Dry Needling: How It Works, What It Treats, Risks and Recovery
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is dry needling?
Dry needling is a treatment in which a trained provider inserts thin, solid needles into or near myofascial trigger points to relieve muscle pain and improve movement. No medicine is injected. It is usually one part of a wider pain plan with exercise and stretching. Mild soreness is common, while serious complications are extremely rare. [1]
What the research says
Dry needling eases neck pain in the short term. A review of 28 randomized trials found pain dropped by about 1.5 points right after treatment and about 2.3 points in the short term compared with sham, placebo or waiting list, with no clear advantage over other physical therapy treatments and no lasting difference at mid-term. (Navarro-Santana et al., Journal of Clinical Medicine, 2020)
It helps low back pain linked to trigger points, especially combined with other care. Across 11 randomized trials with 802 patients, dry needling reduced pain intensity (SMD −1.06) and disability (SMD −0.76) more than comparison treatments, and adding other therapies gave better pain relief than needling alone. (Liu et al., Archives of Physical Medicine and Rehabilitation, 2018)
Minor side effects are common; major ones are rare. In 20,464 sessions reported by 420 physical therapists, 36.7% had a minor event (bleeding 16%, bruising 7.7%, pain during needling 5.9%), while major events occurred in fewer than 0.1% — about 1 in every 1,024 treatments. (Boyce et al., International Journal of Sports Physical Therapy, 2020)
Key takeaways
Dry needling targets trigger points: tight, tender knots in muscle that can cause pain nearby or in another part of the body. [1]
The needles are solid and contain no medicine, which is why the method is called "dry." [1]
Two main techniques exist: superficial (5–10 mm under the skin) and deep (into the muscle). [1]
Soreness for 24–36 hours and bruising for up to a week are normal. [1]
Shortness of breath after treatment, especially near the chest, needs emergency care. [1]
Dry needling at a glance
Question | Short answer |
What it treats | Musculoskeletal pain and movement problems tied to trigger points |
What is injected | Nothing — needles are solid and sterile |
Other names | Trigger point dry needling, intramuscular stimulation |
Needle time | About 2 seconds to 20 minutes |
Needles per visit | 1–2 at first; up to 10–15 along the spine for back treatment |
Common side effect | Soreness during and after treatment |
Usual recovery | Soreness 24–36 hours; bruising up to 1 week |
[1]
What is dry needling used for?
Dry needling is used to treat musculoskeletal pain and movement problems caused by myofascial trigger points. Acupuncturists, physical therapists and other trained providers use it. [1]
It is almost always part of a larger pain management plan. That plan may also include exercise, stretching and massage. [1]
What are myofascial trigger points?
The word "myofascial" joins two ideas. "Myo" means muscle, and fascia is the thin, white connective tissue wrapped around your muscles. [1]
Trigger points are knotted, tender spots that form inside muscle. They are very sensitive and can hurt when pressed. Sometimes the knot sits right where you feel pain. Often, though, it causes referred pain, which is pain felt in a different part of the body. [1]
Which conditions can dry needling help?
Dry needling may relieve pain and improve range of motion in these conditions: [1]
Body area or type | Examples |
Joints and spine | |
Tendons | |
Head and jaw | |
Injury and overuse | Whiplash, repetitive motion disorders such as carpal tunnel syndrome |
Other pain | Pelvic pain, night cramps, phantom limb pain, postherpetic neuralgia (a complication of shingles) |
How does dry needling work?
Dry needling works by drawing normal blood flow back into a tight, overworked muscle knot and triggering the body's own pain relief. [1]
When a muscle is overused, its fibers stop getting enough blood. Without oxygen and nutrients, the muscle cannot return to its normal resting state. The tissue around the trigger point becomes more acidic, and nearby nerves become sensitized. That is why the area feels sore. [1]
A needle placed in the trigger point helps bring blood back to flush the area and release tension. The small prick can also fire nerve fibers that prompt your brain to release endorphins, the body's natural painkillers. [1]
What is a local twitch response?
A local twitch response is a quick spasm of the muscle when the needle reaches the trigger point. Your provider may move the needle slightly to bring it on. It is a good sign that the muscle is reacting. [1]
Some people feel better almost right away. Others need more than one session. [1]
Does dry needling hurt?
Dry needling can cause some discomfort, but many people barely feel the needle go in because it is so thin. [1]
Stage | What you may feel |
Finding the trigger point | Tenderness when the provider presses on the knot |
Needle insertion | Nothing, or a small prick |
Needle in the trigger point | Pain and a muscle twitch |
Afterward | Tightness or soreness near the site |
[1]
Even if you feel sore after treatment, keep moving and stretching. [1]
What happens during a dry needling session?
