In orthopaedic manual physical therapy, the techniques get all the attention. Manipulation, mobilization, muscle energy, neural mobilization, soft tissue mobilization, etc. You can now add Dry Needling (DN) to this list. Any seasoned clinician will tell you that learning these techniques, with practice, is the easy part. Being able to implement them efficiently and effectively is the hard part. Considering DN, understanding the genesis of myofascial pain, applicable pain science, the mechanisms of DN, its application to orthopaedic diagnoses, and the proper historical context is crucial to understanding the theory behind DN. However, when not placed in the context of a thorough subjective history, a comprehensive neuromusculoskeletal examination, appropriate differential diagnosis and clinical reasoning, it can be challenging to accurately identify the most appropriate patients and achieve optimal patient outcomes.
