Neurologic Dry Needling (NDN) is the evolution from needling points (myofascial trigger points) to needling the system. NDN is utilized to treat all types of neuromusculoskeletal conditions.  These conditions are not limited to orthopedics but are applicable to any condition where inflammation (neurogenic), reduced blood flow and muscle guarding is present.  The NDN treatment system is based on peripheral and central neurologic principles, which is not limited by the traditional trigger point paradigm.  Using the peripheral nerve mapping model allows a broader opportunity to deliver treatment locally, segmentally, and most importantly systemically. 

Treatment of acute and sub-acute pain can respond favorably to dry needling that is focused locally i.e. at the site of pain.  However, patient tolerance can be a limiting factor with a solely local approach that relies on the all or nothing production of a “twitch”.  Failure of this approach may be related to excessive needling dosage required to obtain the goal of exhausting the muscle’s twitch response.  The NDN model does not rely on this shot gun treatment approach; varied levels of stimulation and precise targeting of tissue allows a less vigorous dosage, reduced adverse events and better patient tolerance.  

When pain transitions to recurrent and/or chronic a degree of central sensitization is likely so the treatment must be expanded beyond site specific needling. NDN provides a deeper understanding and a logical approach to targeting expanded areas of peripheral nerve entrapment, inflammation and central sites that facilitate and/or maintain the pain.   

Additionally, in our NDN courses you are instructed on the administration of the IDN bedside Quantitative Sensory Testing (QST) exam that assists in determining the efficacy of dry needling treatment.  In patients presenting with pain, especially long standing pain, sensitization of nervous system tissue spreads, represented clinically as inflamed sensory nerves (homeostatic points).  The number of positive findings discovered during IDN’s bedside QST indicates the severity of inflammation or sensitization in the body.  The greater the number of positive findings is an empirical estimate of how many dry needling treatment sessions are needed to reduce the systemic inflammation/sensitization and how long the pain relief might last.  

The combination of our neurologic assessment with other important subjective and objective clinical indicators provides a global view of patient condition, prognosis and delivers a clinically efficient and effective treatment plan.

I welcome you to attend one of our  NDN courses and experience the next generation of dry needling treatment!

Dr. Frank Gargano
President/Founder
Integrative Dry Needling Institute, LLC