A dry needling session follows a clear set of steps, from a health check to needle removal. [1]
Before treatment
Your provider will review your medical history and examine you to decide whether dry needling suits you. If it does, they will explain the treatment and answer your questions. [1]
Wear loose, comfortable clothing that gives easy access to the area. If not, you will get a gown or cover. You will be treated in a private room or a curtained area. [1]
During treatment
The provider cleans the skin and prepares a needle. Needles are always single-use, sterile and disposable. [1]
They feel the area with one hand to find the trigger point. [1]
With the other hand, they place the needle inside a plastic guide tube and tap it gently into the top layer of skin. The tube is then removed. [1]
The needle is guided to the right depth using one of two techniques. [1]
Technique | Depth | Goal |
Superficial | 5–10 mm into the tissue under the skin, above the trigger point | Stimulate the area over the knot |
Deep | Past the tissue under the skin, into the muscle | Reach the trigger point itself |
[1]
The needle may stay in for as little as 2 seconds or as long as 20 minutes. Some providers use pistoning, an in-and-out technique that moves the needle quickly up and down through the tissue. [1]
Your first visit may involve only 1–2 needles. After seeing how you respond, your provider may use more. For back treatment, that can mean 10–15 needles along the spine. Muscle soreness or twitching during treatment is normal. [1]
What should you expect after dry needling?
After dry needling, mild soreness and possible bruising are normal and usually settle within days. [1]
Your provider removes the needles, checks your skin for any reaction and throws the needles into a sharps container. You will be asked to get up slowly. If you feel dizzy, you will rest before leaving. [1]
After treatment | What to do |
Right away | Drink plenty of water to stay hydrated |
First 24–36 hours | Expect extra muscle soreness; keep moving |
Up to 1 week | Bruising near the site may appear, then fade |
[1]
What are the benefits of dry needling?
Dry needling can release trigger points, which may ease muscle pain and stiffness and improve flexibility and range of motion. [1]
As part of a full treatment plan, it is inexpensive and generally considered safe. The risk of complications is low when a trained provider performs it. [1]
Research is still growing. For low back pain, studies suggest dry needling may help, but their quality is too low for firm conclusions. Learn more about complementary approaches for low back pain. [3]
What are the side effects and risks of dry needling?
The most common side effect of dry needling is soreness during and after treatment. Most other effects are minor. [1]
Side effect | How common |
Soreness | Most common |
Stiffness, bruising, fatigue, fainting | Usually minor |
Infection | Possible — check your provider's training |
Collapsed lung (pneumothorax) | Extremely rare; linked to needling in the upper back or chest area |
[1]
When should you get help after dry needling?
Seek help right away if you notice either of these signs: [1]
Bleeding from the needle site: press firmly on it and contact your provider or doctor.
Shortness of breath: contact your provider or doctor, or call emergency services immediately. If needling was done around the upper back (thoracic area), it could rarely cause a collapsed lung, which needs a chest X-ray and further care.
Who should not get dry needling?
Dry needling is not recommended for children under 12 because it can be painful. If a child is considered, both parent and child must consent, and gentler options should be tried first. [1]
Talk to your doctor before dry needling if you: [1]
Are pregnant
Cannot fully understand the treatment
Have a strong fear of needles (trypanophobia)
Have a weakened immune system
Have just had surgery
Take blood thinners
How is dry needling different from acupuncture?
Dry needling and acupuncture use the same type of thin needle, but they rest on different medical systems and are done by different providers. [1][4]
Dry needling | ||
Based on | Western medicine: pain patterns, posture, faulty movement and orthopedic testing | Eastern medicine |
Treats | Muscle tissue | Musculoskeletal pain and other body systems |
Goal | Reduce pain, inactivate trigger points, improve movement | Broader treatment across body systems |
Performed by | Trained providers such as physical therapists | Licensed acupuncturists |
Usually used | Within a wider physical therapy plan | On its own or alongside other care |
[1]
How is dry needling different from a trigger point injection?
A trigger point injection contains medicine and is given by a physician. Dry needling uses a solid needle and puts nothing into the body. [1]
Who can perform dry needling?
Depending on local laws, dry needling may be performed by licensed physical therapists, athletic trainers, chiropractors or medical doctors who have trained in the procedure. In the United States, dry needling by physical therapists is approved in 37 states and Washington, D.C. Some states do not allow it under the rules that govern providers there. [1] You can read more about how physical therapists use dry needling. [2]
Because training standards vary, always confirm that your provider has proper training in dry needling. [1][4]
Conclusion
Dry needling is a minimally invasive way to treat painful muscle knots. A thin, solid needle reaches the trigger point, restores blood flow and helps the muscle relax. Many people notice less pain and easier movement, sometimes after a single visit. [1]
It works best as part of a full plan that includes exercise and stretching. Expect short-lived soreness and possible bruising, and know the rare warning signs. Because it is still an invasive procedure, talk with your doctor first. They may suggest gentler treatments before needling. [1]
Living with stubborn muscle pain? Start with our plain-language guides to myofascial pain syndrome, neck pain and back pain, then bring your questions to your doctor or physical therapist to build a plan that fits you.
