THERAPIES & TRADITIONS · GUIDE
Dry Needling: What Research Shows by Condition
What systematic reviews found for dry needling in neck, shoulder, back, knee, hip, heel, headache and jaw pain, with the strength and limits of each result.
Content last updated . This page has not been medically reviewed.
Back to AcupunctureThe big picture
A 2023 umbrella review (a review of 36 systematic reviews) concluded dry needling is superior to sham or no intervention and equally effective as other interventions for short-term pain reduction in any body region, with limited data for mid- and long-term effects and contradictory results for function. [1] A 2017 review of 13 trials of dry needling by physical therapists found very low to moderate quality evidence of benefit in the immediate to 12-week period, and said evidence of long-term benefit was lacking. [2] A 2014 review described a paucity of high-quality evidence for short- and long-term pain reduction from needling trigger points, and questioned in-and-out techniques at muscle trigger points. [3] A 2019 review rated the evidence for dry needling in myofascial pain from very low to moderate, and concluded it was not greater than placebo. [4]Condition by condition
| Area | What the review found | Strength of evidence |
|---|---|---|
| Neck and shoulder trigger-point pain | Compared with control or sham, dry needling was effective in the short and medium term in a review of 20 trials (839 patients); wet needling (with lidocaine) was better than dry needling in the medium term. [5] | Promising but limited |
| Neck pain vs physical modalities | 8 trials found no significant difference from physical modalities; all had high risk of bias because participants were not blinded. [6] | Insufficient evidence of an advantage |
| Subacromial shoulder pain | Slight pain reduction in the short and mid term (low quality); effect on disability very uncertain. [7] | Promising but limited |
| Low back pain | A review of 4 trials and 2 meta-analyses reported decreased pain intensity and disability with dry needling for myofascial back pain; it asked for better long-term studies. [8] | Promising but limited |
| Knee (osteoarthritis, patellofemoral pain) | A 2026 review of 20 trials reported short-term pain and function gains, with moderate certainty, moderate risk of bias (mainly from blinding) and short follow-up. [9] A review of dry needling plus exercise in knee osteoarthritis (6 trials, 453 people) found lower pain at 3 months than exercise alone, with limits noted. [10] | Promising but limited; see guideline note below |
| Hip | 7 trials (273 patients); dry needling performed better than several controls, but strong evidence was lacking. [11] | Insufficient evidence |
| Plantar heel pain | A meta-analysis of 7 trials found lower pain scores than control but a similar success rate; the authors asked for placebo-controlled trials. [12] | Mixed |
| Tension-type and cervicogenic headache | 3 studies; improvement but no significant difference between groups, and the authors judged evidence insufficient to strongly advocate. [13] | Insufficient evidence |
| Orofacial pain | 24 trials; most had unclear or high risk of bias, and little reliable evidence of benefit was found. [14] | Insufficient evidence |
| Jaw (temporomandibular) disorders | A 2025 review of 10 studies reported improvements, with most trials at low risk of bias. [15] | Promising but limited |
Dry needling compared with exercise
A review of 22 studies found that 17 reported no added benefit of dry needling over exercise alone, though three found greater improvement when it was combined with exercise in knee osteoarthritis, trapezius pain and low back pain. [16]What it means
Dry needling shows short-term pain benefit in several reviews, but the evidence is held back by small trials, blinding problems and short follow-up, and it is often no better than exercise or other physical therapy. For conditions not listed here, Proper evidence not found in the reviews checked.Frequently asked questions
Does dry needling work for back pain?
Reviews report short-term pain and disability improvement for myofascial back pain, with calls for long-term studies. [8]
Is dry needling better than exercise?
In one review of 22 studies, most found no added benefit over exercise alone. [16]
Is dry needling better than physical therapy?
For neck trigger-point pain it was not significantly different from physical modalities. [6]
Does dry needling help headaches?
Evidence was judged insufficient to strongly advocate it for tension-type or cervicogenic headache. [13]
Do results last?
Evidence of long-term benefit is lacking. [2]
More details: evidence, limits and cautions
The details behind this page: cautions, limits of the evidence and where sources disagree. Open any note to read it.
