I was a 26-year old wide-eyed, green-horn physical therapy student on clinical rotation at Keesler Air Force Base in Biloxi, Mississippi. A patient came into our clinic with stubborn shoulder pain that had been unsuccessfully treated over the past several years. My clinical instructor pulled out a long, thin needle & inserted it into the patient\u2019s posterior deltoid (back of shoulder) causing the patient’s muscle to powerfully twitch \u2013 something I had never seen or heard of in my schooling! The patient sat up, half startled, half excited & to his surprise moved his arm freely with no pain. \u201cNot bad\u2026\u201d I thought to myself.<\/p>\n\n\n\n

Since the great state of Idaho allowed Functional Dry Needling (FDN) to be practiced at Physical Therapy clinics there has been a lot of confusion (understandably so) about what FDN is, what it does, and what sort of patient benefits most. This is my attempt to bring clarity to this interesting procedure. <\/p>\n\n\n\n

FDN is a progressive, orthopedic technique in which a very thin needle (similar to an acupuncture needle) is inserted into myofascial tissue, often at the site of a trigger point (a painful, neuromuscular \u201cknot\u201d). The inserted needle produces a neuromuscular twitch which facilitates a host of changes such as: <\/p>\n\n\n\n

• Reduction of pain & stiffness<\/li>
• Normalization of neuromuscular functioning<\/li>
• Changes to muscle & nervous system biochemistry. <\/li><\/ul>\n\n\n\n

  A common misconception is that this technique is similar to, or related to acupuncture. Although the needle is very similar to that used in acupuncture, the implementation & results are quite different. The needle is typically positioned much deeper into the soft tissue, eventually making contact with the underlying bone. Or it can be \u201cthreaded\u201d through the entirety of the myofascial tissue. After insertion, there are several ways to manipulate the tissue in order to achieve maximal effect. In “mechanical pistoning” the needle is physically moved up & down throughout the tissue to activate the telltale neuromuscular twitch. Another method is to apply electrical stimulation (as in the pic below) through the needle(s) so that the tissue experiences an exogenous rhythmic, heartbeat-like sensation.<\/p>\n\n\n\n

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