Do you have muscles in parts of your body that feel tense? One of the most practical solutions is functional dry needling. The treatment uses thin needles to shut down or deactivate knotted or painful areas in the muscles. By Inserting the needles in the area, you elicit a contraction or local twitch response followed by an enduring relaxation. Since the needle reaches deep parts of your muscles, the technique could realize pain relief. Functional dry needling should be executed by a skilled physical therapist. For many years, Suarez Physical Therapy has helped hundreds of patients in Las Vegas promote the ability to move, restore function, prevent disability, and reduce pain.

What is Functional Dry Needling?

You might have heard of functional dry needling (FDN) treatment and wondered what it could be or if it is something that might help you.

While the procedure's name might sound intimidating, FDN is minimally discomforting and a safe technique for patients with musculoskeletal presentations.

Developed in the 1980s, it is a medical intervention that uses thin filiform needles to penetrate your skin and stimulate your underlying myofascial trigger points, connective tissues, and muscular for management and treatment of movement impairments and neuromusculoskeletal pain.

The technique is used to treat dysfunctions in connective tissue, skeletal muscle, and fascia, diminish persistent peripheral nociceptive input, and restore or lower impairment in the body function and structure. It results in improved engagement and activity.

Your physical therapist will identify your trigger points or any dysfunctional or painful areas in the muscle that might be causing your symptoms. A trigger point is a palpable and direct source of pain, with several contracted knots in the muscle feeling like tight bands. The band could develop as natural protective measures in response to sustained postures, repetitive motion, and injury. Pain stemming from trigger points is caused by a reduced blood flow, causing hypoxia within your trigger points. The muscle knots could result in pain, affect performance, muscle stiffness, muscle weakness, and limit motion. If left untreated, they could worsen with time.

The thin needle is then inserted into the location to realize a local twitch response that could help eliminate pain, release muscle tension, quiet muscular spasm and activity, and improve tissue flexibility.

Electrical stimulation could also be used to offer more relief from your symptoms or facilitate the anticipated muscle activity. Individually-designed exercises often accompany it to improve function.

Typically, the dry needling procedure is a ten to thirty-minute session.

While you might experience soreness following the FDN session, you'll notice some improvement in the symptoms within a day or two. The degree of improvement increases with every additional session. And when you adjust to the procedure, post-procedure soreness will decrease, and results will be more apparent immediately after the treatment.

Some of the conditions treated with functional dry needling include:

  • Chronic and acute pain
  • Headache
  • Calf and knee pain
  • IT-Band Friction Syndrome
  • Back and neck pain
  • Myofascial pain and stiffness
  • Pain that has failed to respond to conventional physical therapy
  • Sciatica
  • Whiplash
  • Tendinitis
  • Injury prevention and rehabilitation
  • Plantar fasciitis
  • Shoulder Dysfunction (rotator cuff strain, impingement, adhesive capsulitis)
  • Hip pain
  • Achilles Tendinopathy
  • Shin splints (Medial Tibial Stress Syndrome)
  • Runner's Knee (Patellofemoral Pain Syndrome)

How Many FDN Sessions Do You Require?

In an acute pain situation, you might need only a single session. On the contrary, in more chronic pain cases, you might require more sessions before noticing changes. Since FDN could have cumulative effects if you fail to see results following your initial session, you should undergo a maximum of three sessions before deciding to pursue alternative options. Your therapist should discuss the individualized treatment during the initial session.

Functional Dry Needling Isn't Painful

Experienced therapists use thin filament needles. The initial feeling of the needle penetrating through your skin is minimal. After the needle reaches your muscle, the twitch sensation feels like a deep cramp but lasts for approximately twenty seconds. You might experience muscle soreness for a maximum of twenty-four hours, but the long-term outcome is worth it.

How Large are the Needles? How Many Will Your Doctor Use?

Needle depth and diameter are chosen depending on your target muscle and the surrounding tissues' anatomy and size. Many acute injuries could respond to more apparent stimulation using a small diameter and short needle. Your physician might use several needles throughout your whole muscle. On the other hand, a chloric injury with more extensive fibrosis might need more closely spaced, longer, and deeper needles.

Different Types of Functional Dry Needling

Functional Dry needling is the needling procedure of your trigger points while treating myofascial dysfunction and pain using disposable sterile needles. Generally, there are three primary forms of FDN, namely:

  • Intramuscular stimulation
  • Superficial dry needling
  • Intramuscular electrical stimulation

In the intramuscular stimulation, a needle is inserted into the taut band or trigger point. It triggers the taut band's local twitch response. Most patients perceive the local twitch response as a feeling of muscular release. It also means that the physical therapist treated the correct trigger point.