How to read this page
Dry needling is mostly studied for musculoskeletal pain and "myofascial" trigger points. Reviews combine trials that differ in technique, number of sessions and comparison treatment, so a result for one body area should not be applied to another. Many trials compare against sham needling or against other treatments, and it is hard to hide a needle from the person receiving it. Read sham acupuncture and placebo controls for why. This page describes research findings only; it is not advice to treat any condition.
Where guidelines disagree with trials
For knee osteoarthritis, the NICE guideline says not to offer acupuncture or dry needling, even though some newer reviews report short-term gains. [17][9] Guidelines weigh certainty, sham comparisons and cost differently than single reviews. See acupuncture for knee osteoarthritis and acupuncture for shoulder pain.
When to see a doctor first
New numbness, weakness, fever, unexplained weight loss, injury or severe pain needs medical assessment before any needling. For safety see dry needling side effects and safety.
References
- Chys M, et al. Clinical effectiveness of dry needling in patients with musculoskeletal pain: an umbrella review. J Clin Med. 2023. PubMed 36769852 Read 2026-10-22.
- Gattie E, et al. The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2017;47(3):133-149. PubMed 28158962 Read 2026-10-22.
- Dunning J, et al. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev. 2014. PubMed 25143704 Read 2026-10-22.
- Charles D, et al. A systematic review of manual therapy techniques, dry cupping and dry needling in the reduction of myofascial pain and myofascial trigger points. J Bodyw Mov Ther. 2019. PubMed 31563367 Read 2026-10-22.
- Liu L, et al. Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2015. PubMed 25576642 Read 2026-10-22.
- Chen et al. Comparison of dry needling with physical modalities for myofascial trigger point of patients with neck pain: a systematic review and meta-analysis. J Bodyw Mov Ther. 2025. PubMed 41316611 Read 2026-10-22.
- Para-Garcia et al. Dry needling alone or in combination with exercise therapy versus other interventions in subacromial pain syndrome: a systematic review and meta-analysis. Int J Environ Res Public Health. 2022. PubMed 36078676 Read 2026-10-22.
- Dach et al. Treating myofascial pain with dry needling: a systematic review for the best evidence-based practices in low back pain. Arq Neuropsiquiatr. 2023. PubMed 38157883 Read 2026-10-22.
- Hu et al. The effectiveness of dry needling at myofascial trigger points for knee disorders: a quantitative synthesis of randomized controlled trials. PLoS One. 2026. PubMed 41961845 Read 2026-10-22.
- Tayyab et al. Dry needling combined with exercise therapy versus exercise alone in knee osteoarthritis: a systematic review and meta-analysis. Ther Adv Musculoskelet Dis. 2026. PubMed 42453275 Read 2026-10-22.
- Forogh et al. Efficacy of trigger point dry needling on pain and function of the hip joint: a systematic review of randomized clinical trials. Acupunct Med. 2024. PubMed 38149616 Read 2026-10-22.
- He et al. Effectiveness of trigger point dry needling for plantar heel pain: a meta-analysis of seven randomized controlled trials. J Pain Res. 2017. PubMed 28860848 Read 2026-10-22.
- France S, et al. Evidence for the use of dry needling and physiotherapy in the management of cervicogenic or tension-type headache: a systematic review. Cephalalgia. 2014. PubMed 24623124 Read 2026-10-22.
- Kuzdzal et al. Dry needling for orofacial pain: a systematic review and meta-analysis of randomized clinical trials. Pain Rep. 2024. PubMed 39574485 Read 2026-10-22.
- Khayamzadeh et al. Dry needling in treatment of temporomandibular joint disorders: a systematic review. Clin Exp Dent Res. 2025. PubMed 40917038 Read 2026-10-22.
- Salazar-Arias et al. Dry needling and exercise in the treatment of musculoskeletal pain: a systematic review. Sportverletz Sportschaden. 2026. PubMed 42086197 Read 2026-10-22.
- NICE, Osteoarthritis in over 16s: diagnosis and management (NG226). Read 2026-10-22.
Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.