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the risks of dry needling and how to avoid them

Dry needling is a dangerous technique

Dry needling is a technique in which acupuncture needles are applied directly into the musculoskeletal system of the human body to reduce muscle hypertonus, reduce pain of the treated area, promote tissue regeneration and increase mobility of the joint attached to the treated muscle. 

Since the application of the needle sometimes goes up to 7cm deep into the tissue, the technique can be very dangerous in unskilled hands.  

Some of the possible consequences of Dry needling are: 

  2. Infection
  3. Organ injury
  4. Hematomas
  5. Miscarriage
  6. Nerve injury
  7. Fainting 
  8. Stuck needle
These are just some of the possible consequences if the technique is performed by an unskilled or trained person without a proper medical education..
Dry needling technique

1. Pneumothorax

Pneumothorax is a lung collapse.

Pneumothorax occurs when air from the lungs leaks into the space between the lungs and the chest wall. This air pushes the outside of the lungs and causes them to collapse. 

Pneumothorax is by far the most dangerous possible consequence of the Dry needling technique that may occur due to the application of a needle into the pulmonary pleura. 

Signs of pneumothorax are:

  • Chest pain on one side, especially when inhaling
  • Strong cough
  • Rapid breathing 
  • Rapid heartbeat 
  • Shortness of breath 
  • Skin that looks blue
In the event of a pneumothorax, the patient must urgently go to the hospital in order to treat the issue. To avoid the possibility of pneumothorax always use shorter needles when you are close to the pulmonary pleura, and follow the rules learned on the Dry needling education

2. Infection

Infection is a possible side effect of Dry needling that can be very easily avoided if the therapist follows all the rules. 

1. rule is that you never treat a patient who already has a serious inflammatory process in the body such as fever or any other type of inflammation and infection. Dry needling creates trauma in the tissue and brings the body into an additional process of inflammation and can further increase the body temperature and endanger the health of the patient. 

2. rule is that you never enter the joint cavity with a needle. Legally in the Republic of Croatia, only medical doctors may enter the patient's joint because there is a high chance of infection during the same. Also, Dry needling does not act directly on the joint and it is completely unnecessary and dangerous to treat it in this way. 

3. rule is that you always use sterile needles that come in sterile plastic wraps. You will never use the same needle on more than one patient because it creates a serious risk of infection and transmission of infectious diseases from patient to patient. 

Kidney injury

3. Organ injury

Using Dry needling technique, we treat only the musculoskeletal system or the muscles themselves. 

If you use the technique correctly it is completely unnecessary to get close to the organs themselves and thus endangering the health of the patient. 

Acupuncture needles are extremely thin and it is difficult to create permanent trauma to the organ (except the pleura) but they should certainly be used in every possible treatment and application to avoid the presence of the organ itself

If you stick to every rule from the Dry needling education you should not have any risk of injury to your patient's organs.  

4. Hematomas

Hematomas are common in Dry needling technique and are usually completely harmless if they are not located near vital structures

In the treatment of Dry needling ALWAYS avoid the arteries and veins but sometimes you will hit the capillaries with a needle. 

This phenomenon is completely harmless and it is only important to stop the patients bleeding and instruct him in how he can speed up the process of hematoma healing

Also on the next Dry needling treatment we will never apply the needle directly into the hematoma

Needle puncture hematoma

5. Miscarriage

This is one of the risks of the Dry needling technique that is not actually a direct risk but great caution is needed. 

In the first quarter of pregnancy Dry needling is not suggested at all because there is the highest chance of a spontaneous abortion. 80% of spontaneous abortions occur in the first trimester. 

In the the second two quarters it is necessary to obtain written consent from the doctor who leads the pregnancy confirming that the doctor approves Dry needling Therapy.

Given that Dry needling Therapy is performed directly on the musculoskeletal system, there is not too great of a chance of endangering the fetus of a woman or for spontaneous abortion, but it is necessary to implement all the above precautions in order to protect the patient and yourself.  


6. Nerve injury

Since the needles in Dry needling technique are applied up to 7cm in the depth of the tissue there is a chance of getting a needle into the nerve if you don't know the anatomy extremely well. 

If you follow all the rules of application of the technique learned in education, you should avoid large peripheral nerves in 99% of cases. 

In case you hit a nerve the patient will feel a pronounced burning sensation that will go beyond 30 seconds and it is necessary to remove the needle as soon as possible and apply elsewhere where there is no nerve. 

Since the needles used in Dry needling are extremely thin, permanent nerve damage cannot occur. But certainly do not risk and do not apply needles near large peripheral nerves! 

Ischiadic nerve injury
Fall unconscious

7. Fainting

A significant number of the population has a fear of needle puncture and in that part of the population there is a serious risk of fainting when applying the Dry needling technique. 

Always ask the patient before treatment does he have fear of needles , and does he have history of fainting at the same time. 

If the patient confirms one or both of your claims, calmly explain to him how during Dry needling we use an acupuncture needle that is extremely thin and a puncture as a puncture can hardly be felt

If you notice an extremely high level of fear of the patient even after the explanation, decide on another technique so that you do not create unnecessary trauma to the patient. 

It is also important that the patient is lying down when applying Dry needling technique so there would be no injury in case he falls unconscious! 



8. Stuck needle

This is one of rare or even impossible situations if you buy quality needles and apply Dry needling technique in an adequate way.

At the time of use of the low quality needles there is a chance of breaking the needle in the patient's body. If this happens, it is necessary to carefully squeeze the needle out of the skin or if it is not possible to take the patient to an emergency reception so that the needle is removed by the doctors. 

A broken needle in the thoracic area can be very dangerous for the lungs or pleura and to avoid this is you should always buy high quality needles 

Dry needling needle

9. Therapist needle injury

This is by far the greatest risk to a dry needling therapist and you need it at all times to avoid it!

We all have patients from many different areas of life and we can't know if there is a patient that we treat with an infectious disease

For this reason NEVER turn the needle towards yourself and ALWAYS be extremely careful when applying the needle into the patient's body. 

For additional safety of the patient and therapist, you will always wear a medical glove on your hand that touches the skin and that does not manipulate the needle. The glove will prevent the transmission of viruses and bacteria from the therapist to the patient and vice versa

Be careful where you learn!

There are several organizations that teach dry needling training with the extremely incompetent and inadequate lecturers that can teach you to do significantly more harm than good. 

The same organizations are accepting uneducated participants who do not have the basic medical knowledge to apply the Dry needling technique. 

In the Physioverse Academy , Dry needling and all other techniques are taught exclusively by highly educated and experienced medical experts, and the participants of the education can only be people with adequate previous medical knowledge and education. 

Always try to find the best possible teacher and organization which exclusively accepts college-educated medical professionals on courses such as Dry needling, spinal manipulations and other similar extremely demanding special techniques. 

Take a look at the clip from our lectures at the Faculty of Kinesiology in Zagreb on the topic “risks of Dry needling techniques " in 4K quality!

Education for physiotherapists
Bsc. PT. Toni Marić

Bsc. PT. Toni Marić

Toni is bacc. physical therapist and the owner of the Ad Sacrum clinic who has been treating top athletes for years and also teaches at the Dry needling courses for physiotherapists.

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