First as a student and later as an assistant instructor dry needling I noticed that there is a certain need amongst students and colleagues for a few clinical and practical examples or cases concerning practicing dry needling (DN). This is the reason why I wanted to write this practical quick guide which hopefully can contribute to develop confidence in effective needling. Dry needling is an innovative clinical successful and reasonable evidence based tool for the elimination of myofascial trigger points and thereby diminishing myofascial pain and movement restriction. It is important that musculoskeletal therapists apply it properly because it can give fast and lasting relief. On the other hand if dry needling and myofascial pain is not thoroughly understood there is obviously not a fast and lasting relief which could lead to frustrations for therapists and patients and could give dry needling a negative appearance. At the same time this practical quick guide wants to be an advocate for using dry needles not only as a myofascial pain syndrome tool but also primarily as a mobilizing tool. Dry needling has a well-known and documented mobilizing quality but this is in general not emphasized as a primary objective in dry needling myofascial pain. Dry needles can be used primarily as a tool to relax muscle fibres in the absence of an obvious myofascial pain pattern. The goal with this is to improve and restore normal mobility in a region and thereby diminishing strain in the whole kinetic chain. When dry needles in the first place are used as a mobilizing tool they fit very well in a manual therapist toolbox where improving of mobility is a main goal.

This practical quick guide wants to stimulate musculoskeletal therapists to combine neuro-musculoskeletal therapeutic approaches including dry needling instead of choosing (un)consciously for one approach. For instance the approaches such as the myofascial pain syndrome (Travell, Simons), neuropathy (Gunn), segmental (embryology) neurophysiology and biomechanical (manual therapy). The goal of musculoskeletal dry needling therapy is bringing a swift, lasting, clearly decrease of complaints confirmed by the patient thereby reducing the number of required treatments.

This practical quick guide is for musculoskeletal therapists who have successfully finished the basic practical courses for dry needling myofascial trigger points and the myofascial pain syndrome. At this point one should know how to dry needle hygienic and safe. The anatomic knowledge must be excellent. This quick guide is a practical guide and it does not elaborate on psychology, pain physiologic, anatomy or the theoretical aspects of the working hypotheses of dry needling. There are books, course syllabi and articles which explain the neurophysiologic mechanics of myofascial pain and dry needling. This guide is certainly not a substitute for the mandatory practice courses dry needling. The content of this quick guide is based on clinical experience and best evidence. It is not meant to be conclusive, it must be critical reviewed and it hopes to be an aid in stimulating clinical reasoned self-exploration with musculoskeletal dry needling.