Table of ContentsView All
View All
Table of Contents
Purpose
Risks
Contraindications
Before
During
After
Interpreting Results
Dry needling is a therapeutic procedure used to relievemuscular painand improve jointrange of motion(ROM). Dry needling side effects may include soreness, bleeding, bruising, and fatigue.
The procedure involves the insertion of a needle intomyofascial trigger points—which are small muscle knots that can be highly sensitive and painful to the touch.
A minimally invasive treatment with a low risk of complication, research suggests that dry needling may be effective in relieving acute andchronic pain.It is often used along with other treatments including stretching,massage,ultrasound,electrical nerve stimulation, and heat therapy.
This article discusses the purpose, risks, and contraindications of dry needling, as well as what to expect before, during, and after the procedure.
Also Known AsIntramuscular stimulationTrigger point dry needlingMyofascial dry needling
Also Known As
Intramuscular stimulationTrigger point dry needlingMyofascial dry needling
Purpose of Dry Needling
Dry needling is an outpatient procedure that involves the insertion of fine, short stainless steel needles (25-gauge or thinner) into the skin and muscle at trigger points. This elicits a muscle twitch response in the muscle, which helps relieve the symptoms.
Dry needling was developed in the 1980s and was modeled after theTraditional Chinese Medicine(TCM) technique ofacupuncture. There are several variations of dry needling, all of which have the same purpose.
Needles are placed into or near trigger points
AcupunctureNeedles are placed onmeridians(energy pathways that enableqito flow through the body)Used to help treat a myriad of health conditions. The needles are meant to stimulate the central nervous system to release beneficial chemicals to assist with healing and function
Needles are placed onmeridians(energy pathways that enableqito flow through the body)
Used to help treat a myriad of health conditions. The needles are meant to stimulate the central nervous system to release beneficial chemicals to assist with healing and function
How Dry Needling Works
Unlike hollow needles that deliver medications (sometimes known as “wet” needles), this treatment uses solid filiform needles that don’t contain anything (a.k.a. “dry”). The needles are placed directly into or near muscle knots or into connective tissues.Often the trigger point is near the location of your pain, although sometimes pain is referred elsewhere in the body. For example, a trigger point in your neck may cause pain in your shoulder.
There are several theories about how dry needling works to relieve trigger points.
A 2017 systematic review of 15 studies published in theJournal of Complementary Therapies in Medicinefound dry needling offers short-term benefits of reduced pain, increased ROM, and better quality of life in patients with myofascial pain.
While the research is promising, the study authors note more quality studies are needed before dry needling can be definitively recommended.
Myofascial Pain Syndrome and the Spasm Cycle
Risks of Dry Needling
Side effects associated with dry needling include:
Side effects may last a few hours or up to one to two days. Most of these side effects are minor and do not cause significant injury or distress to patients who undergo dry needling.
A rare but dangerous side effect of dry needling is organ damage resulting from a needle that punctures a major organ. This may include apneumothorax(punctured lung) if needles are inserted in the chest.
Who Should Not Get Dry Needling?
If you have an infection, you should not have dry needling until after the infection completely resolves. Pregnant women, people who are unable to understand the purpose of dry needling, and people who are very afraid of needles should not undergo dry needling.
If you are currently takingblood thinnersor have any of the following conditions, talk to your healthcare provider before trying dry needling to be sure it’s safe for you:
How to Find a Dry Needling Practitioner
Used in both traditional orthopedic physical therapy settings and alternative medicine practices, there are no specific credentials or special trainingrequiredto practice dry needling. This means you need to ask your healthcare provider for a recommendation to make sure that you are going to someone who is appropriately qualified and experienced to do the procedure.
Before the Procedure
Prior to administering dry needling, your practitioner will review your medical history and do a physical examination to determine if you are a suitable candidate. If they think you will benefit from dry needling, they will explain the process in detail and ensure you are receptive to the treatment.
The procedure may be done at the first office visit or you may have to make another appointment for the treatment. Be sure to ask any questions you have and let the practitioner know if you need time to decide if dry needling is right for you.
Timing
Dry needling typically takes 10 to 15 minutes. If you are receiving other treatments at the same time, such as physical therapy or massage, your appointment can last 30 to 60 minutes or longer.
Location
Dry needling may occur in a healthcare provider’s office, a therapy clinic, or an outpatient rehabilitation center. It is often performed in a procedural area, such as a separate exam or therapy room, or a curtained-off area of a larger room.
