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Dry Needling For Knee Pain

How Dry Needling Helps With Joint Problems

Dry Needling for Knee Pain

November 9, 2019 By Alex Hirsch

Dry needling is a treatment used to relieve muscle pain due to trigger points or myofascial pain syndrome . Trigger points commonly develop due to overuse, lack of use, or trauma to the muscles in question. Dry needling can also help improve range of movement.

For patients suffering from sore joints, dry needling may be able to break you out of the cycle of pain occurring at the joint and improve your mobility. This is because joint problems due to arthritis, herniated discs, muscle or ligament strains, and more are often accompanied by muscle tension and muscle spasms.

Dry needling which causes knotted muscles to contract then relax loosens tight muscles, eases joint pain, and improves blood flow to the affected area. Orthopedic patients suffering from knee pain, shoulder pain, hip pain, and/or back pain have been successfully treated with dry needling.

A Typical Dry Needling Treatment For Knee Pain What Does It Feel Like

The good news about dry needling for knee pain is that it isnt exquisitely painful in the hands of a trained provider. Im not going to lie, dry needling is NOT COMPLETELY pain-free. Know that pain from dry needling isnt going to last a significant amount of time. Expect some pain, usually what feels like a post-workout muscle soreness, to last anywhere from 12 to 48 hours after treatment. Everyone has a different pain threshold and perception, and it often depends on how significant your knee pain is in the first place.

When youre having dry needling, your provider will target specific areas in the muscle called trigger points. Trigger points are pain producing taut bands of muscle fibers, and theyre the main finding in whats called myofascial pain syndrome.

For more on myofascial pain syndrome check out this content where I discuss the topic > dry needling and knee pain.

After your provider stimulates a trigger point near the knee with a needle, the muscle will produce a muscle twitch response. This causes that muscle to involuntary twitch or spasm. What a strange feeling it can be when your muscle is twitching on its own, but the good news is that after the trigger point is dry needled the twitching will stop and your muscle will relax. This is part of the therapeutic effect of dry needling for knee pain and can sometimes be uncomfortable. The twitch response can also feel relieving though!

Dry Needling For Patellofemoral Pain

Dry needling is a type of therapy that can be used to treat patellofemoral pain. This therapy involves inserting a needle into the skin and muscles around the knee joint. This can help to release trigger points and reduce muscle tension. Dry needling can be an effective treatment for patellofemoral pain, but it is important to consult with a trained therapist before beginning this type of therapy.

Pain in the knee cap and front of the knee is a common term used to describe Patellofemoral Pain Syndrome. Runnin knee pain and stiffness, which can cause muscle spasms and limitations in how people can climb and descend stairs, kneel down on their knees, and perform other daily activities, can affect how people can perform those tasks. Chiropractic care, massage, and dry needling can help to improve the therapeutic effects of rest and specific knee exercises for runners suffering from runners knee pain. Athletes who used dry needling on their gluteus medius and quadratus lumborum muscles reported significant knee pain and performance improvement.

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Dry Needling Vs Opioid Use

Compared to opioid pain medication, dry needling is a safe and effective alternative to controlling musculoskeletal pain especially in chronic pain patients. Opioids have a long list of side effects and can lead to spiraling dependencies.

Opioids work by binding to receptors in the brain and body, however, there are limits to the number of receptors that can be utilized. Once every receptor has something bound to it, any additional increase in dosage has no effect. Steadily increasing the dosage level means that the medication is not working and other options need to be explored.

Studies have found longer relief of pain is best managed through dry needling as compared to wet needling and medication. The use of dry needling is just one component in controlling pain. A skilled therapist will use needling to remove any painful trigger points but also direct the patient in a beneficial exercise program to continue to decrease and control pain.

The Link Between Myofascial Pain And Knee Osteoarthritis

Dry Needling: what it is &  how its helped my running injuries

A common treatment for extreme joint and muscle pain is known as trigger point injection. During these procedures, a patient is assessed for myofascial pain, which is characterized by:

  • Deep and aching muscles pain
  • Muscle pain that is persistent and doesnt get better
  • Tender, tense knots along muscles
  • Tense bands of muscles

Myofascial pain originates in the muscles due story medication, muscle relaxants or pain relievers, these medication injections are initially quite painful. However, following a spasm of the muscles, many patients with knee osteoarthritis experience relief from their knee pain. To practitioners of dry needling therapy, it is clear that trigger points play a large role in the stiffness, loss of motion and chronic pain of this knee disorder.

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The Costs Of Knee Osteoarthritis

There are over 100 forms of arthritis, and OA is the most common and most often leads to chronic disability. Costs associated with knee OA are very high considering treatments, adaptations in activity level and lost productivity at work. This painful disease affects millions of patients about 13% of women and 10% of men aged 60 years and older have symptomatic OA of the knee.

Dry Needling As An Alternative Treatment For Chronic Knee Pain

Osteoarthritis of the knee is a progressive disease common among the aging population and a leading cause of disability. It is typically categorized as excessive wear and tear, with symptoms including joint stiffness, joint swelling, limited range of motion, eventual lower extremity malalignment, and pain ranging from barely perceptible to debilitating.

