Dry Needling & Blood Thinner Medications: Is it a Safe Combination?
One of the precautions we talk about in Dry Needling (DN) education courses is the safety of performing DN on patients who are taking anti-thrombolytic (blood thinning) medications. A recent study by Munoz, et al. (2022) looked into the safety profile of this precautionary combination of interventions.
According to this study, there has been no real investigation as to the efficacy or risk-profile of performing DN on patients who are taking blood thinning medications, and this topic has significant relevance to performing DN when these medications are a part of someone’s current medical history.
This study looked at bleeding responses from a variety of “DN” types including, DN, Acupuncture, EMG, BOTOX injections, and ultrasound-guided needle biopsies, along with the type of blood thinning medications including anti-platelet & anti-coagulant agents.
Munoz et al. have made the following recommendations, (which AOPT Seminars CDN programs teaches in our Comprehensive Dry Needling program prior to this study’s recommendations) in regards to DN patients who are taking blood-thinning medications/ agents:
Clinicians must always provide patients with the possible risks of DN and obtain at least an oral informed consent prior to DN.
When specific information about the patient’s coagulation status, such as the INR, is not readily available, clinicians should determine the potential risk factors by including specific questions during the clinical interview, such as the patient’s experience with bleeding following venipuncture.
When a given patient presents with diminished coagulation, clinicians may consider initially reducing the intensity of the DN techniques. Although the bleeding response for every patient may vary between days or even on the same day, it is recommended to observe the patient’s bleeding response and initially avoid DN in deeper muscles until its safety has been established with more superficial muscles, especially with patients on anticoagulant therapy.
Applying prolonged hemostasis following DN is recommended (provide compression to DN locations upon removing needles for 5-10 seconds to mitigate bleeding response).
Given a long history of safety in venipuncture, BOTOX injections and EMG studies being used on patients taking blood thinners, taking anti-thrombotic medication should not be considered an absolute contraindication for DN techniques. If specific dry needling and individual risks are properly considered, anti-thrombotic medications do not change the risk and safety profile of dry needling.