In & Out vs Marinating…?

[John]

Sue,

Can you please explain the rationale for letting the needles marinate for 10minutes or so vs a more in/out method? I understand why we do the in/out for the upper trap, pec and lat along w/ the joint line in the knee; however, why do we not do that for all other points?

Thanks!
Logan

[Unknown was SFDN]

Logan!
First off, I love the name of your subject! lol!
Second, let me apologize for taking some time to get back to you. I wanted to look up a few things before I responded.

The best answer I can really find is best described by Dr. Dunning in his article: DN- a lit review with clinical implications (1). Most clinical trial research we have, have left needles in for 5-40 minutes and a systematic review showed that leaving needles in the low back for 10 minutes was “better” than immediate removal.

With that said, from a clinical experience perspective, I think there are times when in and out (for safety reasons…upper trap, pec, lat/ teres) is still highly effective and I have seen huge, positive changes with that method. Theoretically, all we need to do is create a lesion to begin the physiological cascade of healing.

I do also feel (personally when I get needled, and subjectively from my athletes) that specifically when in contractile tissue (aka muscle and ligament) that people feel a “letting go” sensation as we let that needle “marinate”. I know I feel like the muscle is melting/ relaxing/ letting go when it is left for some time to fit.

So, for now based on the evidence we have, I will leave a needle sit for up to 40 minutes (but often 10 minutes simply based on scheduling) unless I have a safety concern. In those cases, I am relying on the physiological cascade being kick started by simply creating the lesion.

This would be a FANTASTIC study for any grad student or researcher out there…same diagnosis…same needle areas, different in situ times…look at outcomes. Any takers??? :-)

Hope that helps.
Sue

[Unknown was SFDN]

Forgot the reference:

1. Dunning, J, Butts, R, Mourad, F, Young, I, Flannagan, S, and Perreault, T. Dry needling: a literature review with implications for clinical practice guidelines1. Phys Ther Rev 108331913X13844, 2014.

[John]

Thanks, Sue!!! I feel the same type of relaxation after a few minutes when I needle myself and get that report from my patients. I’ve just had some patients who are somewhat uncertain about the needling, and for those patients I just go in, out and done, and they seem to be comfortable with that.

Thanks again!
Logan

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