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  • Writer's pictureMiracle Rehab Clinic

Dry Needling by a Physical Therapist

Updated: Apr 25, 2022

If you've ever wondered what dry needling therapy is, you're in the rapidly growing group of people interested in this unique healing technique.

While the name "dry needling" sounds a little intimidating, it's a powerful therapy modality with multiple benefits when performed by a trained physical therapist.

In short, dry needling is an effective way to treat neuromusculoskeletal pain and movement issues by treating muscular trigger points.

To answer what the trigger points are and what specific health issues dry needling can solve, let's look closer into dry needling by a physical therapist. Learn about different kinds of physical therapy here.

What Is Dry Needling?

Dry needling is also sometimes called trigger point dry needling or myofascial trigger point dry needling.

Dry needling can be done by doctors, acupuncturists, and physical therapists. In this article, we'll focus on dry needling physical therapy.

Trigger points are knotted areas that sometimes develop in the muscles. These points are sensitive, often painful to touch, and can cause pain that manifests in other areas, e.g., a trigger point in the neck may cause pain in the shoulder.

While performing trigger point dry needling, physical therapists use thin solid needles to push through the skin into trigger points and stimulate the tissues.

The needles will stay inserted superficially or deeply for a certain amount of time, depending on the specific condition and treatment plan.

How does dry needling work?

While it's not 100% clear how dry needling works to relieve trigger points, it is believed that dry needling changes how the brain and muscles communicate and let the system return to a more normal movement pattern.

This may be due to the stimulation of a local twitch response, an involuntary reflex contraction of muscle fibers that triggers a chemical reaction with a pain-relieving response. Another theory is that the insertion of the needle causes small lesions that stimulate tissue repair and regeneration in the days immediately following treatment.

Dry needling history

Dry needling has been used as a healing modality since the 1940s.

In 1979, Dr. Karel Lewit reported pain relief by stimulating trigger points using hypodermic and acupuncture needles.

However, in 1989 the hypodermic needles stopped being used anymore, and all dry needling therapists adopted the acupuncture needle that is used to this day.

Dry needling has gained mass popularity in the early 2000s and is now a common healing modality used at various physical therapy and other health centers to relieve pain.

Trigger points

Let's talk a little bit more about trigger points. A trigger point is contracture in a muscle fiber that can disrupt body function, restrict the range of motion and cause pain, tenderness, or discomfort.

Trigger points are hard to treat and eliminate, but dry needling is an effective method for dealing with trigger point pain.

Dry needling treats muscle tissue, and its goal is to reduce pain, inactivate trigger points and restore function. However, it rarely is a standalone procedure and is usually combined with different healing modalities.

Difference from acupuncture

Sounds a little like acupuncture? While dry needling and acupuncture have similarities, there are quite a few differences.

According to Healthline, one practice has been used for thousands of years as an alternative treatment, and the other's been adopted in the last couple of decades.

Acupuncture is used for relieving pain, discomfort, and other issues by opening up a person's energy flow or chi. Dry needling done by a physical therapist stimulates trigger points or muscles that are irritable. It can be quite useful for people with chronic pain or recovering from traumatic events, like a car accident for example.

What Kind of Needles Are Used?

Physical therapists use solid filiform needles, which are not like the hollow needles used during medical procedures to deliver medications.

The filiform needle penetrates the skin and stimulates underlying myofascial trigger points and muscular and connective tissues. It allows targeting tissues that are not manually palpable.

The dry needles are sterile and disposed of after use.

What Kinds of Pain Does Dry Needling Treat?

Dry needling can alleviate the pain that occurs from a myriad of conditions besides trigger points. Some people wonder: is physical therapy is painful? In most cases, like this one, physical therapy exists exactly to tackle that pain.

These conditions include muscle tension and spasms, arthritis, nerve irritation, ligament strains, pelvic pain, herniated discs, tendonitis, whiplash, various spinal problems, and reduced range of motion.

