Achilles tendonitis (AT) is a common, often chronic condition causing pain and stiffness along the back of the lower leg, particularly prevalent among runners and athletes. This overuse injury can significantly hinder daily activities and exercise, often persisting for months or years. Dry needling (DN) has emerged as a specific technique that many people with persistent Achilles pain are now exploring as part of their recovery plan. The effectiveness of this therapy in managing the symptoms and underlying pathology of AT is important for those seeking relief.
Defining Dry Needling and Its Application
Dry needling is a modern therapeutic technique that uses thin, stainless steel filiform needles to address musculoskeletal pain. The term “dry” means that no medication or fluid is injected. DN is distinct from traditional Chinese acupuncture; it is rooted in Western medical principles and focuses on treating neuromuscular dysfunction and pain.
The primary application for tendon issues like Achilles tendonitis involves targeting myofascial trigger points, which are hyper-irritable spots within a taut band of skeletal muscle. For AT, the practitioner typically inserts needles into tight spots within the gastrocnemius and soleus muscles of the calf, which exert significant tension on the Achilles tendon. The goal is to elicit a localized twitch response, leading to muscle relaxation and a reduction in the mechanical load placed on the stressed tendon. In some cases, percutaneous needle tenotomy may be used, where the needle is inserted directly into the damaged portion of the tendon itself.
Clinical Evidence of Relief
Clinical research suggests that dry needling offers benefits for individuals suffering from Achilles tendonitis, particularly when combined with a rehabilitation program. Studies frequently report significant pain reduction and improved functional scores in the short to medium term. Combining dry needling with exercise yields greater pain reduction and better functional results compared to exercise alone.
Dry needling has shown comparable short-term efficacy to more invasive treatments, such as platelet-rich plasma (PRP) or autologous blood injections, in relieving pain associated with tendinopathies. The positive effects are often seen quickly, allowing patients to tolerate the strengthening and loading exercises necessary for long-term tendon health. While widely used for mid-portion Achilles tendinosis, evidence suggests it may be less effective for insertional Achilles lesions located at the heel bone attachment.
Physiological Effects on Achilles Tendons
Dry needling exerts its therapeutic effects through localized physiological mechanisms that encourage tissue repair and modulate pain. One mechanism involves stimulating localized blood flow to the area. Tendons with chronic injury often suffer from poor vascularity, and needle insertion causes microtrauma that prompts a rush of oxygen and nutrients, initiating the healing cascade.
This stimulation encourages the activity of fibroblasts, the cells responsible for producing new collagen fibers. By physically disrupting the diseased tissue, the technique aims to restart the body’s natural repair process and promote a healthier collagen structure. Neurologically, dry needling helps reset communication between muscles and nerves, disrupting chronic pain signals. It is also thought to reduce local inflammation markers and facilitate the release of endogenous opioids, the body’s natural pain-relieving chemicals.
Safety Considerations and Post-Treatment Care
Dry needling is a safe procedure when performed by a certified, qualified practitioner, such as a physical therapist or chiropractor with specialized training. The most common side effects are mild and temporary, including localized soreness, muscle aching, or minor bruising at the insertion sites. This soreness typically resolves within 24 to 72 hours.
Rare, more serious risks are extremely low in the Achilles area, but contraindications exist for individuals with bleeding disorders or those who are pregnant. Post-treatment care is crucial for maximizing the benefits of the session. Patients are advised to maintain hydration and perform gentle stretching and specific tendon loading exercises as prescribed by their therapist. Integrating dry needling with active rehabilitation techniques is considered the best approach to achieve lasting relief and restore full tendon function.