Dry Needling for Pelvic Floor: Benefits, Process, and Safety

By Dr. Zarina Vitebsky, DPT, MSPT, PRPC, TPS, LPF, DN on 10/30/2023

Dry Needling For Pelvic Floor Physical Therapy


Explanation of Pelvic Floor Physical Therapy

Pelvic floor physical therapy is a specialized form of physical therapy that focuses on the muscles, ligaments, and connective tissues in the pelvic region. These muscles play a crucial role in supporting the bladder, uterus, and rectum, as well as controlling bowel and bladder function. Pelvic floor physical therapy aims to improve the strength, coordination, and function of these muscles to alleviate symptoms such as urinary or fecal incontinence, pelvic pain, and sexual dysfunction.

Introduction to Dry Needling

Dry needling is a technique used by physical therapists to treat myofascial pain and trigger points in the muscles. It involves inserting thin, sterile needles into specific points in the muscles to stimulate a healing response and release tension. Unlike acupuncture, which is based on traditional Chinese medicine, dry needling is rooted in Western medicine and anatomy.

Importance of Pelvic Floor Physical Therapy Dry Needling

Dry needling is a valuable tool in the treatment of pelvic floor dysfunction. It can be used to target specific trigger points in the pelvic floor muscles, releasing tension and improving blood flow. This can help alleviate symptoms such as pelvic pain, urinary or fecal incontinence, and sexual dysfunction. Additionally, dry needling can help improve the effectiveness of other pelvic floor physical therapy techniques, such as exercises and manual therapy.

Understanding the Pelvic Floor

Anatomy of the Pelvic Floor

The pelvic floor is a group of muscles, ligaments, and tissues that form a sling-like structure at the bottom of the pelvis. It is made up of three layers: the superficial perineal layer, the deep urogenital diaphragm, and the pelvic diaphragm. The pelvic floor muscles attach to the pubic bone in the front and the tailbone in the back, and they support the bladder, uterus, and rectum.

Function of the Pelvic Floor Muscles

The main function of the pelvic floor muscles is to support the pelvic organs and maintain continence. These muscles also play a role in sexual function and stability of the pelvis and spine. They work together with the abdominal and back muscles to provide core stability and help with posture and movement.

Common Pelvic Floor Disorders

There are several conditions that can affect the pelvic floor, including pelvic organ prolapse, urinary incontinence, and pelvic pain. Pelvic floor disorders can be caused by a variety of factors such as pregnancy and childbirth, obesity, chronic constipation, and aging. Symptoms may include pelvic pressure or heaviness, urinary or fecal incontinence, and pain or discomfort in the pelvic region.

What is Dry Needling?

Definition of Dry Needling

Dry needling is a form of physical therapy that involves inserting thin, solid needles into specific points in the body to alleviate pain and improve muscle function. These needles are typically the same size as acupuncture needles, but the techniques and goals of dry needling are different.

History of Dry Needling

Dry needling was first developed in the 1940s by Dr. Janet Travell, a physician who specialized in treating musculoskeletal pain. She used hypodermic needles to inject trigger points in muscles, which she believed were the source of pain. This technique evolved over time and eventually became known as dry needling.

Differences between Dry Needling and Acupuncture

While both dry needling and acupuncture involve the use of thin needles, they have different origins and purposes. Acupuncture is a traditional Chinese medicine practice that focuses on balancing the body's energy flow, or qi, while dry needling is based on Western medicine principles and targets specific muscle trigger points to relieve pain and improve function.

Benefits of Pelvic Floor Physical Therapy Dry Needling

Pain Relief

Dry needling is a technique used in pelvic floor physical therapy to target specific trigger points in the pelvic floor muscles. These trigger points can cause pain and discomfort in the pelvic region, which can be alleviated through the use of dry needling. By inserting thin needles into these trigger points, the muscles are stimulated and release tension, providing relief from pain.

Improved Muscle Function

Dry needling can also help improve muscle function in the pelvic floor. By targeting trigger points and releasing tension, the muscles are able to relax and function more efficiently. This can lead to improved bladder and bowel control, as well as better support for the pelvic organs.

