Dry Needling: The Most Painful Thing I’ve Ever Loved

By AshleyJane Kneeland, Special to Everyday Health

Imagine you have pockets of a highly pressurized, toxic gas caught in your shoulders. Now imagine these painful pockets keep growing in size, every hour of the day, inflaming your muscles and pinching your nerves. And, as a result you’re miserable — grasping to keep your sanity.

Then imagine you find a medical professional willing to puncture your skin and release all that painful pressure — after which some soreness remains, although it's nothing compared to the blessed relief you’re now feeling.

That procedure, dry needling, is what works best for me and the painful spasms that course through my shoulders. The needles deflate my muscle spasms, which feels like air rushing out of an overfilled balloon. It is, without a doubt, the most painful thing I've ever loved.

Prior to my relationship with dry needling, I had an on-again-off-again fling with trigger point injections. These injections provided six to eight weeks of relief. But the liquid injected contains a steroid, so the injections weren't a viable long-term plan. Because what I’m dealing with is a long-term problem, my shoulders and I moved on to dry needling, which involves no injections, just a bit of brutal poking.

Three Illnesses, All Causing Pain

A person must be pretty desperate to continually pursue such sharp methods of treatment, right?  My despair stems from three illnesses that overlap each other in a Venn diagram kind of way. I made this diagram (left) to show how my lupus, fibromyalgia, and postural orthostatic tachycardia syndrome (POTS) symptoms overlap.

As a kid, I lived with chronic head and body aches. Assuming I was just wimpy and couldn't handle the daily pressures of life, I carried ibuprofen around in my backpack and prayed for a morning math class, before the pain made it hard to concentrate.  I played sports (not very well), competed in mock trials (deciding my true calling in life must be something involving dress suits and heels), and served as a U.S. Senate page (my crowning achievement, which I compulsively must mention when discussing the earlier years of my life). Chances are by now my fiancé and his daughter assume this part of my life is some kind of  “Big Fish” story, but I swear, I really was Head Page. Twice. Which is one more than the number of friends I had.

Throughout all this I continued my reckless reliance on ibuprofen, which most definitely, explains why doctors later found three bleeding holes in my stomach. Then, during my senior year of college, extreme fatigue kicked in and I was no longer able to physically get myself to classes. In the 10 years since then, I’ve also experienced mouth and vulvar ulcers, joint stiffness, migraines, severe GI cramping, tachycardia, and an infuriating intolerance to regular amounts of daily activity.

Why I Tried Dry Needling

What brought me to dry needling were muscle spasms in my neck and shoulders. Creams, patches, muscle relaxers, opiates and heated pool therapy sometimes help, at least temporarily; but new spasms are always appearing, seemingly triggered by everything and nothing at the same time. Of all of the treatments I've tried, dry needling has been the most effective.

The procedure goes a little something like this: After I lie down on a massage table, my physical therapy doctor inserts a thin-filament needle directly into the muscle that is currently tight or spasming. Then she jiggles the needle up and down until my muscle responds with a twitch. The purpose of this twitch is to disrupt the “neurological feedback loop” that keeps the muscle in a contracted state of pain. It’s almost like the spasm is treated with another spasm. However, this intentional spasm results in a release of pressure.

(Dry needling uses needles similar in size to the needles used for acupuncture treatments but, unlike acupuncture, dry needling is not a traditional Chinese medicine technique. Instead of inserting needles into the "energetic pathways" defined by traditional Chinese medicine, dry needling practitioners insert them directly into the muscles and nerve pathways causing the pain.)

In addition to muscle spasms like mine, dry needling has been used to treat conditions including headaches, lower back pain, sciatic pain, temporomandibular joint dysfunction (TMJ), and tendonitis. Dry needling hurts, but for me the hurt is worth it. Naturally, the amount of pain varies involved in the procedure varies for different people and their trigger points. Because the knots in my shoulders are so severe, I find dry needling extremely painful. I walk out of the office feeling like my nerve endings have been cut and exposed to air. A few hours later, that sensation passes, and my shoulders are noticeably more relaxed. Over time — two appointments a week for six weeks — most of my spasms, and their resulting headaches, fade away.

6 Things I've Learned About Dry Needling

Being desperate for pain relief, I've tried many things over the years. I recommend dry needling because, despite the discomfort, it produces long-lasting results. If you have severe pain and want a pleasant experience, get a massage. If you want results, commit to dry needling. Here are six things I've learned:

  1. Schedule medications wisely. If you take Tylenol (or something stronger) at regular intervals, schedule a dosage for right before your appointment. I find the less I’m clenching my muscles, the more effective those helpful “twitches” are.
  2. Keep it loose. After your appointment, resist the urge to curl into a ball like an overwhelmed hedgehog. The more you move around, the looser you will be, and the quicker the pain will dissipate.
  3. Find a physical therapist who is good at the procedure.  After shopping around, I was able to find a physical therapy practice that accepts my insurance and bills dry needling a specific way so that my insurance covers it in full. Don’t give up just because one practice tells you it isn't covered. (Not all physical therapists can practice dry needling because PT license requirements vary from state to state, and the technique is not yet fully accepted. MDs, DOs, and acupuncturists can practice dry needling, but many are not trained.)
  4. Plan your outfit accordingly. My particular impairment favors tube tops layered under a zip-up or button-down shirt.  My outfit choice allows for easy access to my shoulders, and makes it easier to get dressed after the appointment.
  5. Follow your doctor or therapist's orders. Be diligent with the daily stretches your physical therapist assigns. These exercises can make the effects of dry needling last longer. Be gentle when exercising. Stretching aggressively can make things worse.
  6. Make dry needling work for you, not against you.  It’s okay to say, “I only want four needles today.”  If you overdo it, your body will burn out, the pain will be overwhelming, and the process won’t be effective.

Ashley Jane Kneeland, 32, lives in New Hampshire with her fiancé and his daughter.  She works part-time as a bookkeeper and substitute teacher. She is the author of an Amazon Kindle book entitled, Living Incurably Despite Chronic Illness. You can follow her on Twitter and Instagram.

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