During the DN1 course, we emphasize the importance of eliminating twitch responses from a trigger point to deliver the best outcomes for our patients. Achieving a full release is the gold standard, but what happens when things don’t go exactly according to plan?
Picture this: You’re working on a stubborn trigger point, and you haven’t quite cleared all the twitches. Suddenly, your patient asks you to stop. Or perhaps they haven’t said anything, but you notice signs of distress like heavy breathing, sweating, or delayed response to your questions. What now?
Unless the patient explicitly tells you to remove the needle, one of the most effective and underutilized tools in your clinical toolbox is simple: pause.
Give it a rest.
This doesn’t mean stepping away or starting work on another patient. It means halting the pistoning and manipulation of the needle while maintaining your presence and connection with the patient. Keep your palpating hand in place, maintaining steady contact with the needle, and shift your focus to observation and dialogue.
Why the Pause Matters
A short rest offers more than just a breather; it gives the patient’s nervous system a chance to settle. When we needle too aggressively or without pause, the experience can become threatening, triggering a fight-or-flight response that counteracts the therapeutic goals of dry needling.
By pausing:
- You allow the nervous system to downregulate.
- You create space to check in with your patient.
- You reinforce safety, trust, and patient control.
- You can explain the importance of the twitch response and how eliminating it supports recovery.
A well-timed pause also allows you to regroup clinically. Sometimes, after a short break, you’ll find the area a little calmer, allowing you to return to your work more effectively.
Don’t Rush the Process
In busy clinical settings, the temptation to hurry through treatment is real. But rushing through a trigger point, especially one that’s being stubborn, won’t serve your patient or your outcomes. Worse, it can lead to sloppier technique and decreased effectiveness.
Slow down. Be intentional. Remember: dry needling is not just about technique, it’s about the experience you’re creating for your patient.
Sometimes, the most powerful clinical decision you can make is to just give it a rest.
