What Is Dry Needling?

A Therapeutic Procedure to Treat Musculoskeletal Disorders

Dry needling is a therapeutic procedure used by orthopedic doctors, physical therapists, and chiropractors to relieve pain, improve joint range of motion, and address neuromuscular conditions, such as nerve issues that cause muscular pain and weakness. Dry needling is a common technique that relies on a strong evidence base to address specific areas of concern within the body.

Dry needling may be confused for a similar procedure called acupuncture. While both procedures involve the optimal placement of needles on certain body parts, acupuncture is a traditional Chinese medicine treatment that focuses on the movement of energy within the body to relieve pain and prevent disease. Dry needling uses knowledge of anatomy and bodily processes to specifically relieve pain, improve range of motion, or alleviate nerve issues.

Purpose of Procedure

Dry needling may be ordered in response to a patient who presents with musculoskeletal issues, such as muscle pain, scar tissue buildup, muscle weakness, or poor motion. Dry needling is most commonly used to treat trigger points, which are oxygen-deprived muscles that become highly sensitive and painful to the touch. Trigger points may also result in pain elsewhere in the body, also known as referred pain.

In addition to trigger points, dry needling is appropriate for the treatment of joint problems, cervical disc and other spinal problems, tendonitis, migraines, lock jaw or other jaw problems, whiplash, and pelvic pain. Dry needling is also used to treat conditions that evolve from repetitive motion, including carpal tunnel syndrome. While these are the most common conditions that dry needling can assist with, there are other concerns that may warrant your therapist or doctor performing dry needling.

An orthopedic doctor or chiropractor may perform dry needling on patients they deem appropriate for the procedure. These health care professionals may give doctor’s orders to a physical therapist or other therapists requesting the use of this procedure on patients they have evaluated.

Dry needling is not intended to heal or cure any muscle or joint conditions and is best used as part of a treatment plan that includes exercises, activities, massage, application of heat, and health education. 

Risks and Contraindications

Side effects associated with dry needling include soreness during or after the procedure, bleeding where the needles were inserted, fainting, fatigue, and skin bruising. Most of these side effects are minor and do not cause significant injury or distress to patients who receive dry needling.

The rarest, but most dangerous, side effect of dry needling is organ damage resulting from a needle that punctures a major organ. This may include a pneumothorax, or a punctured lung, if needles are inserted in the chest.

Dry needling is not suitable for pregnant women, people who are unable to understand the purpose of dry needling, and people who are very afraid of needles. Those who have recently had surgery and have healing wounds should consult their doctor before dry needling. If you are currently taking blood-thinning medications you should consult their doctor before dry needling. There are other procedures with similar benefits for individuals who require relief from trigger points and other muscle or joint conditions.

While there are risks, the benefits of dry needling are often considered to far outweigh the drawbacks. These risks are significantly decreased by consulting a licensed and trained healthcare professional who uses consistent techniques and sterile equipment.

Before the Procedure

Your doctor will complete a typical evaluation and weigh your readiness to receive a procedure such as dry needling. Your doctor will review your medications and ensure it is safe to receive dry needling while you are taking blood-thinning medications. Your doctor will also ask if you have ever had dry needling performed on you before as well as ask if you have a fear of needles.

After your doctor assesses your suitability for dry needling, they will ask if you are receptive to receiving dry needling. Dry needling will likely not be performed on the same day, so you will have time to think about whether you would like to start this procedure.

Timing

Dry needling typically takes 10 to 15 minutes. Your therapist or doctor will prepare you for several minutes beforehand and educate you on the procedure and what you should expect. If you opt to receive dry needling from a physical therapist, you may need to wait for your appointment, depending on how large the therapy clinic is.

If you are receiving dry needling in addition to other treatments such as exercise, heat, health education, and massage, this will likely be part of a longer therapy session lasting for a total of 30 to 60 minutes.

If you are a new patient, you may need to fill out new patient and history forms. If you are an existing patient, you may need to sign a consent form applying just to the dry needling procedure. This will vary depending on the health care provider that you see and the setting where you receive the dry needling.

There is no waiting period afterward for results or recovery. Your therapist or doctor will likely instruct you to notify them of any unusual side effects or major increases in pain or other symptoms following the dry needling.

