Ultrasound-Guided Dry Needling

What is Ultrasound-Guided Dry Needling?

“Dry needling” is the process of inserting a hypodermic needle into the body without injecting any substance. Some clinicians also refer to using an acupuncture needle in a tight muscle for tension release as dry needling. The key difference is that an acupuncture needle is a much thinner gauge needle, does not tend to cause any trauma to the tissue and tends to be inserted into the muscle belly away from the tendon. In dry needling to treat a tendon problem, we use an ultrasound scanner to identify the damaged tendon tissue that we wish to treat and then while imaging in real-time, we guide the needle to the affected tendon segment, disrupt tissue degeneration and stimulate healing. The process is very accurate and more likely to be successful. 

The information below tells you what is involved and what the possible risks are of having Ultrasound-Guided Dry Needling. It may not answer all your questions, so if you have any queries or concerns, please do not hesitate to contact us.

Why should I consider this procedure?

If you have a tendon problem that is very painful and limits your mobility or function and does not seem to be getting better then this is a treatment option for you. When a tendon stops getting better despite you being diligent with your exercise routine, it may mean that the tendon needs to be encouraged to create an inflammatory response to help it heal faster. The idea by passing the needle into the damaged tissue is to create low-grade trauma which will help stimulate the inflammatory response and kickstart the healing again. You should only consider this procedure if you have followed your clinician’s advice regarding exercise therapy and you have reached a plateau or have not progressed as expected. 

At the appointment:

The clinician will first perform an ultrasound scan to assess the condition again and to ensure this procedure is still indicated. They will use ultrasound to locate the precise part of the tendon to be dry needled.

We use a sterile ‘no touch” technique to insert a fine needle into the part of the damaged tendon causing the pain and pass it through the area several times.  This can be uncomfortable but it only lasts a short period of time.

It’s best to take it easy on the area for the next few days after the procedure to allow the body to start to heal again. It’s important to remember that we are trying to stimulate an inflammatory response so the use of anti-inflammatory medications should be avoided to allow that essential first step in the tissue healing process. This means it may feel aggravated initially after the procedure before it starts to feel better again. 

Risks of the Procedure:

Ultrasound-Guided Dry Needling is a common procedure that has little risk.

As with any injection into the body, there is always a risk of infection. This is extremely rare across all injections administered in all healthcare settings. Around 1:50,000 patients may get an infection according to the literature following an injection procedure. The risk is similar to having a standard blood test. 

Every precaution is taken to avoid infection including a  “no touch” sterile technique to ensure your safety during the procedure. However if the area becomes red, warm or tender, or if you develop a fever in the 5-7 days post procedure please go to your local Accident & Emergency Department and inform them of the procedure you have had done.

When you have dry needling there is a potential for injury or trauma to nerves, blood vessels or soft tissue structures. The clinician uses ultrasound guidance and is trained to take all appropriate steps to minimise risks and avoid injecting or traumatising any soft tissue structures when performing the dry needling. 

If you are taking Warfarin or other blood thinning drugs we may need to discuss the procedure with your GP first.

Does it hurt?

There may be a bit of discomfort at the time of the procedure, but Ultrasound guidance means that it can be delivered much more accurately and quickly. 

If you are unsure or still have more questions, then please contact your clinician to discuss further before the procedure.