What is Dry Needling?

A Definition from the Physical Therapy Perspective

Dry needling is a skilled intervention performed by physical therapists that involves the insertion of thin, monofilament needles into muscles, fascia, or connective tissue.

The goal? To stimulate underlying myofascial trigger points, relieve pain, improve range of motion, and enhance neuromuscular function.

It’s called “dry” needling because the needle is not injecting any substance—unlike a hypodermic syringe used in medications or vaccines. Instead, the mechanical action of the needle is what triggers physiological responses.
Dry needling is not acupuncture, even though the tools look similar. It is based on modern anatomical and neurophysiological principles rather than traditional Chinese medicine.

What Is Dry Needling in Physical Therapy?

The Role of Dry Needling in Rehab Settings

In the context of physical therapy, dry needling serves as a complementary treatment used alongside therapeutic exercise, manual therapy, and education. It’s not a standalone cure—but when used appropriately, it can accelerate recovery and improve functional outcomes.

Dry needling is typically used by PTs to:

Treat myofascial trigger points
Decrease pain and muscle tension
Improve muscle activation or relaxation
Restore movement quality

Because it targets neuromuscular dysfunction directly, many physical therapists find it especially effective for persistent or chronic conditions where conventional interventions haven’t produced full results.

How Does Dry Needling Work?

Understanding the Mechanism Behind the Needle

So what’s actually happening when that thin needle goes into a muscle? The answer involves a mix of mechanical, neurophysiological, and biochemical effects.

— Mechanical Disruption of Trigger Points

At its core, dry needling mechanically disrupts myofascial trigger points (TrPs)—those taut bands of muscle that often feel like knots.

When a needle is inserted into a TrP, it may elicit a local twitch response (LTR), which is a brief contraction of the muscle fibers. This twitch is often considered a sign that the needle has hit the right spot.

— Neurological Modulation

Beyond the mechanical response, dry needling also stimulates sensory nerves. This sends signals to the spinal cord and brain, which can help modulate pain perception via central and peripheral mechanisms.

Think of it as hitting the reset button on faulty neuromuscular circuits.

— Biochemical Cascade

Dry needling has also been shown to influence local chemical environments. Inserting a needle into a trigger point can lead to reduced concentrations of pain-inducing substances like substance P and CGRP (calcitonin gene-related peptide) while increasing blood flow to the area.

Summary: How Dry Needling Works

Disrupts trigger points
Resets abnormal neuromuscular activity
Reduces inflammatory markers and pain chemicals
Enhances local circulation
Restores homeostasis in muscle tissue

What Is Dry Needling Good For?

Here are some of the most common conditions where dry needling can be helpful:

Myofascial Pain Syndrome: This is the bread and butter of dry needling. Myofascial pain syndrome involves trigger points and referred pain patterns—exactly what dry needling targets best.
Chronic Neck and Back Pain: Research supports the use of dry needling for reducing muscle tone and pain in chronic spinal conditions. It’s particularly effective for muscles like the upper trapezius, levator scapulae, multifidi, and quadratus lumborum.
Shoulder Impingement or Rotator Cuff Dysfunction: Needling muscles like the infraspinatus, supraspinatus, and subscapularis can help normalize shoulder biomechanics and reduce impingement symptoms.
Lateral Epicondylitis (Tennis Elbow): Targeting the extensor carpi radialis brevis and surrounding musculature often provides pain relief and improved grip strength.
Headaches and Migraines: Cervicogenic headaches often involve trigger points in the suboccipitals and upper traps. Dry needling these areas can alleviate pain referral patterns.
TMJ Dysfunction: PTs trained in intraoral dry needling can access pterygoid muscles to help patients with jaw pain, bruxism, or TMJ clicking.
Lower Extremity Dysfunction: From plantar fasciitis to patellofemoral pain syndrome, dry needling can help normalize muscle tone and improve motor control.

Clinical Application Tips for PTs

Best Practices and Safety Considerations

Before incorporating dry needling into your clinical toolbox, here are a few key points to keep in mind:

Get Properly Certified: Dry needling is a specialized skill, and regulations vary by state or country. Make sure you complete an accredited training program and understand your local scope of practice.
Use Clean Technique: While the needles are sterile and disposable, it’s crucial to follow universal precautions and maintain a hygienic field to avoid infection.
Educate Your Patients: Explain what dry needling is—and what it isn’t. Clarify that it’s not acupuncture and inform patients about what sensations to expect (soreness, twitching, etc.).
Start Conservatively: Especially in your early days of practice, begin with superficial or easily accessible muscles and avoid high-risk zones (e.g., the thoracic cavity) until you’ve gained more experience.

Final Thoughts: Is Dry Needling Right for Your Practice?

If you’re a physical therapist looking to expand your skill set or a student considering your future scope of practice, dry needling offers a powerful adjunct to your treatment toolkit.

It bridges the gap between manual therapy and neurophysiological modulation, offering a direct route to address muscle dysfunction and pain.

But like any intervention, it requires proper training, critical thinking, and patient-centered application.

Did you find these tips helpful? Let us know! Contact our PT Success Team at ptlighthouse@thejacksonclinics.com

To learn more about The Jackson Clinics and to explore a career with us, please visit thejacksonclinics.com/careers