Dry Needling: What Is It, How Does It Work, and Does the Research Support It?

For some patients, the idea of putting a needle into a painful muscle sounds intimidating. Others have seen athletes use dry needling and wonder whether it’s simply another recovery trend.

Research suggests dry needling can help reduce pain and improve function for certain musculoskeletal conditions, particularly in the short term. But it’s best viewed as **one tool within a larger rehabilitation program – not a stand-alone cure.**¹

What Is Dry Needling?

Dry needling involves inserting a thin, solid filament needle through the skin and into targeted muscles or other soft tissues.

The term “dry” simply means nothing is being injected. Unlike an injection, the needle doesn’t deliver medication.

Physical therapists may use dry needling to target painful or sensitive areas of muscle, commonly called myofascial trigger points, as well as other tissues depending on the treatment approach.

Common treatment areas include the neck, shoulder, low back, hips, quadriceps, hamstrings, and calves.

Is Dry Needling the Same as Acupuncture?

Although both treatments use similar thin needles, dry needling and acupuncture aren’t the same treatment approach.

Acupuncture originates from traditional Chinese medicine, although modern acupuncture can incorporate several different frameworks.

Dry needling in physical therapy is generally based on a Western musculoskeletal and neuroanatomical approach, with treatment determined by the patient’s anatomy, symptoms, examination findings, and rehabilitation goals.

How Does Dry Needling Work?

You may have heard that dry needling simply “releases a knot.”

That’s an easy way to describe it, but the physiology is more complicated.

Needling a sensitive area may produce local and nervous-system responses that temporarily influence pain sensitivity and muscle activity. Sometimes the needle also produces a brief involuntary contraction called a local twitch response.

But getting a twitch isn’t necessarily the goal.

The more important question is:

Does the treatment create a meaningful improvement in your pain or movement?

Research suggests it can – particularly for short-term pain relief in certain musculoskeletal conditions.

A systematic review and meta-analysis examining 42 studies found that dry needling performed by physical therapists could reduce pain across several musculoskeletal conditions, although results varied depending on the condition and treatment approach.¹

Some individual clinical trials have reported substantial improvements.

For example, a randomized trial involving patients with chronic low back pain found an average 6.45-point reduction in pain on a 10-point scale immediately following a four-week dry needling program combined with exercise. Improvements in pain, disability, and lumbar mobility were still present three months later.²

Another randomized trial found that patients receiving dry needling improved by approximately 2.5 points on a 10-point pain scale and 17 percentage points on the Oswestry Disability Index after six sessions. Importantly, however, dry needling wasn’t significantly better than non-thrust manipulation in that study.³

These numbers don’t mean every patient should expect the same results. They show that clinically meaningful improvements are possible, while also reminding us that dry needling isn’t necessarily superior to every other physical therapy treatment.

Dry Needling Shouldn’t Be the Entire Treatment

Imagine your calf hurts every time you run.

Dry needling decreases the discomfort, and afterward you can perform a calf raise with significantly less pain.

That’s useful.

But if your calf doesn’t currently have the strength or capacity to tolerate 20 miles of running per week, needling alone hasn’t solved that problem.

You still need to progressively rebuild the muscle and prepare it for running.

That’s how we typically view dry needling:

It can create a window where you hurt less or move better – and rehabilitation takes advantage of that window.

Research in patients with radiating low back pain supports this concept. Adding dry needling to standard physical therapy resulted in greater improvements in pain and disability than standard PT alone at two-month follow-up.⁴

What Does Dry Needling Feel Like?

The needle itself is very thin, and some patients barely feel it enter the skin.

When the needle reaches a sensitive area, you may experience a brief ache, pressure, cramp, or twitch. Temporary soreness afterward is also common – somewhat similar to soreness after a workout.

Your physical therapist should explain what to expect and determine whether dry needling is appropriate based on your medical history and examination.

The Goal Is Still to Get You Moving

Dry needling can be a valuable part of physical therapy, but the goal isn’t to have you returning indefinitely because a muscle keeps getting “tight.”

The goal is to determine why you’re having difficulty tolerating an activity and progressively rebuild your ability to perform it.

At Zeek PT & Recovery in North Austin, dry needling may be combined with manual therapy, mobility work, progressive strength training, movement retraining, and sport-specific rehabilitation depending on your individual needs.

Dry needling may help reduce the symptoms.

Rehabilitation prepares you to get back to what you want to do.

Recover. Rebuild. Perform.

References

1. Sánchez-Infante J, Navarro-Santana MJ, Bravo-Sánchez A, et al. Is Dry Needling Applied by Physical Therapists Effective for Pain in Musculoskeletal Conditions? A Systematic Review and Meta-Analysis. Physical Therapy. 2021;101(3):pzab070.
2. Rajfur J, Rajfur K, Kosowski Ł, et al. The effectiveness of dry needling in patients with chronic low back pain: a prospective, randomized, single-blinded study. Scientific Reports. 2022;12:15803. This trial reported significant improvements in pain, disability, and lumbar mobility following dry needling combined with exercise compared with sham treatment plus exercise.
3. Griswold D, Gargano F, Learman K. A randomized clinical trial comparing non-thrust manipulation with segmental and distal dry needling on pain, disability, and rate of recovery for patients with non-specific low back pain. Journal of Manual & Manipulative Therapy. 2019;27(3):141-151. Dry needling produced clinically meaningful within-group improvements, but wasn’t superior to manipulation.
4. Mahmoudzadeh A, Rezaeian ZS, Karimi A, Dommerholt J. The effect of dry needling on the radiating pain in subjects with discogenic low-back pain: A randomized control trial. Journal of Research in Medical Sciences. 2016;21:86. Adding dry needling to standard PT resulted in greater improvements in pain and disability than standard PT alone.

Meta Description: What is dry needling and does it actually work? Learn how physical therapists use dry needling for muscle pain and what current research says about pain relief and recovery.