If you’re dealing with shoulder pain, especially near the front or top of the shoulder, rotator cuff syndrome may be to blame. At Vertex PT Specialists, we frequently treat patients in Columbia, Cayce, Irmo, and surrounding areas dealing with this common issue.
One powerful treatment tool we use is dry needling—a technique that targets dysfunctional muscle tissue to reduce pain, restore mobility, and improve function.
Watch the video below to see Dr. Brandon Vaughn demonstrate dry needling of the distal supraspinatus:
Why the Distal Supraspinatus?
The supraspinatus is one of the four muscles that make up the rotator cuff. It plays a key role in stabilizing the shoulder joint and initiating arm elevation. When the distal portion of the muscle becomes irritated or overloaded, it can lead to symptoms such as:
Sharp pain with overhead movements
Difficulty sleeping on the affected side
Painful arc during shoulder abduction
Positive impingement tests
Targeted dry needling to this area, when performed by an expert, can quickly decrease hypertonicity and improve shoulder mechanics.
Is Dry Needling Safe?
Absolutely—when performed by a licensed provider trained in anatomy and technique. At Vertex PT, all of our therapists are trained in anatomical landmarking, safety protocols, and clean needle technique to minimize risk and maximize outcomes.
Ready to Address Your Shoulder Pain?
If you’ve been told you have rotator cuff syndrome, subacromial pain syndrome, or shoulder impingement, we can help. Our PTs combine manual therapy, exercise prescription, and targeted dry needling to get you back to doing what you love.
Dry Needling the Rhomboids: What a Recent Case Teaches Us About Safety
Dry needling is an effective clinical tool for treating myofascial pain, trigger points, and movement dysfunction. But like any skilled intervention, it requires anatomical precision and clinical judgment—especially when needling near the thoracic cavity.
In June 2025, the journal Physical Therapy published a case report of a pneumothorax following dry needling of the rhomboids and middle trapezius using a rib bracketing technique. You can view the abstract here.
At Vertex PT Specialists in Columbia, SC, we treat scapular, shoulder, and neck pain daily—and we take safety seriously. That’s why we wanted to break down what went wrong in this case, and how to needle the intrascapular region more safely and effectively.
Watch the full video breakdown by Dr. Brandon Vaughn here:
What Happened in the Case?
The patient was a 24-year-old woman being treated for chronic shoulder and neck pain. The treating physical therapist used a rib bracketing technique to needle the left rhomboid and middle trapezius with 0.20 mm × 20 mm needles. She reported a sharp, abnormal pain during one insertion.
Two days later, she developed shortness of breath, chest pain, and a dry cough. A chest radiograph confirmed a moderate pneumothorax, and she required an ER visit, chest tube placement, and overnight hospitalization. Thankfully, she made a full recovery—but the event was entirely avoidable.
What Went Wrong?
Based on the case report and expert commentary, here’s where the technique likely failed:
1. High-Risk Technique in a Hard-to-Palpate Region
Rib bracketing in the intrascapular region is difficult due to narrow anatomy and variable rib depth. Studies show clinicians are only ~66–73% accurate at palpating ribs between the scapula and spine. That margin of error matters when working near the lungs.
2. Needle Was Too Thin
The therapist used a 0.20 mm needle—so thin it may have glided between ribs or provided poor tactile feedback. In high-risk zones, thicker needles (0.30–0.32 mm) are preferred because they allow the clinician to feel bony resistance and avoid over-penetration.
3. No Adjustment for Patient Anatomy
The patient had a low BMI, meaning her skin-to-pleura distance was minimal. Even a 20 mm needle may have been too long. In our clinic, most patients reach the rib around 10–15 mm, depending on build.
4. Missed Warning Signs
The sharp pain reported during insertion was not typical and should have prompted a reassessment. Ignoring those signs can lead to serious consequences.
How We Do It Differently at Vertex PT
At Vertex PT Specialists, we regularly treat patients with scapular pain, postural dysfunction, and shoulder instability—and dry needling is one of the tools we use. But we take every precaution to ensure safety, including:
Here’s how we reduce risk while still delivering results:
We don’t avoid rib bracketing just because a patient has low BMI. Instead, we make sure the technique is executed by clinicians with advanced palpation skills and experience. The issue in this case wasn’t the patient’s body type—it was poor execution.
We choose needle size and depth based on actual tissue feel. Most patients reach rib contact between 10–15 mm. Using a needle that’s too thin or going too deep without feedback is what leads to complications.
We use alternative techniques—when needed. If rib palpation is uncertain, we’ll switch to pincer grip or bolster methods. Safety comes first.
We stay sharp—even with experience. Complacency is dangerous. This isn’t about memorizing depths from a weekend course; it’s about reading the body in front of you.
We educate patients. We explain what to expect during treatment and encourage them to speak up if anything feels off.
