Dry Needling is a needling technique derived from wet Needling, where solutions like botox or saline were injected to treat painful conditions. They discovered that pain also diminished without the solutions. Since then Dry Needling is used in pain conditions based on myofascial triggerpoint involvement.
Dry Needling is based on the theory of myofascial triggerpoints. A Myofascial Triggerpoint (MTrP) is a hypersensitive knot in a striated muscle related to palpable tight fibres in the same muscle. Pressure on the points provokes specific (referred) pain patterns. Since the first description of MtrP and it’s patterns by Travell and Simons [1,2], knowledge has evaluated during the past decade. Visualisation techniques like 2D or 3D and magneticresonance elastography made it possilbe to identify MTrP’s. Research shows a relationship between the size of the MTrP and the level of experienced pain. Advanced knowledge makes it possible to define more specific the characteristics of myofascial pain which clearly are distinct from other types of pain.  The deactivation of MTrP demands a specified technique called Dry Needling. A local twitch response can be made visible by echo:
1.Simons DG, Travell J. Myofascial Pain and Dysfunction − The Trigger Point Manual − Volume 1. Upper Half of Body. Second Edition. Baltimore: Williams & Wilkins, 1999.
2.Travell JG, Simons DG. Myofascial Pain and Dysfunction: the Trigger Point Manual − Vol.2: The Lower Extremities. Baltimore: Williams & Wilkins, 1992.
3.Graven-Nielsen T, Arendt-Nielsen L, Mense S. Fundamentals of musculoskeletal pain. IASP Press, 2008: 1- 496
Dry Needling requires a specific technique: An active or painful triggerpoint is punctured and stimulated to obtain a local twitch response ( a contraction within a sensitive taut band of muscle fibres). The aim is to release the active trigger point i.e. cause it to relax.Needles
Length range: 30-70mm
Diameter range: 0,25-0,30mm
In general counts:
• A 30mm long and 0.18mm to 0.22mm gauge diameter is used in the face, neck, hands, and feet, as those areas are more sensitive.
• A 50mm to 70mm and 0.30mm gauge needle is used for the gluteal region in most patients.
• A 30mm and 0.25mm to 0.30mm gauge needle is generally used everywhere else.