💬 Ever had a patient feel worse after dry needling? Or not respond at all?

🎯 What’s the issue? Most clinicians overlook dosage precision—too much overwhelms the body, too little isn’t effective.

📺 In this Clinical Relevance video, I break down how to customize dosage for faster recovery and better outcomes.

Why Dosage Matters

Dry needling triggers key physiological responses: reducing tissue tension, improving blood flow, and calming inflammation. But getting the dosage right is critical:

🔹 Too much stimulation → Overloads the nervous system, increasing soreness.
🔹 Too little stimulation → Fails to create meaningful change.

⚖️ The key? Balancing intensity with patient tolerance and healing potential.

5 Key Factors That Influence Dosage

1️⃣ Age & Healing Potential

Older adults or those with chronic conditions (e.g., diabetes, cancer) heal more slowly.

🔹 Start conservatively: Fewer needles + basic needle insertions to prevent excessive soreness.

2️⃣ Comorbidities

Conditions like Crohn’s or fibromyalgia amplify systemic inflammation.

🔹 Adjust: Use thinner needles (e.g., 0.16mm) and tailor depth using QST scores. Be cautious with
needle manipulation techniques such as pistoning, rotation and tenting.

3️⃣ Acute Injuries

Treating a fresh ankle sprain? Skip deep needling.

🔹 Opt for microneedling: Boosts lymphatic flow without aggravating trauma.

4️⃣ Current Health Status

Recovering from illness (e.g., flu) or stress? The nervous system is already taxed.

🔹 Reduce intensity: Avoid overstimulation.

5️⃣ Recent Exercise

Post-marathon? Over-needling inflamed muscles can backfire.

🔹 Better approach: Light needling + e-stim to aid recovery.

The Role of the Quantitative Sensory Test (QST)

At IDN, we use QST to assess neurogenic inflammation—a game-changer for tailoring dosage:

🔹 High QST Score (via pressure algometry/thermal testing): Indicates heightened nerve sensitivity →
Start superficial with basic needle manipulation techniques, progress depth gradually.
🔹 Low QST Score: Allows for deeper needling + pistoning → Focus on tissue remodeling.

🚗 Think of QST as your roadmap—it tells you when to ease off the gas or step on it.

Practical Adjustments for Safe, Effective Treatment

✔️ Needle Gauge
🔹 0.16mm: Best for sensitive patients (fibromyalgia, chronic fatigue).
🔹 0.30mm: Best for robust tissue remodeling in resilient patients.

✔️ Depth & Manipulation
🔹 Acute injuries or high QST: Start shallow with basic needle insertions.
🔹 Chronic issues: Start with basic needle insertions then progress to rotation, tenting, or pistoning as tolerance improves.

✔️ Number of Needles
🔹 Begin with 5-10 per session → Adjust based on patient response.

✔️ Frequency
🔹 Most patients benefit from 1-2 sessions weekly until goals are met.

Real-World Case Studies from the Video

🔹 Fibromyalgia Patient
Technique: 0.16mm needles + minimal manipulation.
Result: Prevented flare-ups while improving mobility and activity balance.

🔹 Post-Marathon Runner
Technique: Light needling + e-stim.
Result: Eased calf tightness and delayed onset muscle soreness without worsening inflammation.

🔹 Chronic Low Back Pain
Technique: Progressed from superficial to deep needling guided by QST.
Result: Improved pain thresholds and function over 4 weeks.

Key Takeaways for Clinicians

✅ Start Low, Go Slow: Let patient feedback and QST guide progression.

✅ Respect Systemic Inflammation: Adjust dosage for illness, stress, or intense exercise.

✅ Track & Refine: Document needle count, manipulation technique, depth, and responses to
optimize sessions.

Watch These Strategies in Action

📺 Check out the full video above to see how to fine-tune dry needling for maximum impact.

💬 Have questions? Drop them below—I’m here to help! 🩺

#dryneedling #IDN #neurologicdryneedling #Dosingdryneedling #safedosage #neurogenicinflammation