What to Wear
Dress comfortably as you would for a physical therapy session, preferably in clothes that provide access to the treatment area. For example, if you are receiving dry needling on your knee, you will need to wear pants that can be rolled up above the knee or dress in layers.
If that is not possible, you may need to partially undress or change into a patient gown.
Cost and Health Insurance
Some therapists provide dry needling on a cash-pay basis only.
What to Bring
Be sure to bring a form of payment and any paperwork that you were asked to fill out. Also, bring your health insurance card if your plan offers any coverage.
During the Procedure
At the time of your appointment, you will check in with the receptionist and sign consent forms for treatment.
Pre-Procedure
A medical assistant will bring you to the treatment area, take your vitals, review your medical history, and prepare you for treatment.
You will be asked to adjust your clothes to allow access to the areas of your body being worked on, then instructed how to get into the right position for your treatment.
Throughout the Procedure
Some therapists or healthcare providers will walk you through what they are doing as they are doing it, while others will describe the procedure beforehand. You are encouraged to ask questions at any time to better understand the process.
The technique your provider uses can vary. Common dry needling techniques include:
During the procedure, you may experience muscle soreness, muscle twitching, or an ache. These sensations are regarded as a good sign that your muscles are responding to treatment. However, the treatment should not be painful. Tell your provider if you experience any discomfort or feel faint.
Post-Procedure
Once the needles have been removed, your practitioner will inspect the skin to check for any bleeding or skin reactions.
If you are laying down during the procedure, you will likely be instructed to get up slowly. If you experience dizziness or other symptoms, you may be asked to sit and rest for a short while before leaving.
After the Procedure
Muscle soreness may be worse the morning after your treatment but should resolve in a few days. Bruising may last up to a week. Let your healthcare provider know if you experience any side effects.
If you experience severe side effects, such asshortness of breathor major bleeding, contact emergency services immediately. While rare, this could be a sign of an infection or organ damage due to a puncture.
To determine whether dry needling is an effective treatment for you, your healthcare provider or therapist willpalpateyour trigger points and ask you about your level of pain, movement, and stiffness following your session.
In some cases, your response to dry needling will be evident during the treatment, although some people may need to have a few sessions before muscle knots release and pain is reduced.
Most people require at least two or three dry needling sessions to reach the full effects of treatment, though some may need up to six office visits. Dry needling can be done once or twice a week, depending on your condition. Your healthcare provider will let you know when you need to make a follow-up appointment.
If you experience adverse side effects or do not wish to continue receiving dry needling, your practitioner can discontinue therapy and recommend different procedures or treatments to assist in managing your symptoms.
Discontinuation of this treatment will not cause adverse effects.
A Word From Verywell
Dry needling is intended to improve your quality of life, so be sure that you begin treatment knowing what it can and cannot do. And as always, consult your healthcare provider before having any procedure to make sure that it is safe for you.
What Are Trigger Points—and How Can Therapy Help?
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Espejo-Antúnez L, Tejeda JF, Albornoz-Cabello M, et al.Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials.Complement Ther Med. 2017;33:46-57. doi:10.1016/j.ctim.2017.06.003
Cerezo-Téllez E, Torres-Lacomba M, Fuentes-Gallardo I, et al.Effectiveness of dry needling for chronic nonspecific neck pain: a randomized, single-blinded, clinical trial. Pain. 2016;157(9):1905-1917. doi:10.1097/j.pain.0000000000000591
Physiopedia.Dry needling.
Dommerholt J, Gerwin RD.Contracture knots vs. trigger points. Comment on Ball et al. Ultrasound confirmation of the multiple loci hypothesis of the myofascial trigger point and the diagnostic importance of specificity in the elicitation of the local twitch response.Diagnostics2022;12:321.Diagnostics (Basel). 2022;12(10):2365. doi:10.3390/diagnostics12102365
Jafri MS.Mechanisms of myofascial pain.Int Sch Res Notices. 2014;2014:523924. doi:10.1155/2014/523924
McAphee D, Bagwell M, Falsone S.Dry needling: A clinical commentary.Int J Sports Phys Ther. 2022;17(4):551-555. doi:10.26603/001c.35693
Painful and tender muscles: Dry needling can reduce myofascial pain related to trigger points.J Orthop Sports Phys Ther. 2013;43(9), 635. doi:10.2519/jospt.2013.0505
Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T.Dry needling: a literature review with implications for clinical practice guidelines.Phys Ther Rev. 2014;19(4):252-265. doi:10.1179/108331913X13844245102034
American Physical Therapy Association.Description of dry needling in clinical practice.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