Increased Blood Flow

When dry needling is performed on the pelvic floor muscles, it can also increase blood flow to the area. This can help with healing and tissue repair, as well as reducing inflammation and promoting overall muscle health.

Reduction of Trigger Points

Trigger points in the pelvic floor muscles can cause a variety of symptoms, including pain, urinary and bowel dysfunction, and sexual dysfunction. Dry needling can effectively reduce these trigger points, providing relief from these symptoms and improving overall pelvic floor function.

Improved Bladder and Bowel Control

One of the main benefits of pelvic floor physical therapy dry needling is its ability to improve bladder and bowel control. By targeting trigger points and improving muscle function, dry needling can help reduce urinary and bowel incontinence, as well as other bladder and bowel dysfunctions.

The Process of Pelvic Floor Physical Therapy Dry Needling

Initial Assessment and Evaluation

The first step in pelvic floor physical therapy dry needling is an initial assessment and evaluation. This involves a thorough examination of the patient's medical history, symptoms, and any previous treatments. The therapist will also perform a physical examination to assess the patient's pelvic floor muscles and identify any trigger points that may be causing pain or dysfunction.

Selection of Appropriate Needles

Once the trigger points have been identified, the therapist will select the appropriate needles for the treatment. These needles are typically thin and flexible, and are specifically designed for dry needling. The therapist will take into consideration the depth and location of the trigger points when choosing the needles.

Insertion of Needles into Trigger Points

Once the needles have been selected, the therapist will insert them into the trigger points. This is done with precision and care, as the needles need to be placed in the correct location to effectively release the tension in the muscles. The therapist may use a guide tube to help guide the needle into the trigger point.

Manipulation of Needles to Elicit a Twitch Response

After the needles have been inserted, the therapist will manipulate them to elicit a twitch response. This is a small involuntary contraction of the muscle, which indicates that the trigger point has been successfully released. The therapist may also use techniques such as rotation or lifting and thrusting to further release tension in the muscles.

Removal of Needles and Post-Treatment Care

Once the treatment is complete, the therapist will remove the needles and provide post-treatment care instructions. This may include gentle stretching exercises, heat or ice therapy, and recommendations for follow-up appointments. It is important for the patient to follow these instructions to ensure the best possible outcome from the dry needling treatment.

Safety and Considerations

Qualifications of a Pelvic Floor Physical Therapist

A pelvic floor physical therapist is a specialized healthcare professional who has received additional training and certification in treating pelvic floor dysfunction. They typically have a Doctor of Physical Therapy (DPT) degree and have completed specialized courses in pelvic floor rehabilitation. It is important to ensure that your therapist is qualified and experienced in treating pelvic floor issues before beginning treatment.

Potential Risks and Side Effects

As with any medical treatment, there are potential risks and side effects associated with pelvic floor physical therapy dry needling. These may include bruising, bleeding, and temporary discomfort at the site of the needle insertion. It is important to discuss any concerns or potential risks with your therapist before starting treatment.

Precautions for Certain Medical Conditions

While pelvic floor physical therapy dry needling is generally safe, there are certain medical conditions that may require precautions or modifications to the treatment. These may include pregnancy, bleeding disorders, or compromised immune system. It is important to inform your therapist of any medical conditions or medications you are taking before starting treatment.

Importance of Communication with the Therapist

Communication with your therapist is crucial for a successful treatment outcome. It is important to openly discuss any concerns or discomfort you may experience during or after the treatment. Your therapist can also provide you with tips and techniques to manage any discomfort and ensure that the treatment is effective.

Follow-up Appointments and Maintenance

Pelvic floor physical therapy dry needling is often not a one-time treatment and may require multiple sessions for optimal results. Your therapist will work with you to develop a treatment plan and schedule follow-up appointments as needed. It is also important to continue with any recommended exercises or self-care techniques to maintain the benefits of the treatment.

If you are experiencing pelvic floor dysfunctions associated with the issues above, please reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at

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