Peppering needling is a Dry Needling technique closely related to and originated from Wet Needling. In tendinopathy peppering( moving the needle up and down and thus pricking the tendon to make it bleed) needling is often used to induce the procedure of autologous blood injections. There are indications that the procedure in itself induces therapeutic effects.
The Dry Needling in which the needle repeatedly passes through the tendon to disrupt the fibres and induce bleeding. It injures the tendon in such a way that it triggers the healing process in the tendon. It enhances blood flow. And calms inflammation.
The Dry Needling technique is described in the literature in preceding the Wet Needling of Autologous blood in tendons. The peppering or moving up and down rapidly of the needle to disrupt the tendon can be used as a needling technique in itself for tendinopathy.
From the NICE Guideline IPG438:
A variable amount of blood is withdrawn from the patient by standard venesection. Sometimes the blood is centrifuged to produce a platelet-rich sample. About 2–3 ml of whole blood or platelet-rich plasma is injected into and around the damaged tendon, sometimes with ultrasound guidance. Local anaesthetic is usually used. ‘Dry needling’ (repeatedly passing a needle through the tendon to disrupt the fibres and induce bleeding) may be performed before injection of the blood. A ‘peppering’ technique is sometimes used to inject the autologous blood; this involves inserting the needle into the tendon, injecting some of the blood, withdrawing without emerging from the skin, slightly redirecting and reinserting. After the procedure, patients are usually advised to avoid strenuous or excessive use of the tendon for a few weeks, after which physiotherapy is started. The procedure may be repeated if needed.Needles
Length range: 30-60mm
Diameter range: 0,25-0,30mm