Dry Needling in Columbia, SC—With Safety in Mind
If you’re dealing with upper back, scapular, or shoulder pain and considering dry needling, it’s essential to work with clinicians who understand both the anatomy and the risks involved. At Vertex PT Specialists, we provide expert dry needling at our clinics in Cayce–West Columbia, Downtown Columbia, and Irmo, SC. We also offer outpatient home health dry needling across Lexington and Richland counties—bringing skilled care directly to your doorstep.
Whether you’re recovering from injury, managing chronic pain, or aiming to move better, our therapists prioritize clinical precision and evidence-based treatment in every session.
https://i0.wp.com/vertexpt.com/wp-content/uploads/2025/07/DRY-NEEDLING1.jpg?fit=1080%2C1080&ssl=110801080Brandon Vaughnhttp://ecbiz218.inmotionhosting.com/~wwwver6/wp-content/uploads/2017/02/logo-horiz.pngBrandon Vaughn2025-07-25 15:55:112025-07-25 21:06:44Dry Needling the Rhomboids Safely: Lessons from a Recent Pneumothorax Case
Low back pain is one of the most common reasons people seek physical therapy. At Vertex PT Specialists, we use advanced techniques like dry needling to target deep spinal stabilizers that traditional treatments often miss.
In this video, Dr. Josh Jeffery, PT, DPT, CSCS, reviews the anatomical considerations, palpation techniques, and safe application of dry needling to the erector spinae and multifidus—key muscles responsible for lumbar support and segmental control. Watch the Video
Dry Needling the Lumbar Spine for Low Back Pain Relief
Why Target the Erector Spinae and Multifidus?
The erector spinae and multifidus are deep postural muscles that play a critical role in spinal stability. When irritated or inhibited, they can contribute to chronic low back pain, joint dysfunction, and muscular compensation patterns.
Dry needling helps:
Improve muscle activation and proprioception
Reduce myofascial tension
Restore mobility in adjacent spinal segments
Decrease pain and improve functional outcomes
This approach is especially useful for patients who haven’t responded to stretching, manual therapy, or exercise alone.
Get Dry Needling in Columbia, SC
At Vertex PT Specialists, we treat low back pain using personalized, evidence-based techniques delivered one-on-one by licensed Doctors of Physical Therapy.
https://i0.wp.com/vertexpt.com/wp-content/uploads/2025/07/3.jpg?fit=1080%2C1080&ssl=110801080Brandon Vaughnhttp://ecbiz218.inmotionhosting.com/~wwwver6/wp-content/uploads/2017/02/logo-horiz.pngBrandon Vaughn2025-07-21 16:25:572025-07-21 16:29:45Dry Needling for Low Back Pain: Targeting the Erector Spinae and Multifidus
At Vertex PT Specialists in Columbia, SC, we work with patients who suffer from persistent neck pain and headaches that haven’t improved with traditional approaches. One of the most effective treatment options we offer is dry needling, particularly targeting a deep muscle called the Obliquus Capitis Inferior (OCI).
What Is the OCI and Why Does It Matter?
The OCI is one of the suboccipital muscles located at the base of your skull. When this muscle becomes tight or irritated, it can compress the suboccipital nerve and contribute to a type of headache called a cervicogenic headache. These headaches often start in the neck and wrap around the head, radiating into the temple, jaw, behind the eye, or even into the teeth.
This happens due to referral patterns into the trigeminocervical nucleus, a key structure where upper cervical nerves and cranial nerves (like CN V, VII, IX, X, XI, and cervical nerves C1–C2) converge. Tension in the OCI can light up this system and result in persistent, often misunderstood head pain.
How Dry Needling Helps
Dry needling is a targeted manual therapy technique used by our Doctors of Physical Therapy to release tension in deep muscular structures. When applied to the OCI, dry needling can:
Decrease pressure on the suboccipital nerve
Improve upper cervical mobility
Reduce neural irritation to the trigeminocervical complex
Provide long-term relief from cervicogenic headaches
Watch the Technique
Below is a demonstration of dry needling the OCI, performed by Dr. Brandon Vaughn, PT, DPT, OCS, CSCS. This technique is performed with precision and care to target the deep suboccipital region effectively and safely.
Serving Columbia and the Surrounding Areas
Vertex PT Specialists provides physical therapy services including dry needling for cervicogenic headaches across Columbia, Cayce-West Columbia, Lexington, and Cayce, SC. If you’ve been dealing with chronic headaches and haven’t found relief, we encourage you to reach out.
Contact Us
Reach out to us today to schedule your evaluation with one of our licensed Doctors of Physical Therapy Let us help you get to the root cause of your headaches and build a path forward.
Dealing with deep low back or flank pain that doesn’t respond to stretching or massage? The quadratus lumborum (QL) is a common driver of stubborn low back pain—especially pain that wraps around the flank or worsens with sitting, standing, or side bending. At Vertex PT Specialists in Columbia, SC, we offer dry needling to the QL as part of a targeted, one-on-one treatment plan.
Dry needling the QL requires precision. This deep muscle lies near the kidneys and lungs, and effective treatment demands anatomical expertise. Our Doctors of Physical Therapy are highly trained in this technique to ensure both safety and results.
