Dry Needling for Cervicogenic Headaches and Migraines
Do you have headaches or migraines? Do your headaches limit your ability to focus, work, or have fun? Have you tried medication or other treatments but still have headaches? Many people suffer from headaches and migraines, leading them to seek relief from a variety of different healthcare professionals and treatment options. One option that not everyone is familiar with is physical therapy. Physical therapists have multiple tools, modalities, and treatment techniques to help with headaches or migraines including dry needling. Before we get into what is dry needling, and who is appropriate for this treatment, let’s review a couple of terms.
What is a cervicogenic headache?
In the physical therapy and medical world, there are different classifications of headaches: migraine, tension-type headache, trigeminal autonomic cephalalgias, and other primary headache disorders. A cervicogenic headache is under the tension type classification. For these headaches, the pain experienced is referred from either the upper neck joints or the muscles around the neck and head. Frequently, people with these headaches notice a change in symptoms with a change in head position and prolonged positioning such as working on a computer or reading. Some migraines can also be of similar origin, but migraines can also be caused by light and sound and be more severe/long lasting.
What is dry needling?
The American Physical Therapy Association defines dry needling as “a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments.” In non-medical jargon, dry needling is a technique where a needle is inserted into a muscle knot (trigger point) to decrease tension and therefore decrease pain. Dry needling is performed after a physical therapy evaluation and discovery of trigger points potentially related to the person’s pain, generally in conjunction with other treatments like manual therapy, exercise, and postural changes.
Many people ask, is dry needling like acupuncture? No, the only similarity is the needle. Dry needling is based off a musculoskeletal examination. Acupuncture is described as balancing the energy flow in your body. In addition, dry needling is a component of a full physical therapy treatment plan. Whereas, acupuncture is frequently a stand-alone treatment.
Could dry needling help my headaches or migraines?
Does your headache change when you move your head or change positions? Does it get worse if you sit and work on your computer or read a book? Does your headache get better when you go for a walk? If you answered yes to these questions, then it is likely dry needling could be beneficial for you. One study found that dry needling demonstrated similar improvements in headache and migraine related pain and function compared to pharmacological interventions. Another study found that dry needling the muscles of the neck (upper traps and suboccipitals) resulted in decreased incidence of headaches, improved neck range of motion and improved functional rating by the participants.3
Dry needling can be done during your scheduled physical therapy appointment as part of your treatment. It can be performed more than once but is not frequently done more than twice a week. When dry needling is used to decrease headaches or migraines it is performed to the muscles in the neck or base of the skull. The needles are inserted into the muscle knot (trigger point) then removed shortly afterward. Though dry needling is effective at decreasing headaches, it is used as a piece of a complete physical therapy treatment plan that can involve manual therapy, exercise, or postural changes. Therefore, it is important to complete your exercises and other treatments as directed to gain the full benefits of dry needling and physical therapy.
Common Questions Regarding Dry Needling
You may be thinking, all this research sounds great, but I still have questions and concerns. Below, are answers to a couple of the most commonly asked questions regarding dry needling that our physical therapists are asked in the clinic by patients.
- “Are there any side effects to dry needling?”
Yes, but they are normally very minor. It is normal for a patient to experience muscle soreness (like soreness after a workout) after dry needling. Bruising and slight bleeding are possible, but not common. Your physical therapist will go over all other potential side effects before treatment is performed.
- “Is dry needling safe?”
Yes, dry needling is very safe. Physical therapists that perform dry needling all have a certification and have completed extensive training.
- “Will the needle go into my spine?”
The needle will not go into your spinal cord. Physical therapists are trained to insert the needle into the trigger point we believe is causing the pain and avoid any other structures, such as the spinal cord. There are some muscles that run along your spine that your physical therapist could dry needle. However, after your evaluation, your physical therapist will determine and discuss with you which muscles would most benefit from dry needling.
- “I’m afraid of needles. Do I have to see the needle?”
Your physical therapist will discuss your feelings about dry needling with you. It is possible, and even common, to lay on your stomach while these muscles are dry needled, therefore you do not have to see the needle.
How do I get dry needling?
The first step is to schedule a physical therapy evaluation with a physical therapist trained to do dry needling. The physical therapist will perform a thorough evaluation and discuss with you if you are a candidate for dry needling.
For an individualized treatment plan to help you with your pain, consult with one of our physical therapists in Chicago (virtually via our telehealth platform or in person) by calling us at (312) 374-5399 or by scheduling an appointment online. If you have further questions regarding dry needling, we would also be happy to answer them. Remember to also check out our Facebook, Instagram, and Twitter pages for more fun facts and articles on nutrition, physical therapy, and exercise!
Submitted by Kellie Stickler
Reviewed by James Caginalp PT, DPT, CSCS, CES, PES
- American Physical Therapy Association. (2013). Description of dry needling in clinical practice: An educational resource paper. http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/
- Vȧzquez-Justes, D., Yarzȧbal-Rodríquez, R., Doménech-Garcia, V., Herrero, P. & Bellosta-López, P. (2020). Effectiveness of dry needling for headache: A systematic review. Neurologia. https://www.ncbi.nlm.nih.gov/pubmed/31948718.
- Sedlighi, A., Nakhostin Ansari, N., Naghdi, S. (2017). Comparison of acute effects of superficial and deep dry needling into trigger points of the suboccipital and upper trapezius muscles in the patients with cervicogenic headache. J Bodyw Mov Ther, 21(4): 810-814. https://www.ncbi.nlm.nih.gov/pubmed/29037632.