Why did dry needling make my pain worse?

Answered by Phillip Nicastro

Dry needling is a therapeutic technique that involves the insertion of thin needles into trigger points in muscles, tendons, or ligaments to relieve pain and improve muscle function. While it can be an effective treatment for many people, it is not uncommon for individuals to experience an increase in pain following a dry needling session. This phenomenon is often referred to as post-needling soreness.

There are several reasons why dry needling may temporarily worsen pain. Firstly, the needle insertion itself can cause tissue damage. When the needle is inserted into the trigger point, it can create micro-tears in the muscle fibers, leading to temporary inflammation and an increase in pain. This inflammatory response is a natural part of the body’s healing process, but it can result in discomfort and soreness in the days following the treatment.

Additionally, dry needling can cause a local hemorrhagic response, which means that small blood vessels in the area may be punctured by the needle. This can result in localized bleeding and the release of chemicals that contribute to the inflammatory response. The presence of blood in the muscle tissue can also cause irritation and sensitivity, leading to increased pain.

Furthermore, dry needling stimulates the nervous system by targeting trigger points, which are hyperirritable spots within a muscle. These trigger points are often associated with increased muscle tension and pain. When a needle is inserted into a trigger point, it can elicit a strong sensory response, including pain, which may temporarily exacerbate symptoms.

It is important to note that post-needling soreness is typically a transient side effect and should resolve within a few days. It is not uncommon for individuals to experience an initial increase in pain before experiencing a decrease in symptoms and improved muscle function. However, if the pain persists or worsens significantly, it is advisable to consult with a healthcare professional to rule out any complications or underlying conditions.

In my personal experience as a healthcare provider, I have seen patients who initially reported increased pain following dry needling sessions. However, in most cases, this was followed by a reduction in symptoms and an overall improvement in their condition. It is important to communicate any concerns or unexpected reactions to your healthcare provider so that appropriate adjustments can be made to your treatment plan.

To manage post-needling soreness and minimize discomfort, there are a few strategies that can be helpful. Applying ice or a cold pack to the treated area for short periods can help reduce inflammation and numb the area, providing temporary pain relief. Gentle stretching exercises and heat therapy can also be beneficial in relieving muscle tension and promoting healing. It is crucial to follow any instructions or recommendations provided by your healthcare provider to ensure a safe and successful recovery.

Post-needling soreness is a common and temporary side effect of dry needling. The pain experienced after a session is primarily due to tissue damage, local bleeding, inflammatory response, and stimulation of the nervous system. While the initial increase in pain can be concerning, it is often followed by a reduction in symptoms and improved muscle function. It is important to communicate any concerns with your healthcare provider and follow their guidance for proper management of post-needling soreness.