well, alongside exercise and manual therapy it can help to break the cycle of muscle tension, pain and restricted movement that affects people’s everyday function and ability to complete the activities they enjoy.
A Patient Example
One of my recent patients came to clinic presenting with persistent neck pain and tightness that was causing headaches – Cervical neuralgia with Cervicogenic headaches being the official diagnosis. They had permanent tightness in the neck which was significantly affecting their ability to move their neck and headaches were a near daily occurrence. Their pain meant they were unable to complete the 2 things they loved, yoga and swimming.
Their treatment plan combined three elements: dry needling into the tight areas of the upper-shoulder/neck muscles, soft tissues work to reduce muscle guarding and a graded exercises programme to rebuild strength and mobility in the neck and upper back.
Over the course of treatment they reported noticeably less tension through the neck, a reduction in overall pain and the headaches stopped altogether. With symptoms under control they were able to return to both swimming and yoga, the two activities their neck pain had taken away from them.
What the research says
This kind of combined approach is aligned with current evidence. The results from a randomised controlled trial following patients with cervicogenic headaches mirrored my anecdotal findings. Patients were split into 3 groups for comparison: 1. conventional physical therapy 2. physical therapy with dry needling and 3. Physical therapy with a sham dry needling method. They found that dry needling has a positive effect on pain and disability reduction.
A large 2021 systematic review and meta-analysis looked at the results of multiple trials that researched the effects of dry needling for tension-type, cervicogenic and migraine headaches. This concluded that the technique is a viable option worth considering as a part of a broader treatment plan. A more recent study went a step further, finding that while both conventional physiotherapy and physiotherapy combined with dry needling significantly reduced pain and pain-related disability in patients with cervicogenic headaches, the group who received dry-needling achieved better overall outcomes.
We have to acknowledge the limits when it comes to research and applying the findings. Some of the evidence has statistical significance that is low to moderate, others can only conclude on short-term improvements. More research is needed to strengthen the findings however, it is clear that dry needling combined with physiotherapy does appear to reduce symptoms in patients with neck pain.
The takeaway
Dry needling isn’t a stand alone miracle treatment that will fix the problem and research is clear about that. However, when used as a part of a comprehensive treatment programme it supports pain reduction and a decrease in pain-related disability. As mentioned above there is reasonable evidence for this and it has matched what we saw clinically with this patient. We can expect less tension, more movement and a genuine return to the activities that matter you! If you have pain that is holding you back from the things you enjoy, get in touch and we can discuss whether dry needling and a tailored treatment programme is the right fit for you.