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Is Dry Needling Safe

Dry needling therapy is safe and accompanied by very few precautions or contraindications. There is both research support and anecdotal evidence showing its effective use in the treatment of knee pain. Treatment time is relatively short, ranging from 10 to 30 minutes for each session. The cons are only slight discomfort during needle insertion, possible bruising, and the 4-12 weeks it takes to get results.

While no single treatment works for every patient dry needling may be right for you, especially if other options have not worked and you wish to postpone knee replacement surgery. For more information on dry needling from certified specialists, contact your local ProActive Physical Therapy clinic today!

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Dry Needling For Lateral Knee Pain

#DryNeedling #KneePain Dry Needling of VMO and Medial Patellofemoral Ligament for Bicyclist

Dry needling for lateral knee pain is an effective treatment option for many people. The needles used in this therapy are thin and inserted into the skin near the lateral knee pain. This helps to release trigger points and stimulate healing. Dry needling is often used in combination with other therapies, such as massage, to provide the best results.

Dry needling is becoming more popular among chiropractors and physical therapists as a result of a variety of orthopedic injuries. The specific nature of Lateral knee pain makes it easier to determine what is causing it. Youll need to do most of your dry needling above and below the knee to treat lateral knee pain. My dry needling treatment for knee pain lasted about 30 minutes. We will discuss how it feels right now, discuss the home exercise program I designed for you, and maybe even do some supportive therapies to help it feel better faster. We primarily target pain trigger points that are either causing or contributing to your pain. Dr. Jason Williams DC is a chiropractic physician who works out of AccessHealth in Cary, North Carolina. He uses acupuncture, dry needling, and other supportive therapies to treat neuromusculoskeletal pain. Dr. Williams specializes in treating athletes from the MMA, Muay Thai, and CrossFit communities, among others.

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Periosteal Electric Dry Needling For Knee Osteoarthritis: Effectiveness & Mechanisms

The current body of evidence strongly supports the use of needling therapy, i.e. acupuncture for treating the pain, stiffness and related-disability associated with knee OA.1-7 Zhang et al8 cited a 69% consensus following a Delphi study recommending the use of acupuncture for the symptomatic treatment of OA and reported a moderate effect size for this needling modality .


However, does stimulating a needle manually cause the same, or different, physiological effects than stimulating it electrically in patients with knee OA? A recent meta-analysis concluded electroacupuncture is superior to manual acupuncture for improving pain and function in patients with knee OA.9 Eleven RCTs with 695 participants were included. The meta-analysis indicated that electroacupuncture was more effective than pharmacological treatment and manual acupuncture for pain reduction and functional improvement in patients with knee OA. Likewise, in a secondary analysis that pooled data from the Manheimer et al Cochrane review,10 Langevin et al11 concluded that electroacupuncture was superior to manual acupuncture .11 Notably, this may be one reason why the Foster et al12 and Chen et al13 studies found unfavorable results when investigating the effects of manual acupuncture in knee OA.




  • Huang J, Zhuo LS, Wang YY, et al. . Zhen Ci Yan Jiu. 2007 32:115-118.
  • More Knee Replacement Recovery Tips

    The most important thing to do is to work with your therapist on a knee replacement pain management protocol. But there are also many things you can and should think about incorporating into your everyday practice.

    • Wear your knee brace if applicable

    • Keep your knee straight as much as possible

    • Exercise 20-30 minutes a few times a day

    • Walk 20-30 minutes a few times a day

    For people who did not have dry needling treatment for knee pain, doing these activities could be difficult. Your therapist will help set up a reasonable training regiment, and help you prepare for life after physical therapy.

    Its your knee. Being able to recover with minimal pain is the best way to get to where you feel like yourself again.

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    Is Dry Needling The Same As Acupuncture

    Although dry needling and acupuncture both involve the insertion of thin needles, they are completely different. One of our physical therapists here in Nashville, TN, Kevin Hovde, compares dry needling and acupuncture to “the difference between Western and Eastern medicine”. Dry needling is used to treat pain in the body by targeting trigger points, while acupuncture is based on Chinese medicine and is made to create balance and energy in the body.

    Dry Needling For Knee Pain: Risks And Benefits

    Dry Needling

    Dry needling is a type of therapy that involves inserting a thin needle into the skin to stimulate trigger points, or knots, that can form in muscles. This therapy is also sometimes called intramuscular manual therapy. Dry needling is used to treat a variety of conditions, including knee pain. This therapy can help to release knots that are causing pain and tension in the muscles around the knee. It can also help to improve blood flow and reduce inflammation. Dry needling is generally considered to be a safe and effective treatment for knee pain. However, as with any type of treatment, there are some risks involved. These risks include bruising, soreness, and bleeding. If you are considering dry needling for your knee pain, it is important to discuss the risks and benefits with your doctor or physical therapist.

    will examine the effects of dry needling on pain, muscle performance, and knee function in patients suffering from patellofemoral pain syndrome . To relax the muscle for pain relief, dry needling employs tiny, monofilament needles that are injected directly into the tissue and manipulated. A pain scale of 11 is used to rate pain on a scale of 0 10, with 0 being no pain and 10 being extreme pain. The pressure pain threshold is being used to assess pain sensitivity as well as the possibility of abnormal pain processing. The Isometric knee and hip peak torque will be measured to determine knee extension, knee flexion, hip abduction, and hip extension.