With superficial dry needling, the needle is inserted obliquely into your skin to approximately three to four mm above your trigger point. It leads to numerous reflex analgesic mechanisms through your brain and spinal cord.

More than two (2) needles are inserted into your taut bands in the intramuscular electrical stimulation. Light transcutaneous electrical nerve stimulation (TENS) currents stimulate it.

Your physician should choose the right technique based on your needs, preferences, and symptoms.

Functional Dry Needling is Not Acupuncture

If you have been advised to use dry needling over acupuncture, it might not be apparent to you. The two procedures seem similar to a layman. So, what is the variation? The main variation involves where the needles are inserted.

Dry needles (without fluids) are inserted during functional dry needling. However, that does not mean acupuncture needles have medication. In both treatments, needles are used to initiate an internal self-healing process.

Acupuncture is a form of traditional Chinese medicine (TCM) whose principles were developed many years ago. Its needles are inserted in a manner that corresponds with the meridian line thought to connect your body's internal organs and other systems. Thanks to “qi” flows (the flow of energy between your meridian points). The advantages of this procedure originate from the qi flows.

On the other hand, dry needling is founded on the modern understanding of human anatomy. The procedure targets essential muscle groups instead of meridian points.

Contraindications for FDN

Sometimes dry needling should be practiced with precaution or should not be practiced at all. These cases include:

  • Whether with fever or not, a person with an acute systemic infection should not be treated with functional dry needling. The procedure's reaction can't be evident in advance, and the patient must seek medical intervention.
  • If you have a life-threatening emergency or an acute emergency, you should receive medical treatment.
  • People who take anticoagulant medication, an INT-Score of at least 1.5, and those suffering from native coagulant dysfunction should not be treated with functional dry needling.
  • Patients suffering from paresthesia should not be treated with FDN because they cannot give good feedback.
  • Lymphoedema is another contraindication since the infection risk in the affected area increases immensely. Therefore, FDN should not be used in your affected site after the removal of the lymphnode.
  • Persons with a greater risk of infection, including diabetic and immunodeficient patients, must be treated with a lot of care.
  • Your therapist should not apply dry needling in areas of skin alternation, allergic skin reaction, and skin infection.
  • Because of the high risk of infections, functional dry needling must not be used in areas of hematomas.
  • Another contraindication is an implant.
  • Functional dry needling should not be used in joint replacement or osteosynthesis because of reduced immune reactions and high risk of infections, respectively.
  • Expectant mothers should be treated with caution and only during the first trimester. The patient should give consent before the medical procedure.
  • IMES (intramuscular electrical stimulation) should not be used to treat patients with cardiac pacemakers.
  • Severe pulmonary disease patients shouldn't be treated near their thorax.
  • Therapists should handle epilepsy patients with caution.
  • Dry needling should not be applied to your eyes, genitals, or mucous membrane.
  • If you have a contagious disease, the doctor must handle you with precaution.
  • A patient with a psychiatric disorder should be treated with functional dry needling only when they agree, understand the medical procedure and risks, and correctly interpret the stimuli and provide their full consent.
  • Children should be treated after giving their own and their parents' consent.

How to Prepare for Your Functional Dry Needling Treatment

Like most people, you might be discouraged by the idea of any medical procedure that uses needles. However, it is worth realizing that the treatment in question is minimally uncomfortable and painful. Therefore, the most practical method to prepare for the treatment is to remain calm and relaxed.

Make sure you put on loose-fitting clothing. It permits your physical therapist to access your muscles while allowing you to be comfortable since you will lie on the table for approximately twenty minutes. A pair of shorts is almost effortless when accessing your leg muscles, while loose-fitting pants could help the therapist access the muscles of your hips and low back.

Before administering the procedure, the practitioner will analyze the medical history and conduct a physical exam to decide if you qualify for the procedure. If they believe you're an appropriate candidate, they should describe the process and make sure you're receptive to functional dry needling.

Moreover, these are the various aspects of the treatment that an experienced therapist should inform you about:

  • Indication and aims of the treatment
  • Different types of functional dry needling alongside their pros and cons
  • The facts that dry needling is different from acupuncture
  • The expected reaction during your treatment including dull pain, local twitch response, short prick through your skin
  • The fact that you can always interrupt your treatment with a prearranged codeword or signal word
  • Possible complications of the treatment

The procedure could be conducted during your initial office visit, or you might be required to schedule another physical therapy appointment for your treatment. Make sure you ask questions and notify the therapist if you need time to decide if FDN is suitable for you.

The procedure might occur in your physical therapist’s office, outpatient rehabilitation center, or physical therapy clinic. Typically, it is performed in a procedural area like a therapy room, a curtained-off section of a big room, or a separated room.

During the Functional Dry Needling Procedure

Usually, patients are treated in a lying position. You should, with the assistance of a support cushion, be relaxed. Your muscles should also be accessible.

