One advantage of adding dry needling to your clinical arsenal may not get enough attention. Dry needling articles and testimonies usually focus on patient benefits, such as decreased pain, increased flexibility and range of motion, restoration of strength, decreased spasticity, or improvements in scar tissue mobility. Yet, dry needling also benefits clinicians…..
An older study [1] investigating occupational musculoskeletal injuries of physical therapists and physical therapy assistants reported that injuries to the upper back and the wrist and hand had the second highest injury prevalence (23% of injured PTs) only after the low back (62% of injured PTs). While low back pain was most common among PTs working in rehabilitation settings (75%), outpatient settings (64%), hospitals (63%), or skilled nursing facilities (SNF) (52%). Only 13% of PTs working in hospitals experienced wrist or hand injuries compared to 38% working in SNFs and 32% in outpatient settings. Clinicians aged between 21 to 30 years who worked between 41 and 50 hours per week experienced the highest injury prevalence and years of experience did not impact the injury prevalence.
Bork and colleagues [2] found similar results with 29.6% of physical therapists reporting work-related musculoskeletal disorders (WMD). Physical therapists who routinely performed manual therapy had a higher prevalence of self-reported musculoskeletal symptoms in the elbows, wrists, and hands. They were 3.5 times more likely to have had musculoskeletal symptoms in the wrists and hands than physical therapists who did not routinely perform manual therapy. The lifetime prevalence of WMSDs ranges between 55% and 91% [3, 4] with a 12-month prevalence of 40-91.3% [4]. A study from Taiwan reported a prevalence ranging from 6.1% to 75.2%, and an incidence ranging from 6.1 to 29.1 per 100 person-years [5].
Work-related musculoskeletal disorders occur early in a physical therapist’s career. About 50% of PTs reported WMSDs during the first five years of employment [3].
An Australian study [6] confirmed that private practitioners reported more neck, upper back, elbow, wrist, hand, and thumb symptoms compared to other therapists. Manual therapy was associated with an increased risk of WMSDs. Two unpublished papers [7, 8] supported that the thumb is a common anatomical region prone to injury among manual physical therapists. Eleven percent of Kuwaiti physical therapists reported hand and wrist problems [9].
Dry needling is classified as a manual therapy in the fourth edition of the APTA Guide to Physical Therapist Practice [10]. As an instrument-assisted manual therapy, dry needling is much less demanding on the clinicians’ hands. Many dry needlers no longer experience daily pain in their hands and thumbs after a full day in the office. While saving your hands may not be your primary motivation to start dry needling in your office, the reduced biomechanical stress on your wrists, hands, and thumbs is a nice added benefit.
Jan Dommerholt, PT, DPT / President/CEO, Myopain Seminars
References
1. Holder, N.L., et al., Cause, Prevalence, and Response to Occupational Musculoskeletal Injuries Reported by Physical Therapists and Physical Therapist Assistants. Physical Therapy, 1999. 79(7): p. 642-652.
2. Bork, B.E., et al., Work-Related Musculoskeletal Disorders Among Physical Therapists. Physical Therapy, 1996. 76(8): p. 827-835.
3. Vieira, E.R., et al., Work-related musculoskeletal disorders among physical therapists: A systematic review. J Back Musculoskelet Rehabil, 2016. 29(3): p. 417-28.
4. Milhem, M., et al., Work-related musculoskeletal disorders among physical therapists: A comprehensive narrative review. Int J Occup Med Environ Health, 2016. 29(5): p. 735-47.
5. Chen, C.Y., et al., Work-related musculoskeletal disorders among physical therapists in Taiwan. Medicine (Baltimore), 2022. 101(7): p. e28885.
6. Cromie, J.E., V.J. Robertson, and M.O. Best, Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses. Phys Ther, 2000. 80(4): p. 336-51.
7. Balon, M.B., Thumb and wrist symptoms of manipulative therapists. 1984, Lincoln Institute: Melbourne, Victoria, Australia.
8. Jensen, J.B., Stress and joint symptoms survey related to work environment of physiotherapists and manipulative therapists [1983, La Trobe University: Melbourne, Victoria, Australia.
9. Alrowayeh, H.N., et al., Prevalence, characteristics, and impacts of work-related musculoskeletal disorders: a survey among physical therapists in the State of Kuwait. BMC Musculoskelet Disord, 2010. 11: p. 116.
10. American Physical Therapy Association, APTA Guide to Physical Therapist Practice 4.0. 2023, American Physical Therapy Association: Alexandria, VA, USA.