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    What Is Dry Needling

    Dry Needling is a technique used in physical therapy to treat musculoskeletal pain. This process involves sticking extremely thin needles into or around a trigger point to relieve pain and tension. It is called dry needling because there is no transmission of fluid or medicine when the needle is injected.

    How Does It Work

    To perform trigger point dry needling, your physical therapist must have the proper education and training as defined by state regulatory boards. Dry needling practice in Maryland is recognized to be within scope of the physical therapists practice.

    Dry needling is commonly connected with the traditional Chinese healing practice of acupuncture. Similarities between the two exist in terms of skin penetration with a thin filament needle for therapeutic benefits. Where they differ though is in the origin, philosophy, and theories.

    Acupuncture, performed by acupuncturists, is based on preserving the ancient theories and tenets of traditional Chinese medicine, while dry needling takes on a more modern, scientific approach.

    Dry needling, performed by physical therapists, is based on western neuroanatomy and modern scientific study of both the musculoskeletal and nervous systems. The physical therapists at 360 Physical Therapy & Wellness will perform dry needling in a series of carefully executed steps.

    First, the specific pain and trigger points will be identified by performing manual therapy techniques. Once identified, the needle is placed at the site of the identified trigger point. A plastic guide tube is then used help tap the needle in place. The guide tube is removed, and the needle is then inserted into the muscle tissue and surrounding fascia.

    Most patients can expect to see positive results from trigger point dry needling within four sessions.

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    Dry Needling And Post Knee Replacement Surgery Pain

    Earlier we talked about a study that suggests dry needling can help lessen post-surgery pain in total knee replacements. Fascinating, right?

    Heres what we know: the study observed 40 patients undergoing a total knee replacement. The 40 subjects were unknowingly randomized to a true dry needling group or to a sham group where the procedure mimicked a dry needling intervention, but was not true dry needling. Each of the participants were examined for myofascial trigger points by an experienced physical therapist 45 hours before surgery.

    Immediately following anesthesiology and before surgery started, subjects in the true group were dry needled in all previously diagnosed trigger points, while the sham group received no treatment in their myofascial trigger points. This is where it gets good. The results concluded that subjects in the true group had less pain after their surgery and showed significant differences in the need for immediate post-surgery opioids.

    So that begs the question, why isnt dry needling more commonly recommended to individuals undergoing a total knee arthroplasty? The answer is simple. Awareness!

    An Argument For Dry Needling To Treat Knee Pain

    Dry needling for knee pain and exercise after

    I would argue that in the majority of causes of knee pain, trying a conservative treatment such as dry needling is a good place to begin your journey to becoming pain-free. More invasive medical treatment for knee pain such as steroid injections, PRP or stem cell injections, surgery, and medications will be an option still if dry needling fails to relieve knee pain. However, if 75%-85% of musculoskeletal pain is related to trigger points as some scholars suggest, you may not need those more invasive treatments to relieve knee pain if you try dry needling first.

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    What Type Of Conditions Can Dry Needling Treat

    Dry needling is ideal for those who suffer from chronic, long-term pain caused by repeated stress or injury.

    However, dry needling therapy can also help people with acute pain brought on by transitory injury. Dry needling therapy is frequently sought after by those who have previously received manual physical therapy.

    When trying to relieve pain and stress, dry needling is frequently the next step if these therapies have failed.

    Numerous ailments can benefit from this type of physical therapy needling, including:

    Chronic or long-term painAchilles tendonitisHeadaches and migraines

    Dry needling is suggested as a supplemental therapy to other conventional therapies for people who require intensive physical therapy.

    Dry Needling Augments Conventional Treatments To Runners Knee

    In a study published in the Archives of Physical Medicine and Rehabilitation, it was demonstrated that dry needling applied to the gluteus medius and quadratus lumborum muscles of female athletes substantially affected their knee pain and performance in comparison to those that only received rest and rehabilitation exercises.

    In the study, two groups of female athletes that experienced patellofemoral pain syndrome received 4 weeks of exercise therapy to specifically address their runners knee symptoms, but one of the groups received dry needling treatment to the gluteus medius and quadratus lumborum muscles. All of the participants demonstrated improvements in pain and function throughout the study, but the athletes that also received dry needling, showed significantly greater improvements in pain, function, and pressure point tenderness.

    The evidence from this study clearly shows the importance of rehabilitation exercises and proper medical care for runners knee. Additionally, this study highlights the compounding effect of incorporating dry needling treatment sessions for pain relief with runners knee.

    Whether you are an athlete or not, when knee pain is present, there are specific treatment options that have been proven to help reduce pain, and inflammation. The doctors at Synergy Chiropractic of Houston are able to help you overcome your pain, and return to optimal function. Do you experience runners knee? We can help!

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