Dry Needling: The Complete Guide to the Benefits, Risks, Cost, and More

dry needling treatment

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Whether you're dealing with a stubborn shoulder injury that's been lingering for years or a strained hamstring from this weekend's yoga class, when muscle pain strikes, it can be miserable and debilitating. Many of us continuously dip into the usual arsenal for treating muscular issues—stretching, strengthening, some heat or ice, and maybe even some over-the-counter anti-inflammatories. But we recently learned about another treatment you may be interested in, called dry needling.

Keep reading to hear what some physical therapists have to say about using dry needling to treat muscle pain.

Meet the Expert

  • Dr. Briana Bain is a physical therapist based in Virginia Beach, VA. She received her doctorate in physical therapy from Mary Baldwin University's College of Health Sciences.
  • Tina Anderson, MS, PT is a Michigan-based physical therapist specializing in complex neuromusculoskeletal dysfunction.
  • Dr. Bianca Beldini is a dry needling-certified physical therapist with a holistic approach to healing and recovery. Her patients include MLB pitchers, NYC ballet dancers, and more.
  • Kyle Atwell, DPT, OCS, COMT, CMTPT, FAAOMPT is both an orthopedic clinical specialist and a fellow of the American Academy of Orthopedic Manual Physical Therapists.
  • Carol Grgic is a physical therapists specializing in dry needling, and has been performing the procedure for over 10 years.

What Is Dry Needling?

Dry needling is a treatment performed by specially trained physical therapists to reduce pain and improve neuromusculoskeletal conditions such as muscle injuries or even neurological conditions. (Not all physical therapists are certified in dry needling.) It's safe, only mildly uncomfortable, and is usually paired with exercise and other methods of rehabilitation. "The procedure involves inserting a thin, monofilament needle into muscle tissue (most commonly), which can provoke an involuntary “twitch” or focal contraction of the target muscle fibers," explains Anderson.

The treatment is called dry needling because the needle does not contain medication like a traditional injection, so the needle is "dry", says Grgic. The needles used in dry needling are much thinner and more flexible than those used to inject medications, which reduces discomfort and stress on the body's tissues.

Benefits of Dry Needling

Dry needling can be a significantly helpful treatment for acute or chronic neuromusculoskeletal issues, including back pain, headaches, tennis elbow or plantar fasciitis.

"Dry needling has the capacity to improve muscle performance, improve nerve function, improve the integrity of tendons and ligaments, and reduce pain and inflammation," Anderson says. "The mechanism of action impacts overall tissue health by increasing local blood flow and oxygen saturation, reducing pain and tissue sensitivity, and improving muscle performance through stimulation of the nervous system."

Here are a few ways dry needling can be beneficial, courtesy of Grgic:

  • Deactivates trigger points, which are tight bands in the muscles that can develop following an injury
  • Reduces muscular tension or nerve irritation.
  • Reduces scar tissue formation
  • Minimizes swelling in acute injuries
  • Promotes homeostasis, allowing the body to heal more effectively

How to Prepare For a Dry Needling Appointment

Like many people, you may be put off by the idea of any treatment that involves needles, but it's important to realize that dry needling is not very painful or uncomfortable—at all. The best way you can prepare for your treatment is by not stressing about it.

It's also really important to make sure you only receive this treatment from a trained professional. "In the U.S., dry needling requires advanced education and is performed by specially trained physical therapists, occupational therapists, athletic trainers, and some chiropractors," Grgic says.

What to Expect During Your Appointment

During your appointment, you'll need to expose the area requiring treatment, so be sure to wear clothing that makes it convenient to do so. Your physical therapist will use an extremely thin needle to puncture the trigger point of the muscle to help treat myofascial pain in that area. "Typically, the needles are left in the trigger point for just a few seconds to a few minutes, depending on the severity of the trigger point," says Dr. Bain.

While the needles don't contain any fluid or medicine (like traditional injectables), your physical therapist may decide that you're a candidate for electrical stimulation via the dry needles. "There are multiple ways to use electrical stimulation," Dr. Bain says. "It can raise your pain threshold an distract your brain from trigger point-related pain for reduced pain during (and ideally for a few hours following) the treatment."

dry needling therapy
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Dry Needling vs. Acupuncture

Dry needling and acupuncture both use needles and can both be used to treat pain, but beyond that, they're not very similar at all. Acupuncture is a form of Eastern medicine that uses uses needles as a way to balance chi, or energy, as well as fluids, blood, and lymph within the body. "Acupuncturists utilize many needling techniques including that which is used in dry needling," says Beldini.

Dry needling is a form of Western medicine where a needle is used to release taut bands of muscle fibers. "We can palpate trigger points and correlate the pain from that trigger point to the patient’s familiar pain experience," Atwell says. "Dry needling typically penetrates into the muscle at the depth of the trigger point."

The Cost

Like other medical and rehabilitative treatments, dry needling can vary in price depending where you go for treatment and whether the treatment is covered by your insurance. For this reason, we recommend asking about the cost prior to your treatment.

Potential Side Effects

The use of needles is the biggest drawback to dry needling. Though the needles used in this procedure are not dangerous, if someone is afraid of needles they probably aren't going to want to sign up for a dry needling treatment. "The good news, however, is that the needle used in dry needling is so thin—thinner than a needle used for a flu shot—that most people don’t really experience much of the sharpness generally associated with needles," says Atwell.

He also raises another potential drawback to dry needling—the sensation of the twitch response that occurs when the needle enters into a trigger point. "This is an unusual sensation, similar in some ways to the sensation felt when someone checks for reflexes," he says. "The twitch response usually occurs without warning which can be startling to some."

There's also a small chance of puncturing the lungs (pneumothorax) if dry needling is performed over the rib cage. Atwell says that when proper precautions are taken, the risk of pneumothorax is extremely low. Dry needling also isn't a good fit for people with certain medical conditions, such as bleeding disorders.

After treatment, you should also expect some muscle soreness. "Post dry needling muscle soreness can feel dull and aching, like many experience after a hard workout," Beldini says. Many people experience bruising after treatment as well.

The Final Takeaway

Try dry needling if you're looking for a new way to treat muscle pain. "Dry needling is a highly effective, non-pharmacologic, low-risk, first-line strategy that should be considered as a component of a rehabilitation program to optimize recovery from injury or disability," Anderson says.

One thing we love about dry needling is that it offers a non-drug alternative to treating muscle pain—in a time when prescription pain medicines play a huge in the opioid crisis, this is a huge win. "If it is performed by an experienced practitioner, dry needling can be a profound pain modulator for those suffering from myofascial pain," Beldini says. "Dry needling can give the patient an option to not have to use a narcotic or addictive drug for pain."

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