
DRY NEEDLING IN THE PEDIATRIC POPULATION -
Applicability and Safety
by Brittani Cookinham, PT, DPT, ATC, LAT, Physical Therapy Manager, EXOS‐TX & Alexandra Sperduti, ATC, SPT, Physical Therapy Student, Stony Brook University, NY
Background
Dry Needling (DN) has grown in popularity as a form of treatment for a variety of neurological and orthopedic conditions including trigger points, muscle tension, scar tissue restriction, swelling, circulation restrictions and muscular dysfunction(1). Performed by certified professionals: physical therapists, physicians, and chiropractors(2), DN consists of inserting thin, sterile needles into symptomatic areas to promote circulation, allowing the body to stimulate the healing process. It is important to note that DN is meant to be a comfortable procedure, but can cause discomfort based on the sensitization of the patient’s nervous system(2).
Dry Needling Versus Acupuncture
Patients commonly ask what the difference is between DN and acupuncture. Acupuncture is a Chinese form of medicine based on needle insertion into specific body points along meridians (channels) to target internal dysfunction(3). DN is a Western-approach of inserting needles locally into symptomatic areas, creating micro-lesions to underlying tissue therefore increasing local/systemic blood flow which stimulates healing and pain relief(2). Both techniques use the same needles but use different approaches to heal the body.
Dry Needling and Pediatrics
Dry needling, while it is supported in the literature, the majority of the research is
based on adult subjects; DN to the pediatric population specifically is still elementary in the research. Numerous blogs report empirical evidence of the appropriateness and efficacy of DN in children younger than 18 years old. The largest obstacle is emotional and cognitive maturity, affecting a child’s ability to comprehend the future benefits associated while accepting a possibly painful procedure(4). Needle phobia is also a concern to keep in mind when dealing with this population(3). Even though there is a lack of evidence supporting the use of dry needling in the pediatric population, there is a wealth of literature supporting the benefits of acupuncture in children.
Guidelines
The American Physical Therapy Association (APTA) empirically cautions clinicians when dry needling children under the age of 12 due to the possible lapse of procedural understanding(1). Clinicians are advised to use their best judgment and clinical expertise when applying dry needling techniques to pediatric patients.
References
1. APTA Public Policy, Practice, and Professional Affairs Unit. (2013). Description of Dry Needling in Clinical Practice‐Educational Resourse Paper
2. Ma,YT, Ma, CHO ZH. (2005). Biomedical Acupuncture for Pain Management, AnIntegrative Approach. St.Louis, Missouri: Elsevier
3. Adams D, Cheng F, Jou H, Aung S, Yasui Y, Vohra S. The Safety of PediatricAcupuncture: A Systematic Review. PEDIATRICS. 2011;128(6):e1575‐e1587. doi:10.1542/peds.2011‐1091.
4. GrangerJ. Dry Needling. YOUTHSPORTSPT. 2014. Available at: https://youthsportspt.com/category/dryneedling/.AccessedMay26,2016.

Brittani Cookinham, PT, DPT, ATC, LAT, Physical Therapy Manager, EXOS‐TX
214-618-3246
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