What Is Dry Needling? How It Is Done and Why It Is Debated

What it is

Dry needling is a treatment in which a practitioner puts a thin, solid needle through the skin into muscle or nearby tissue to treat pain and movement problems. "Dry" means nothing is injected, unlike "wet" needling, which uses hollow needles to deliver medicines. [1] The American Physical Therapy Association (APTA) describes it as a technique physical therapists use, where state law allows, with a very thin needle aimed at trigger points. [2]

It goes by other names, including trigger point dry needling and intramuscular manual therapy. [2] The needles are the kind used in acupuncture, which is why its place in health care is disputed. See acupuncture vs dry needling.

This page describes the treatment in general terms only. It is not a how-to, and needling should only ever be done by a trained, regulated practitioner.

What is a trigger point?

A trigger point is described by APTA as a small, highly sensitive area within a muscle, which can be tender and may cause pain elsewhere in the body. [2] Whether trigger points can be reliably found is itself debated. A 2014 review reported a lack of robust evidence validating the clinical criteria for diagnosing them, and found that manual examination to locate a trigger point was neither valid nor reliable between examiners. [1] A 2021 review of imaging studies found that trigger points showed measurably different biomechanical properties and blood flow than healthy tissue, but said more studies were needed to test how accurate and repeatable the methods are. [3]

How it is proposed to work

Proposed explanations, not established facts, include effects on tiny nerve endings: one review says the needle tip touches or pricks nociceptors (pain-sensing nerve endings) when inserted into a trigger point. [1] APTA's public page says research suggests it can improve pain control and reduce muscle tension. [2] Because dry needling is not tied to qi or channels, it is usually explained in biomedical terms. A paper comparing the two found a significant correlation between trigger points and traditional acupuncture points. [4]

Who offers it

In the United States, physical therapists are the main group, in states where it is within their scope of practice. [5] Other professionals offer similar needling in other places. For example, a Canadian physiotherapy association statement describes dry needling as including acupuncture, trigger point dry needling and intramuscular stimulation. [6] Acupuncturists and some physicians also use needles; see who else offers acupuncture. Laws differ: see dry needling regulation.

What a visit generally involves

APTA says dry needling is typically one part of a larger treatment plan, that gloves are worn, and that used needles go into a medical sharps container. [2] When you contact a physical therapist about it, APTA advises asking about their experience and education. [2] Professional training pathways vary; see dry needling training and credentials.

Does it work?

Short answer: some studies show short-term pain relief, long-term benefit is not established, and many trials cannot hide from patients whether they got a needle. A 2023 review of 36 reviews found it better than sham or no treatment, and about as good as other treatments, for short-term pain. [7] A 2017 review found evidence of long-term benefit was lacking. [8] Details are on what research shows by condition.

"Dry needling near me"

This site does not list practitioners. To check one: confirm their license with the state board, ask which board oversees dry needling in your state, ask about their needle training, and ask what to expect, including risks, before you agree.