What a Precision Physical Therapy Session Looks Like

All visits, whether comprehensive or abbreviated will include:

  • Assessment Part 1: Subjective exam where Dr. Baldwin will ask you questions about your complaints to better understand your specific situation and what may be contributing
  • Assessment Part 2: A very simple objective exam where Dr. Baldwin will test your muscles, joints, and nerves to more definitively rule in/out what is contributing to your complaints, and know exactly what muscle targets to treat. We will also gather specific comparable signs through this testing that we will look at after treatment to make sure we are doing the right thing and seeing progress.
  • Confirmed informed consent for intramuscular dry needling treatment and to rule out potential contraindications, and if determined that needling is not appropriate for you, a discussion of other treatment options, 
  • Actual treatment: dry needling, myofascial decompression, or other hands-on treatment with constant monitoring during to ensure safety and treatment effectiveness
  • Immediate follow-up after treatment to see if positive outcomes are seen and re-test comparable signs gathered earlier 
  • Instruct you in and go over a simple home program of targeted exercises to address the areas treated
  • Discussion of next steps and scheduled follow up as needed

This process will vary in length and complexity based on whether we are focused on one particular area of the body and looking for a short/simple visit, (Abbreviated Assessment + Treatment), or if we are focused on multiple areas of the body and looking for a little more in-depth attention (Comprehensive Assessment + Treatment).

For returning clients, the assessment portion will end up being quite a bit shorter, particularly if addressing similar complaints or areas of the body as done previously. Focus in these cases will be a little more towards the actual treatment.

Modern Dry Needling—A Precision-Based Approach

Our Dry Needling Philosophy

At Precision Physical Therapy, we utilize a modern, evidence-informed approach to intramuscular dry needling, including the strategic use of indwelling needles with electrical stimulation (e-stim). This advanced technique is commonly used for individuals experiencing muscle and nerve-related symptoms and dysfunction, to support recovery, and improve neuromuscular function. It’s so much more than just “releasing trigger points,” it is acting with your neuromuscular system in a very therapeutic way. This combination of dry needling and e-stim is called “Dry Needling 2.0” as taught by the Institute of Clinical Excellence. 

Treatment is individualized and will be integrated with education, movement and loading strategies, and corrective exercise to ensure long-term results—not just temporary relief. Dry needling is not a standalone solution, but a tool used to help you get on the right track. Dry needling creates a window of opportunity to actually experience the long term and sustainable changes that you are looking for. Dry needling targets dysfunctional muscle and nerve tissue.

When combined with low-level electrical stimulation, indwelling needles enhance therapeutic effects by:

  • promoting improved fluid dynamics within the muscle/circulation
  • neuromuscular signaling
  • changes in resting muscle tone
  • more efficient muscle recruitment
  • calming nerve irritation.

This approach is commonly used to support:

  • Musculoskeletal pain and tension
  • Muscle strains and overuse injuries
  • Nerve-related symptoms such as radiating or radicular pain or altered sensation
  • Movement inefficiencies and impaired muscle activation
  • Recovery from training/competition, work demands, or repetitive stress. 

Conditions We Treat

Dry Needling is beneficial for:

 Muscle strains (any region of the body)
Jaw pain/dysfunction (TMJ)
Athletic recovery
Sciatica
Lumbar pain/radiculopathy
Plantar fasciitis/plantar foot pain
Tennis Elbow (lateral elbow)
Golfer’s Elbow (medial elbow)
Cervical radiculopathy
Cervicogenic headaches
Hip Pain/Gluteal tendinopathy
Shoulder Pain/Rotator cuff tendinopathy
Achilles tendinopathy/heel pain

And More!

Benefits of Dry Needling

When performed by a licensed physical therapist or other qualified provider, dry needling combined with active strategies will help:

  • Decrease pain (pain modulation)
  • Improve range of motion and mobility
  • Normalize muscle tone, activation, and recruitment patterns
  • Promote improved muscle and nerve health
  • Support faster recovery and improved performance
  • Target and calm nerve related symptoms
  • Promote improved hemodynamics/fluid movement within muscle tissue
  • Improve tolerance to exercise and daily activities
  • Enhance the effectiveness of therapeutic exercise and movement retraining

Other Treatments

What else we provide

Aside from dry needling, which is a focus of his practice, Dr. Baldwin also provides some additional hands-on treatment techniques that can be used in combination with dry needling or in circumstances when dry needling may not be the best option for you. Proper screening and assessment will be done prior to these treatments as well to determine if you are an appropriate candidate. 

