Piercing the Pain:

Exploring the Benefits of Dry Needling Therapy with Neurological Issues

By now you’ve probably all heard about dry needling. It’s kind of like acupuncture, but not really. Same needles, different application, sometimes combined with the use of electrical stimulation depending on the goal of the treatment. The site of the needle application can affect local tissues, affect messaging at spinal cord level, and/or affect someone systemically by affecting signals to the brain. Dry needling has been shown to help with pain management, muscle activation, improving range of motion, and scar management with musculoskeletal issues and spinal radiculopathy. But what about utilizing this modality to treat neurological issues, such as those that present post stroke, with Parkinson’s, with Cerebral Palsy, or with Multiple sclerosis? Many people that suffer from these conditions have pain or mobility limitations due to spasticity or low muscle tone. 

Well we have good news. When it comes to reducing pain and spasticity, dry needling can help! Studies have shown that when needles are applied to the target muscle until a twitch is produced it causes a local stretch of the spastic muscle and afferent modulation of the reflex arc that decreases the excitability of the alpha motor neuron. Basically, it calms down the overactive nerve allowing for improved range of motion and increased function. These effects are further increased when the needles are applied in conjunction with use of electrical stimulation. Dry needling can also reduce the number of spasms people experience throughout the day, improving quality of life, as well as function. It has also been shown to improve dynamic stability, walking velocity, and self-independence in multiple studies of people of varying neurological conditions. These effects have been reproduced in studies of people post stroke, with multiple sclerosis, incomplete spinal cord injuries, cerebral palsy, and traumatic brain injuries. 

The caveat here that we need to mention however, is that in the studies that assessed functional improvements the participants were receiving physical and/or occupational therapy in conjunction with the dry needling. The participants in said studies did show greater improvements in functional testing when it was combined with dry needling versus the control groups receiving therapy only. Also, most studies that showed benefits of utilizing dry needling also stated that multiple sessions were required to produce a significant difference versus one session of dry needling. Dry needling is less costly, less time consuming, and takes up less space than many other modalities that can be used for neurological rehab so it stands to reason that it would be a worthwhile adjunct to traditional functional training interventions. 

Now what are the risks? The risks are no greater for someone dealing with a neurological condition versus someone seeking treatment for a musculoskeletal condition. Typical side effects are bruising or bleeding at the needle site and pain at the needle site (which typically resolves within 24 hrs). It would be contraindicated to utilize this modality if the person affected had cognitive impairment or was combative, had a true phobia of needles, or their immune system was also compromised for some reason. Sometimes people experience presyncopal symptoms, syncope, or have an infection at the needle sit, but these instances are very rare.  If you are being treated by a qualified therapist they will be able to provide a central nervous system and/or a cardiovascular system assessment in the event that someone is symptomatic after treatment. A thorough past medical history and interview would typically be enough to determine if the person was a good candidate for dry needling and if there were any contraindications or precautions that needed to be addressed. 

While further research is needed on this topic there is currently moderate evidence to suggest that dry needling has significant benefits when utilized in conjunction with functional training for those with neurological conditions. If the person was unable or unwilling to participate in therapeutic functional training, dry needling could still be advantageous to reduce pain, muscle spasm, and spasticity. Either way it seems that a person’s quality of life can be improved through use of this modality with minimal risk for negative outcomes. 

If you are experiencing any of these symptoms or have a friend or family member who is dealing with one of these conditions, but has not had relief through other therapies we recommend getting a thorough evaluation from a qualified physical or occupational therapist. Make sure they are certified in dry needling and be prepared with any questions you may have. As always, Clash is always here to answer them as well! 

Sources:

• Li, Ling-Xin1; Zhang, Ming-Ming2; Zhang, Yin1; He, Jing1,*. Acupuncture for cerebral palsy: a meta-analysis of randomized controlled trials. Neural Regeneration Research: June 2018 - Volume 13 - Issue 6 - p 1107-1117 doi: 10.4103/1673-5374.233455
• Surya, Nirmal & Ramamurthy, Guhan. (2022). Dry needling in stroke. Exploration of Neuroprotective Therapy. 2. 10.37349/ent.2022.00016. 
• Surya, Nirmal & Ramamurthy, Guhan. (2022). The Emergence of Dry Needling in Stroke Rehabilitation. 
• Pérez-Trujillo, María & González-Platas, Montserrat & Pérez-Martín, María & Revert-Gironés, María & Gonzalez-Platas, Javier. (2021). Dry needling for treating spasticity in multiple sclerosis. Journal of Physical Therapy Science. 33. 505-510. 10.1589/jpts.33.505. 
• Brandín-de la Cruz N, Calvo S, Rodríguez-Blanco C, Herrero P, Bravo-Esteban E. Effects of dry needling on gait and muscle tone in Parkinson’s disease: a randomized clinical trial. Acupuncture in Medicine. 2022;40(1):3-12. doi:10.1177/09645284211039232
• Del Pilar Pérez-Trujillo M, González-Platas M, Pérez-Martín MY, Revert-Gironés MC, González-Platas J. Dry needling for treating spasticity in multiple sclerosis. J Phys Ther Sci. 2021 Jul;33(7):505-510. doi: 10.1589/jpts.33.505. Epub 2021 Jul 1. PMID: 34219954; PMCID: PMC8245259.
• Sánchez Milá, Zacarías & Salom-Moreno, Jaime & Fernández-de-Las-Peñas, César. (2018). Effects of Dry Needling on Post-Stroke Spasticity, Motor Function and Stability Limits: A Randomised Clinical Trial. Acupuncture in Medicine. 36. acupmed-2017. 10.1136/acupmed-2017-011568.