What is Dry Needling, and Can It Help with Muscle Pain?

By Alicia Baughman, PT, DPT, OCS, Cert. MDT

Dry needling is a treatment technique some physical therapists use to help reduce muscle pain, tightness, and movement restriction. A thin sterile needle is inserted into a targeted area of muscle, often where a sensitive trigger point or “knot” is present.  For some people, dry needling may decrease pain or make movement more comfortable, but it is generally most useful as part of a physical therapy plan that also addresses strength, mobility, and everyday movement.  

If you have heard about dry needling but are unsure what it actually does, how it differs from acupuncture, or whether it could help you, here are answers to some of the questions we hear most often. 

What does dry needling do?

Physical therapists may use dry needling to target sensitive areas within a muscle, sometimes referred to as trigger points. These are areas that may feel tight or tender when pressed and can sometimes contribute to pain or restricted movement. 

Trigger points can develop for different reasons, including repetitive activity, sustained positions, changes in how the body is being loaded, or following an injury. During dry needling, a physical therapist inserts a very thin needle into a carefully selected area based on what they find during an evaluation. There is no medication in the needle, and nothing is injected. That is where the word “dry” comes from. 

Researchers are still studying exactly how dry needling produces its effects. Current evidence suggests that the technique may affect both the muscle being treated and the nervous system’s response to pain. Depending on the condition, dry needling may provide short-term improvements in pain, muscle sensitivity, or movement. The response varies from person to person. 

Is Dry Needling the Same as Acupuncture?

No. Dry needling and acupuncture use similar thin needles, but they come from different clinical approaches. Acupuncture targets the body’s meridians based on Chinese medicine philosophy, following an independent practice standard and clinical reasoning.  

When a physical therapist performs dry needling, the technique is used as an adjunct to traditional therapy and is most successful when done in combination with targeted exercises which aim to enhance stretching, strengthening, and motor control training.  The American Physical Therapy Association recognizes dry needling as an intervention used by appropriately trained physical therapists. Laws and requirements vary from state to state. 

Does Dry Needling Hurt?

People experience dry needling differently. Because the needles are very thin, you may feel very little as the needle enters the skin. When the needle reaches the targeted tissue, some people notice a brief ache, cramp, or muscle twitch. Temporary soreness afterward is also possible. 

Minor reactions such as soreness, small amounts of bleeding, or bruising are among the more commonly reported side effects. A 2026 systematic review examining adverse events associated with dry needling found that minor reactions can occur, while major adverse events were uncommon. Serious complications are still possible, which makes appropriate training, anatomy knowledge, patient screening, and safe technique important. 

Your physical therapist should explain what to expect, review relevant precautions, and answer your questions before treatment. Dry needling is also optional. If you are uncomfortable with needles or the technique is not appropriate for you, your physical therapist can discuss other treatment options. 

Is Dry Needling Safe?

For appropriately screened patients, dry needling is generally considered a low-risk intervention when performed by a properly trained healthcare professional. However, “low risk” does not mean “no risk.” 

Dry needling involves inserting a needle through the skin, so the clinician performing it needs a strong understanding of anatomy and safe treatment techniques. Physical therapists who provide dry needling complete specific education in the technique. 

What Problems Can Dry Needling Help?

Dry needling has been studied for several musculoskeletal pain conditions. Physical Therapists may consider dry needling for some patients experiencing problems such as: 

• Neck or back pain 

• Shoulder pain 

• Tennis or golfer’s elbow 

• Hip or knee pain 

• Muscle-related pain or tightness 

• Plantar heel pain or plantar fasciitis 

Research provides some support for its use in selected conditions. For example, a systematic review of dry needling for nontraumatic shoulder pain found moderate-quality evidence for a small short-term reduction in pain and lower-quality evidence for improvement in pain-related disability. Another review examining subacromial shoulder pain found favorable results when dry needling was added to other conservative treatments, although the researchers noted limitations in the available studies. 

Dry needling has also been studied for plantar heel pain. A systematic review and meta-analysis found moderate- to low-quality evidence suggesting improvements in pain and pain-related disability, while also cautioning that the number of available trials was small. 

What does that mean for you? 

It means the question should not simply be, “Can dry needling treat my diagnosis?” A better question is, “Based on what is causing my pain and limiting my movement, could dry needling be useful as part of my treatment?” That answer requires an evaluation by a physical therapist. 

How Quickly Does Dry Needling Work?

There is no universal timeline. Some people notice a difference in pain or movement shortly after treatment. Others experience soreness first or require multiple treatment sessions before noticing whether the technique is helpful, and some people may not respond to dry needling at all.

Your response can depend on the condition being treated, how long symptoms have been present, what else is contributing to the problem, and what treatment is being used alongside dry needling.

What Can Improvement After Dry Needling Look Like?

Improvement does not look the same for every patient. Some people notice a change in pain or movement shortly after treatment, while others improve more gradually as dry needling is combined with the rest of their physical therapy plan. We’ve seen dry needling play a useful role in several different situations.

One patient came to physical therapy with ongoing migraines and shoulder pain that has been affecting her for years. Her therapist used dry needling on several muscles around the back of the shoulder, including the rotator cuff, and her range of motion improved during the session. At a later visit, dry needling was used for muscles at the base of her skull and along the side of her neck (suboccipital muscles and levator scapulae). She reported feeling significant relief and became emotional because it was the first substantial relief she had felt in years.

Another patient was experiencing pain in the front of the shoulder and biceps area. After the physical therapy examination, dry needling was incorporated into treatment for a muscle at the back of the shoulder (infraspinatus). The patient reported that the shoulder pain was resolved after two treatment sessions. 

For a runner experiencing pain along the inside of the foot, the therapist used dry needling on a small muscle that helps support the arch (abductor hallucis). After treatment, the patient reported being able to run without the same symptoms, and the therapist also observed a noticeable improvement in midfoot mobility. 

These examples show how differently patients may respond. One person may notice less pain, another may gain movement that had been restricted, and another may find it easier to return to an activity that had been uncomfortable. 

They are individual patient experiences, not a prediction of what dry needling will do for everyone. The more important question is whether the findings from your physical therapy evaluation suggest that dry needling could help address a specific part of your pain or movement problem. When it does, we can use that improvement as an opportunity to work on the strength, mobility, movement, or activity tolerance needed for long-term progress. 

How do I know if dry needling is right for me? 

If pain, tightness, or limited movement is affecting your ability to exercise, work, sleep comfortably, or participate in an activity you enjoy, a physical therapist can evaluate what may be contributing. 

An evaluation may include looking at your strength, mobility, movement patterns, symptoms, activity demands, and how your body responds to different movements or loads. From there, your therapist can determine whether dry needling could reasonably help as part of your plan or whether another approach makes more sense. 

At LHMPTI, we do not begin with “Can we dry needle this?” We begin with “Why is this person hurting or having trouble moving?” Dry needling may be one tool that helps. The larger goal is choosing the right combination of treatment, movement, and training to help your body handle what you need it to do. 

References 

American Physical Therapy Association. Dry Needling. APTA. Current guidance on dry needling in physical therapist practice. 

American Physical Therapy Association. State Laws and Regulations Governing Dry Needling Performed by PTs. Updated July 18, 2026. 

Rabanal-Rodríguez G, et al. Frequency and Severity of Adverse Events Associated With Dry Needling: A Systematic Review and Meta-Analysis. Physical Therapy. 2026. 

Griswold D, et al. Dry Needling for Subacromial Pain Syndrome: A Systematic Review with Meta-Analysis. Pain Medicine. 2023. 

LHMPTI