These include:

  • Myofascial Decompression (Cup Therapy):
    • a modern evidence-based approach to cupping that involves active movement strategies with instrument assisted soft tissue mobilization by use of cups and negative pressure
    • “Myofascial Decompression addresses connective tissue restrictions by improving the mobility of the soft tissue layers. The use of negative pressure with suction cups creates space between the soft tissue layers that allows each layer to slide one upon another with decreased viscosity and improved movement efficiency.” (Cup Therapy)
  • Joint Mobilization - hands on, often passive movement of joints with specific forces to improve range of motion and joint health
  • Spinal Manipulation - high velocity low amplitude thrust joint manipulation to the spine

Safety, Risks, and Precautions

Dry needling is a generally safe intervention when performed by a properly trained and licensed physical therapist. As with any invasive medical or therapeutic procedure, there are potential risks, which may include:

  • Temporary soreness or bruising
  • Mild bleeding at the needle site
  • Fatigue or lightheadedness
  • In very rare cases - pneumothorax or hemothorax (will be discussed more in depth during your visit if applicable)

Serious adverse events are rare. At Precision Physical Therapy, safety is a top priority. We take extensive precautions to minimize risk, including:

  • Thorough screening and clinical assessment prior to each treatment
  • Strict adherence to clean needle technique and infection control standards
  • Use of evidence-based anatomical knowledge and precise needle placement
  • Clear communication and informed consent before every session
  • All treatments are tailored to the individual, and dry needling is only performed when clinically appropriate.

Contraindications

When Dry Needling or E-Stim May Not Be Appropriate

Dry needling and electrical stimulation are valuable physical therapy tools, but they are not appropriate for every individual or every condition. At Precision Physical Therapy, a thorough evaluation is completed before treatment to determine whether these interventions are safe and clinically appropriate.

Dry needling and/or electrical stimulation may be contraindicated or used with caution in individuals with:

  • Active infection, open wounds, or skin lesions near the treatment area
  • Bleeding disorders or use of certain anticoagulant medications
  • Compromised immune systems
  • Pregnancy (particularly in first trimester)
  • History of adverse reactions to needling procedures
  • Inability to communicate discomfort or provide informed consent

Electrical stimulation may be contraindicated or modified for individuals with:

  • Implanted electronic devices (such as pacemakers or defibrillators)
  • Certain cardiac conditions
  • Seizure disorders
  • Sensory impairments that limit accurate feedback

 

Individualized Clinical Decision-Making

Not all contraindications are absolute. In some cases, treatment may be modified, delayed, or avoided altogether based on individual risk factors, clinical presentation, and patient preference. Dry needling and e-stim are only performed when deemed appropriate following a comprehensive assessment and discussion of risks, benefits, and alternatives. Patient safety, informed consent, and clinical judgment guide all treatment decisions. If you have questions or concerns about whether dry needling and electrical stimulation is appropriate for you, these will be addressed thoroughly prior to initiating care. If it is determined that you are not an appropriate candidate for dry needling, other options for treatment will be discussed with you.

Dry Needling & Acupuncture

How are they different?

Intramuscular Dry Needling, when performed in the modern way, is distinctly different from acupuncture. Although dry needling and acupuncture both involve the use of thin monofilament, sterile needles, they are distinct practices with different training backgrounds, philosophies, and clinical applications. Both dry needling and acupuncture can be effective within their respective frameworks. At Precision Physical Therapy, dry needling is utilized as an integral part of a comprehensive physical therapy approach focused on restoring movement, function, and recovery.

Dry Needling

Dry needling is a modern physical therapy technique grounded in Western medicine and contemporary understanding of anatomy, neurophysiology, and movement science. It is used by licensed physical therapists, chiropractors, physicians, and other health care providers to evaluate and treat musculoskeletal and neuromuscular dysfunction. We are trained to treat very specific structures for very specific reasons. 

Acupuncture

Acupuncture, rooted in Eastern and Traditional Chinese Medicine (TCM), is based on the concept of restoring energy flow (Qi) through specific meridian points to support overall health and wellness. This is not true of all acupuncturists, but their training is rooted in these concepts whereas a physical therapist is not trained this way.

Key Differences Include:

  • Clinical Framework:
    • Dry needling is based on anatomy, biomechanics, and nervous system function.
    • Acupuncture is based on traditional meridian and energy-based models.
  • Treatment Goals:
    • Dry needling focuses on improving movement, reducing muscle and nerve-related pain, and restoring neuromuscular function.
    • Acupuncture is commonly used to promote systemic balance and general wellness.
  • Assessment & Application:
    • Dry needling uses a physical therapy evaluation to identify specific tissues; dysfunctional muscles, nerves, or other neuromuscular impairments. Needle placement is determined by movement assessment and anatomical findings—not meridian maps.
  • Integration with Movement and Load:
    • Dry needling is often combined with therapeutic exercise, neuromuscular re-education, and functional loading strategies to support long-term outcomes.

Legal & Medical Disclaimer

Dry needling is a physical therapy intervention performed by a licensed physical therapist within the scope of practice defined by Wyoming law. 

As defined by the Wyoming State Board of Physical Therapy: “'Dry needling' is a manual therapy technique that uses a filiform needle as (a) mechanical device to treat conditions within the scope of physical therapy practice. It is based upon Western medical concepts, requires a physical therapy examination and physical therapy diagnosis, and treats specific anatomic entities. Dry needling does not include the stimulation of auricular or acupuncture meridians.” (WY Board of Physical Therapy, Rules and Regulations, Chapter 1, Section 4(f))

The information provided on this website is for educational purposes only and is not intended to diagnose, treat, or replace medical advice from a physician or other qualified healthcare provider. Outcomes from dry needling and physical therapy services may vary between individuals. Participation in physical therapy services is voluntary, and all patients are encouraged to discuss their care with their primary healthcare provider as needed. If you experience new or worsening symptoms, you should seek appropriate medical evaluation.