FAQ
What is dry needling?
Dry needling is a treatment in which a trained provider inserts thin, solid needles into or near muscle trigger points to ease pain and improve movement. Nothing is injected into the body. [1]
Does dry needling hurt?
Dry needling may cause brief discomfort, such as a small prick or a muscle twitch when the needle reaches the trigger point. Some people do not feel the needle go in at all. Soreness afterward is common. [1]
What conditions does dry needling treat?
Dry needling is used for musculoskeletal pain and movement problems linked to trigger points, including neck and back pain, tendonitis, headaches, TMJ disorders, whiplash and carpal tunnel syndrome. [1]
How long does soreness last after dry needling?
Soreness after dry needling usually lasts 24–36 hours. Bruising near the site may last up to a week. Drinking water and staying active can help. [1]
How many dry needling sessions will I need?
Some people feel better almost immediately after one dry needling session, while others need more than one. Your provider will adjust the number of needles and sessions to your response. [1]
Is dry needling the same as acupuncture?
No. Dry needling and acupuncture use the same type of needle, but dry needling is based on Western medicine and targets muscle trigger points, while acupuncture is based on Eastern medicine and is performed by licensed acupuncturists. [1]
Is dry needling safe?
Dry needling is generally considered safe when a trained provider performs it. Minor effects like soreness and bruising are common, while serious problems such as a collapsed lung are extremely rare. [1][7]
When should I seek emergency care after dry needling?
Call emergency services right away if you develop shortness of breath after dry needling, especially if the chest or upper back was treated. For bleeding at the site, press firmly and contact your provider. [1]
Who should not get dry needling?
Dry needling is not recommended for children under 12. Talk to your doctor first if you are pregnant, take blood thinners, have a weakened immune system, have a strong fear of needles or have just had surgery.
Who can perform dry needling?
Depending on local laws, licensed physical therapists, athletic trainers, chiropractors or medical doctors with special training may perform it. Ask about your provider's training before your first session.
Related Reading
What Is Myofascial Pain Syndrome? A Plain-Language Guide to the Muscle Pain That Won't Quit explains myofascial pain syndrome and how trigger points cause pain.
Trigger Point Injections: How They Work, What to Expect, and How Long Relief Lasts explains how trigger point injections relieve muscle knots and their risks.
Acupuncture: Benefits, Procedure, and What to Expect explains how acupuncture is done and what it may help.
Physical Therapy: Enhancing Mobility, Strength, and Recovery explains how physical therapy improves strength, movement and pain.
References
Cleveland Clinic. What Is Dry Needling? Cleveland Clinic. Last updated February 20, 2023. https://my.clevelandclinic.org/health/treatments/16542-dry-needling
American Physical Therapy Association. Dry Needling. APTA. Accessed October 31, 2026. https://www.apta.org/patient-care/interventions/dry-needling
National Center for Complementary and Integrative Health. Low-Back Pain and Complementary Health Approaches: What You Need To Know. NCCIH. Last updated January 2020. https://www.nccih.nih.gov/health/low-back-pain-and-complementary-health-approaches-what-you-need-to-know
Zhou K, Ma Y, Brogan MS. Dry needling versus acupuncture: the ongoing debate. Acupunct Med. 2015;33(6):485-490. PMID: 26546163. https://doi.org/10.1136/acupmed-2015-010911
Navarro-Santana MJ, Sanchez-Infante J, Fernández-de-Las-Peñas C, et al. Effectiveness of Dry Needling for Myofascial Trigger Points Associated with Neck Pain Symptoms: An Updated Systematic Review and Meta-Analysis. J Clin Med. 2020;9(10):3300. PMID: 33066556. https://doi.org/10.3390/jcm9103300
Liu L, Huang QM, Liu QG, et al. Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2018;99(1):144-152.e2. PMID: 28690077. https://doi.org/10.1016/j.apmr.2017.06.008
Boyce D, Wempe H, Campbell C, et al. Adverse Events Associated with Therapeutic Dry Needling. Int J Sports Phys Ther. 2020;15(1):103-113. PMID: 32089962. https://pubmed.ncbi.nlm.nih.gov/32089962/
Medical disclaimer
This article is for general education and does not replace advice from your doctor or another qualified health professional. Talk to your healthcare provider before starting any new treatment, including dry needling.
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