Dry needle therapy can also be used to treat musculoskeletal issues, such as shoulder, neck, heel, hip, and back pain.

This means your physical therapist can perform dry needling for the lower back, dry needling for the pelvic floor, dry needling for hamstrings, etc.

Who Should Not Have Dry Needling Treatments?

While dry needling is an effective way to treat various conditions, some people should not have these treatments.

You should not have dry needling if you have an infection until after it completely resolves; pregnant women and people who are afraid of needles should not undergo dry needling either.

You should consult your doctor about dry needling if you're taking blood thinners, have diabetes, bleeding disorders, compromised immune system, epilepsy, or vascular disease.

Are There Side Effects From Dry Needling?

Risks of dry needling side effects are minimal if performed by a licensed physical therapy professional who uses sterile needles.

However, it's essential to have in mind that they still can occur. Among the more common side effects are fainting, fatigue, skin bruising, bleeding at the insertion point, general soreness.

These side effects go away pretty swiftly after the treatment.

What To Expect: Before and After

Because dry needling sounds a little intimidating, it's best to prepare and know what to expect during the treatment procedure.

First step

Therapists have a trigger point map that notes common places in the body where trigger points emerge can be helpful. However, since every patient is a little different, these points need to be specifically located by a professional.

To find a patient's trigger points, a therapist palpates the area with their hands; that's why you want an experienced therapist for your treatment.

Second step

Your physical therapist will then use the needle to penetrate the skin, deep into the muscle tissue. It will stimulate the underlying myofascial trigger point and the surrounding areas.

The needle will produce a twitch reflex that decreases muscle contraction, reduces irritation and pain, and improves flexibility.

The needle will create a lesion, tricking the body into thinking that there's an invader and activating the immune system. The muscle fibers then will produce an inflammatory reaction that helps to reduce inflammation all through the entire body.

The needle will stay in the body for a few seconds for up to 10-15 minutes.

While dry needling is almost painless, you might feel a cramping or aching sensation during the twitch response that will subdue quickly. Cramping is a good sign and a normal reaction.

You may also experience different sensations that are temporary. Stimulating a trigger point with a needle helps draw blood supply back to release the tension, so these sensations are normal.

After the therapy, you might feel a little sore or experience bruising, so you can apply ice and heat to the areas if necessary.

After the treatment

After your treatment, the therapist will evaluate the session's results, including your pain levels, tightness, soreness, etc., and decide on further treatment steps.

While some patients will feel their pain and mobility improve almost immediately after just one session, others will need to attend a few more.

In any case, your therapists will ask you to keep your muscles loose by moving them after the session. It's also normal to feel soreness and a little discomfort for 24 to 48 hours after the session.

Dry needling and other modalities

Dry needling is often a part of a comprehensive physical therapy treatment plan that your therapists will create after a complete examination.

Dry needling is very often used to treat acute muscle spasms, imbalances, and injuries and can be an excellent initial modality before introducing other options.

Because dry needling doesn't use any chemical drugs, there's a high chance that you will need at least a few visits to disturb the pain cycle though you will probably feel some relief after the first cycle.

Dry needling is a great way to relieve pain, but it does not address the source of that pain, so for example, if you have osteoarthritis of the knee or the hip, dry needling will be able to help reduce pain and increase range of motion, it will not actually heal osteoarthritis or reverse its effects.

That's why you will probably use dry needling therapy together with other healing modalities of physical therapy.


Dry needling done by a physical therapist is an effective healing modality for patients suffering from neuromuscular pain in their bodies.

Targeting and relieving trigger points helps release tension, relieve pain, and increase range of motion.

If done by professional physical therapists, dry needling is safe and has minimal or no side effects at all.

Your physical therapist will advise whether dry needling is a helpful addition to your treatment plan after a thorough examination and consultation.

Schedule your consultation today with Miracle Rehab Clinic to learn if dry needling is indicated for you.

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