What is dry needling?
Dry needling is a procedure in which a sterile, disposable, solid filament needle is inserted into the skin and muscle directly at a myofascial trigger point. A myofascial trigger point consists of multiple muscle contraction “knots,” which initiate and often chronically perpetuate the cycle of pain.

What type of problems can be treated with dry needling?
Dry needling can be used for a variety of muscle problems. Muscles and fascia (a connective tissue that is all over the body)  are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headaches  (including migraines and tension type headaches), jaw pain, buttock pain and leg pain (sciatica, hamstring strains, calf tightness/ spasms), sports injuries, and chronic tightness or tension in an area that you can’t seem to get rid of. The treatment of muscles and fascia has the greatest effect on reducing pain that manifests in the nervous system.

Is Dry Needling the same thing as acupuncture?
No.  The dry needling approach is based on the western medicine anatomy & physiology principles, which are not to be confused with the eastern Traditional Chinese Medicine technique of acupuncture. Dry needling is a technique for muscle dysfunction and trigger points, whereas acupuncture can work on organs and systems in the body, while also re-directing chi energy through the body. Dr. Lassiter has the utmost respect for acupuncture and considers it a very valuable health care service.  We refer patients to an acupuncturist if we feel that they will be better served by one.  The only thing dry needling and acupuncture have in common is the choice of tool (they both use the same needle).

How does dry needling work?
The exact mechanisms of dry needling are not known. There are mechanical and biochemical effects. Based on studies by Dr. Jay Shah and colleagues at the National Institutes of Health (NIH), we know that inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. The needle also acts as a direct mechanical disruptor to the pain and muscle contraction that occurs from a trigger point.  It is desirable, but not essential, to elicit a “local twitch response,” which is a spinal cord reflex.  The latent twitch response feels like a muscle that’s grabbing around the needle.  The local twitch response usually occurs with active trigger points, but may or may not occur with passive trigger points.  The local twitch response often won’t occur at all with latent trigger points.

Are the needles sterile?
Yes, only sterile needles are used. Each needle that is used at every visit is brand new.  It is taken out of the package at the time of treatment and disposed of directly after.

Is the procedure painful?
Most patients do not feel the insertion of the needle because they are so tiny. The local twitch response elicits a very quick contraction spark. Others feel it more like a cramping sensation around the needle or a deep ache. The therapeutic effect of the local twitch response is a good and desirable reaction, but it’s not imperative to have the twitch response.

What does dry needling feel like? 
During treatment, patients may experience heaviness in the limbs or a pleasant, relaxing feeling. The benefits of dry needling frequently include more than just relief from a particular condition.

What side effects can I expect after the treatment?
Many patients report being sore after the procedure. The soreness is described as muscle soreness over the treated area and it may continue into the area of referred symptoms. Typically, the soreness lasts between a few hours and two days. Some people experience a heaviness in the area that dissipates over a few hours (may take up to a day).

How long does it take for the procedure to work?
Typically, it takes several visits for a positive reaction to take place. However, many people report a very fast response and considerable relief within a day or two of the treatment.  Again, we are trying to cause mechanical and biochemical changes without the use of any pharmacological drugs (such as cortisone or NSAID’s). Therefore, we are looking for a cumulative response in order to reach a certain threshold, after which the pain cycle will be disrupted.

Once I am feeling better, how often do I need to come back to maintain my progress?
The musculo-skeletal system is under constant pressure from gravity, stress, work, exercise, poor posture, etc.  After treatment, a regular exercise program combined with good posture can prevent many problems from coming back. If the pain comes back, “tune-ups” are recommended to treat and prevent the problem from becoming more severe.

Why is my M.D. not familiar with dry needling?
In the US, dry needling is a relatively new method for treating myofascial pain; not everyone is aware of this effective modality. Often, MD’s will use medicines to treat the symptoms that develop from these myofascial trigger points, but the dry needling procedure is not used to just get rid of the symptoms.  It’s designed to break the cycle from continuing, directly at the source of the problem. Feel free to inform your doctor about this treatment option, to suggest that they Google the procedure, or to suggest that they visit our site for more information on the procedure.

Where does dry needling fit in the entire rehabilitation program?
Dry needling is one of the modality choices that Dr. Lassiter uses in his office to treat patients. He does not use it on every patient that seeks care in his office (it is used on approximately 10-20% of the patients seeking care in his office). Anyone who has a fear of needles or, for whatever reason, does not want the dry needling therapy, will not have the procedure performed. Often, if he chooses to do dry needling, it will be used in the beginning of a treatment program in order to break the pain cycle and reduce chronic muscle trigger point contraction. It is also used if someone is not responding well enough to other techniques or if they have plateaued in their rehabilitation. There are many therapies used in his office and this is just one of the options.


For more information to find out how dry needling may help you, call Dr. Milan Lassiter at (804) 254-5765.

Our office is located at 1303 W. Main St, Richmond VA 23220. We are located near VCU and MCV Hospital in the fan district of Richmond.