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DR. SUBHANJAN DAS, PT 
Subhanjan_82@yahoo.com 
+91 8967549104 
Dry Needling Instructor 
MPT (Musculoskeletal & Sports) 
Assoc. Prof., BIMLS, Burdwan
Also in the series 
 http://www.slideshare.net/SubhanjanDas/introduction-to-dry-needling 
 http://www.slideshare.net/SubhanjanDas/2-brief-hisory-of-needling 
 http://www.slideshare.net/SubhanjanDas/3-superficial-dry-needling 
 http://www.slideshare.net/SubhanjanDas/4-indications-of-dry-needling 
 http://www.slideshare.net/SubhanjanDas/6-dangers-of-dry-needling 
 http://www.slideshare.net/SubhanjanDas/7-physiologic-background-of-dry-needling 
 http://www.slideshare.net/SubhanjanDas/8-dn-vs-acupuncture 
 http://www.slideshare.net/SubhanjanDas/9-electroacupuncture 
 http://www.slideshare.net/SubhanjanDas/10-legalities-involved-in-dry-needling
 Dry needling poses certain potential risks to the 
patient and therapists which are not associated with 
traditional non-invasive physiotherapy treatment.
Pneumothorax 
Dry needling may puncture pleura and cause 
pneumothorax.
 DN should be performed with special precautions 
around thorax 
 needling is done obliquely and superficially. 
Emphysematous patients have maximum risk. 
 A pincer grip should be utilised as in the case of the 
upper trapezius, or needling over bone to protect the 
lung as in the case of the scapula and ribs. 
 The risk of a pneumothorax is very small if proper 
needling techniques are employed
 The risk of a pneumothorax is very small if proper 
needling techniques are employed
Clinical features 
 Sudden and sharp chest pain 
 Breathing difficulty 
 Tight chest 
 Early fatigue 
 Tachycardia 
 dimished chest sounds 
 Low O2 tension 
 Low BP
Blood Vessels 
 with DN there is a potential of injury to blood vessels. 
 Palpating for a pulse to locate an artery prior to DN 
minimizes the risk.
Nerve 
 with DN there is potential for injury to nerves. 
 Special consideration needs to be given in relation to 
the spine and in the posterior sub occipital area 
 the brain stem is accessible through the foramen 
magnum.
Organs 
 Anatomical knowledge of internal organs is important 
as with DN there is potential for 
 injury to internal organs such as the kidney or 
penetration into the peritoneum cavity.
Others 
 Stuck, bent, broken needle. 
 Forgotten needle, forgotten patient. 
 Euphoria
Minor adverse effects 
1. needling pain 
2. aggravation of symptoms 
3. faintness, drowsiness
Patient instructions 
 Regarding activity 
 Regarding decision making!
 rare but serious traumatic complications could be 
avoided if practitioners had better anatomical 
knowledge, applied existing anatomical knowledge 
better, or both (Peuker and Gronemeyer 2001).

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6 dangers of dry needling

  • 1. DR. SUBHANJAN DAS, PT Subhanjan_82@yahoo.com +91 8967549104 Dry Needling Instructor MPT (Musculoskeletal & Sports) Assoc. Prof., BIMLS, Burdwan
  • 2. Also in the series  http://www.slideshare.net/SubhanjanDas/introduction-to-dry-needling  http://www.slideshare.net/SubhanjanDas/2-brief-hisory-of-needling  http://www.slideshare.net/SubhanjanDas/3-superficial-dry-needling  http://www.slideshare.net/SubhanjanDas/4-indications-of-dry-needling  http://www.slideshare.net/SubhanjanDas/6-dangers-of-dry-needling  http://www.slideshare.net/SubhanjanDas/7-physiologic-background-of-dry-needling  http://www.slideshare.net/SubhanjanDas/8-dn-vs-acupuncture  http://www.slideshare.net/SubhanjanDas/9-electroacupuncture  http://www.slideshare.net/SubhanjanDas/10-legalities-involved-in-dry-needling
  • 3.  Dry needling poses certain potential risks to the patient and therapists which are not associated with traditional non-invasive physiotherapy treatment.
  • 4. Pneumothorax Dry needling may puncture pleura and cause pneumothorax.
  • 5.  DN should be performed with special precautions around thorax  needling is done obliquely and superficially. Emphysematous patients have maximum risk.  A pincer grip should be utilised as in the case of the upper trapezius, or needling over bone to protect the lung as in the case of the scapula and ribs.  The risk of a pneumothorax is very small if proper needling techniques are employed
  • 6.
  • 7.  The risk of a pneumothorax is very small if proper needling techniques are employed
  • 8. Clinical features  Sudden and sharp chest pain  Breathing difficulty  Tight chest  Early fatigue  Tachycardia  dimished chest sounds  Low O2 tension  Low BP
  • 9. Blood Vessels  with DN there is a potential of injury to blood vessels.  Palpating for a pulse to locate an artery prior to DN minimizes the risk.
  • 10. Nerve  with DN there is potential for injury to nerves.  Special consideration needs to be given in relation to the spine and in the posterior sub occipital area  the brain stem is accessible through the foramen magnum.
  • 11. Organs  Anatomical knowledge of internal organs is important as with DN there is potential for  injury to internal organs such as the kidney or penetration into the peritoneum cavity.
  • 12. Others  Stuck, bent, broken needle.  Forgotten needle, forgotten patient.  Euphoria
  • 13. Minor adverse effects 1. needling pain 2. aggravation of symptoms 3. faintness, drowsiness
  • 14. Patient instructions  Regarding activity  Regarding decision making!
  • 15.  rare but serious traumatic complications could be avoided if practitioners had better anatomical knowledge, applied existing anatomical knowledge better, or both (Peuker and Gronemeyer 2001).