We have a term for this kind of physio: shake n’ bake. You get some “shake” with massage and manipulation, and you get some “bake” with electric modalities. I want to make it clear that I’m not against manual therapy or therapeutic modalities as they can certainly be helpful in the right contexts, but it’s no secret that they are widely misused by therapists who are either too busy or too lazy to provide personalized and evidence-based treatments for their patients.

Dry needling might be the most polarizing treatment approach in the world of physical therapy. Patients either love it or hate it, and its use can be a topic of debate among clinicians. It is also quite poorly understood, both by patients and therapists. I believe that people should understand the treatments they receive, and I believe that therapists should have a clear rationale for the treatments they offer; therefore, I’d like to answer some of the most common questions about dry needling as objectively as possible before concluding with my opinion based on my read of the literature and my clinical experience.

A woman with very acute lower back pain came to see me for an assessment. Her pain was sharp, intense, and radiated down her legs. She worked full-time and couldn’t afford to take time off, had 3 kids, and told me that she was under a lot of stress.

Many think of variability in movement and rehab as a constant exploration of new patterns and stimuli, but this approach leads to superficial results that lack the characteristic depth of anything truly valuable or meaningful. Using variability as a movement concept is more like rereading your favourite book, or rewatching your favourite movie. Even though you know the story, every retelling uncovers some hidden meaning, or presents something familiar in a new way.

The nervous system is a beautifully complex web of nerves and neurons that allows us to feel, think, and act the way we do. It is a physical structure responsible for sensing the world around us, processing physical, cognitive, emotional, and social information, and coordinating our behaviours accordingly. Nothing in the body is purely physical or purely psychological: everything is connected through the nervous system.