QL Dry Needling Can Help With:
Deep low back or flank pain
Pain that worsens with prolonged sitting or standing
Asymmetric posture or side bending restriction
Pain after lifting, twisting, or repetitive bending
Why Vertex PT?
One-on-one, 60-minute sessions with a Doctor of Physical Therapy
Clinics in Columbia, Irmo, and Cayce–West Columbia
Outpatient home visits available throughout the Midlands
Skilled dry needling to deep muscles like the QL with supporting manual therapy and movement retraining
First-step pain in the morning is a hallmark sign of plantar fasciitis. If the video above hit home, you’re not alone. At Vertex PT Specialists in Columbia, SC, we use dry needling to directly address both the muscular and structural drivers of plantar fasciitis.
Treatment includes not only calf needling, but also perineural needling throughout the foot and periosteal pecking at the insertion point of the plantar fascia on the medial calcaneal tubercle. This helps stimulate a beneficial inflammatory response and jumpstart the healing process.
What Plantar Fasciitis Dry Needling Can Help With:
Chronic or recurring heel pain
Morning pain with first steps
Pain after running, walking, or standing
Limited ankle mobility and stiffness
Why Choose Vertex PT?
One-on-one, 60-minute sessions with a Doctor of Physical Therapy
Clinics in Columbia, Irmo, and Cayce–West Columbia
Outpatient home visits available throughout the Midlands
Evidence-based treatment that addresses the true source of pain
Struggling with buttock pain, sciatica, or tightness in your hip? If the video above caught your attention, you could be experiencing piriformis syndrome—when the piriformis muscle irritates the sciatic nerve. At Vertex PT Specialists in Columbia, SC, we use dry needling to release tight piriformis trigger points and reduce nerve compression.
What Piriformis Dry Needling Helps With:
Buttock pain or deep glute pain
Sciatica-like symptoms down the leg
Tightness or mobility issues with hip rotation
Rapid pain reduction after just a few treatmentsExpert & Safe Treatment
Our physical therapists use precise dry needling techniques—guided by anatomy and landmark palpation—to accurately reach the piriformis while keeping the sciatic nerve safe. We tailor one-on-one, hour‑long sessions with a Doctor of Physical Therapy to fit your specific needs.
Where We Come to You
We see patients in our Columbia, Irmo, and Cayce–West Columbia locations—or come directly to your home via our outpatient home health services.
Struggling with TMJ pain, jaw clicking, or locking? If what you saw in the video looked familiar, dry needling may be exactly what you need. At Vertex PT Specialists, we target the overactive muscles that cause jaw pain—like the masseter and pterygoids—to relieve tension, reduce clicking and locking, and improve function.
What TMJ Dry Needling Helps With:
Jaw locking or popping
Limited opening range
Headaches and facial tightness
Ear pain or tooth sensitivity
Our sessions are always one-on-one for a full hour with a Doctor of Physical Therapy.
We serve Columbia, Irmo, Cayce–West Columbia—and we can even come to your home if needed.
At Vertex PT Specialists, we pride ourselves on staying at the forefront of physical therapy techniques. In our latest video, Brandon Vaughn, PT, DPT, OCS, CSCS, demonstrates and instructs on the proper technique for dry needling the Quadratus Lumborum (QL)—a vital treatment for addressing low back pain and dysfunction.
Check out the video below to see Brandon guide you through this advanced dry needling technique step by step:
What Is Dry Needling?
Dry needling is a powerful treatment designed to relieve muscle pain, trigger points, and movement restrictions. By using thin, sterile needles, physical therapists can target specific muscle groups, leading to:
Improved Circulation: Enhances the healing process by increasing blood flow.
Pain Relief: Releases tension in tight muscles.
Enhanced Mobility: Restores proper function and range of motion.
Why Focus on the QL?
The Quadratus Lumborum is a deep-seated muscle located in the lower back. Dysfunction in the QL can lead to:
Persistent low back pain
Limited hip mobility
Referred pain to the glutes or pelvis
Brandon Vaughn’s demonstration highlights how precise dry needling can effectively alleviate QL-related symptoms, making it an invaluable tool in physical therapy.
About Brandon Vaughn
Brandon Vaughn, PT, DPT, OCS, CSCS, is a seasoned physical therapist and the owner of Vertex PT Specialists. With a wealth of experience and advanced certifications, Brandon specializes in helping patients achieve optimal recovery and performance. In this video, he shares his expertise to empower other therapists and educate patients about effective treatment options.
Why Choose Vertex PT Specialists?
At Vertex PT Specialists, our team of highly trained therapists uses evidence-based techniques to ensure the best outcomes for our patients. Whether you’re dealing with chronic pain or recovering from an injury, we’re here to help.
Learn More or Book an Appointment
Want to know more about dry needling and how it can benefit you? Contact us today at info@vertexpt.com or call 803-973-0100 to schedule your appointment.
