The Uncontrolled Spread of Needle Mania

By John Quintner

John Quintner - 12.3.12

John Quintner

In a truly remarkable editorial, Dommerholt et al. [2019] wonder whether there is any point to the practice of dry needling (DN).

They draw attention to the popularity of this form of “therapy” throughout the world, as well as to its relative safety, but concede that many fundamentally important questions remain unanswered:

  • Is DN more effective than other treatment options?
  • Does DN induce clinically meaningful changes?
  • Which method of DN is preferred? If any?
  • Is it necessary to elicit local twitch responses?
  • What constitutes DN practice?
  • Which patient populations may benefit the most from DN?
  • Is DN contraindicated for patients with certain medical diagnoses?
  • What is the best dosage of DN for various conditions?

It seems impossible to reconcile this huge gap in scientific knowledge with the fact that physical therapists (PTs) are already using DN to target trigger points, tendons, entheses, periosteum, scar tissue and fascia.

To make matters worse, Dommerholt et al. [2019] note that PTs believe, without any evidence, that DN can “lessen spasticity, reduce local and referred pain, eliminate neural entrapments, increase range of motion, and normalize muscle activation patterns”.

Is it any wonder that DN has attracted scathing criticism from some PTs (and other clinicians), who question whether the practice should be part of the scope of therapists of all persuasions (including PTs, occupational therapists, chiropractors and athletic trainers).

Dommerholt et al. [2019], who are DN advocates, appear to distance themselves from this disastrous situation (which could well be termed “needle mania”) when they conclude:

“While it is conceivable that the act of DN offered within a therapeutic context may be sufficient to facilitate a positive response by evoking brain activation in reward-related brain areas, these characterizations do not seem to match the current state of affairs.”

Indeed, the sorry state of affairs that Dommerholt et al [2019] outline in their editorial may reflect the opinion of one astute commentator:

“DN is an utter fool’s errand wrought with placebo – induced by maximal ritual effect, novel and exciting stimulus as well as an injection of hope for those desperate enough to allow someone to stab them with a needle”.*

Ouch!

Reference: Dommerholt J, Fernández-de-las-Peñas C, Petersen SM. Needling: is there a point? Journal of Manual & Manipulative Therapy 2019; 27(3): 125-127, DOI: 10.1080/10669817.2019.1620049