If possible, the physical therapist should see your face to see your reactions and non-verbal communication. If this isn't possible, continual verbal communication with you is advisable.

The physical therapist will begin with sterilizing the region being treated and then prepare the needles.

While some physicians will walk their patients through what they are doing as they are doing it, others will elaborate on the treatment in detail beforehand. It would help if you always ask questions to understand the functional dry needling procedure better.

After the needles are removed, the therapist will inspect your skin for any skin reaction or bleeding.

Make sure you get up from the lying position slowly. If you feel dizzy, you could be asked to sit and relax for a while before leaving.

Safety and Hygiene Arrangements for the Procedure

Functional dry needling is an invasive treatment that carries risks like injury and infections. Hygiene and safety arrangements should lower the risks. Every person is potentially colonized or infected with an organism that could be transferred during treatment.

The physical therapist should put on sterile gloves, mainly when there is a likelihood of contact with blood. The gloves must be taken off and disposed of following the procedure. Then the therapist should wash their hands.

Before and after the medical treatment, the physical therapist must clean hands with water and soap. Sneezing and coughing into the treated site or hand should be avoided.

All needles have an expiration date, and the physical therapist should throw away expired needles.

What to Expect Following Functional Dry Needling Procedure

It is safe to exercise after your medical procedure. However, if you're experiencing muscle soreness, you could prefer lighter exercise like walking.

Bruising from the procedure is normal. Some areas like portions of your legs and arms, face, shoulders, and chest are more likely to get bruises than others. While massive bruising is uncommon, it could occur. You can use ice to reduce your bruising. If it persists, seek medical attention.

You might also feel fatigued, tired, emotional, giggly, and energized following your procedure. Typically, it could last for a couple of hours after the treatment. If it lasts for more than one day, contact the therapist.

You might also experience soreness. It could start in a few hours or the next day and generally lasts for twenty-four to forty-eight hours. Soreness might be different for every patient. Typically, it feels like you had a hard workout. Remember to tell your physician the duration of the soreness during your next appointment.

Occasionally, functional dry needling might worsen the symptoms. If they continue for twenty-four to forty-eight hours, take note of them. It could help your physical therapist change the treatment plan. However, that doesn't mean the procedure can't help your health.

It would be best if you also drank a lot of water after your functional dry needling. It reduces or avoids soreness.

Remember to take your medication as prescribed.

Moreover, you can engage in the following. If it worsens the symptoms or hurts, stop your activity.

  • Stretch or workout
  • Gently massage the area.
  • Continue your regular physical activity.
  • Use ice to reduce soreness.

Remember to avoid the following after your treatment:

  • Doing more than you usually do
  • New sports or physical activities


Many patients require two (2) or three (3) functional dry needling sessions to realize the procedure's full effect, while some might require a maximum of six sessions. The procedure could be conducted at least twice weekly, depending primarily on the health condition. The therapist should notify you when you should make your follow-up appointment.

Should you wish to discontinue the procedure or experience adverse side effects, your physical therapist could discontinue the therapy and suggest alternative treatment methods to manage the symptoms. Breaking the treatment won't result in adverse effects.

Evidence-Based Benefits: What Literature Says about Dry Needling

According to research published in the Journal of Orthopedic and Sports Physical Therapy, scientists analyzed the result of the clinical studies conducted so far to check whether FDN helps reduce arm and neck pain, which are distinct regions for trigger point development. They discovered that FDN could be an excellent pain relief method when handling painful muscles and trigger points or myofascial pain syndrome. The technique acts as an essential treatment when used together with other procedures like exercise.

Myofascial trigger points are usually due to muscle injuries like a repetitive strain or running injury. They are painful when pressed on and could also cause pain in another body area (referred pain). For instance, a trigger point in the face, neck, or shoulder muscles might cause headaches.

Spinal movement dysfunction and chronic upper headaches are linked to myofascial pain syndrome. Kietrys et al. published an analysis on the effectiveness of FDN on the trigger points. Based on their study, they recommend FDN as a practical treatment option. They discovered the results for many patients are apparent immediately after the procedure and at the follow-up meeting.

Find Experienced Functional Dry Needling Near Me

Functional dry needling provides an alternative treatment option to acupuncture for improved muscle movement and pain relief. Combined with physical therapy techniques and exercises, it can treat numerous health conditions, including sciatica, whiplash, tendinitis, migraine headaches, injury prevention and rehabilitation, musculoskeletal issues, and plantar fasciitis. It is also worth noting that the procedure is not for everyone. The physical therapists at Suarez Physical Therapy will work with you to ensure the procedure suits your treatment plan. To learn more about the treatment procedure, contact us today at 702-368-6778.