Location

Dry needling may occur in a doctor’s office, a therapy clinic, or an outpatient rehabilitation center. Dry needling is often provided in a secluded area to allow for the patient to sit comfortably and away from other patients. This may be a curtained off area or a separate exam or therapy room.

What to Wear

You dress as you typically would if they are receiving physical therapy. If you have not received therapy before, your doctor or therapist will instruct you if you need to dress differently. Depending on the area of the body where dry needling is to be performed, you may need to partially undress. If you are receiving dry needling on your knee, you will need to wear pants that can be rolled up above the knee or dress in layers. If you are receiving dry needling on your shoulder, you will need to wear a shirt that can be rolled up above the shoulder or dress in layers.

Cost and Health Insurance

Dry needling does not typically require health insurance pre-approval, as it is a minor, non-emergency, and non-invasive procedure. Insurance coverage will vary depending on your insurance benefits. If you are concerned about the cost of dry needling, you should contact their health insurance provider to inquire whether you can receive coverage and care from an in-network provider. 

What to Bring

You will be able to drive following the procedure and do not need to make additional arrangements. If you need to dress in layers to allow for access to the affected part of the body, you should bring a change of clothes if you are not comfortable remaining in layers. Bring your health insurance card and any new patient paperwork if you were asked to fill out such forms.

During the Procedure

You will check in with the receptionist at your doctor or therapist’s office prior to your appointment. If you are at your doctor’s office, you may interact with a medical assistant who will take your vitals and prepare you to be seen by the doctor. If you are at a therapy clinic or seeing a therapist in another setting, you may interact with a receptionist who will check you in for your appointment.

Pre-Procedure

In some instances, separate paperwork will need to be filled out before you receive dry needling. You should come to the appointment in your change of clothes or change shortly after arriving.

Throughout the Procedure

Your therapist or doctor will clean the area that is to receive dry needling. The dry needling procedure itself should take between 10 and 15 minutes. You will be asked to sit or lay down and relax. You will likely also be asked to notify the therapist or doctor if you are experiencing any discomfort or if you feel as if you may faint. This procedure is being done to relieve pain, so it is not the intention for you to experience any significant pain. In this instance, you should notify your health care provider at the moment.

Your therapist or doctor may place several needles deep into the skin or closer to the surface. The needles may be placed for several seconds up to 10 or 15 minutes in total. These factors are dependent on the symptoms and conditions you are experiencing. You may experience a variety of sensations, such as muscle soreness, muscle twitching, or an ache. These sensations are regarded as a good sign, since it means your muscles are responding to the needle insertion.

Some therapists or doctors will educate you as to what they are doing throughout the procedure, while some health care providers will describe the procedure beforehand. You are encouraged to ask questions to better understand the process.

Post-Procedure

There is no recovery time needed after dry needling. If you are laying down during the procedure, you will likely be instructed to get up slowly and wait for a short time before standing up. This will ensure that you do not get up too quickly and feel faint or lightheaded.

Once the needles have been inserted, they will be removed. Your therapist or doctor will likely inspect the area where they were once inserted to ensure there is no bleeding or skin reaction.

There are no specific instructions to follow after receiving dry needling. You should notify your therapist or doctor of any side effects, pain, or discomfort at any point after your procedure.

After the Procedure

If there are any adverse side effects, you should notify your doctor or therapist immediately. Side effects such as skin bruising or muscle soreness may last several days up to one week. These side effects are typically not severe and usually result from the physical insertion of a needle into the skin.

Your doctor or therapist may recommend rest or other practices for skin bruising and muscle soreness. If you experience more severe and rare side effects such as shortness of breath or major bleeding, you should contact emergency services immediately. This could indicate the presence of an infection or organ damage due to puncture.

Interpreting Results

Based on your feedback and assessments of pain, movement, and stiffness, your doctor or therapist will determine how your body responded to the dry needling. Your feedback can provide information immediately, but your doctor or therapist may wait several sessions to provide additional assessments.

Follow-Up

Your doctor or therapist will discuss your experience with you and if you experience positive results from dry needling, they will likely perform the procedure again. If you experience adverse side effects or do not wish to continue receiving dry needling, your therapist or doctor can discontinue those treatments.

If you continue to experience symptoms with no results from dry needling, they may recommend different procedures or treatments to assist in managing your symptoms. This procedure can be repeated up to two times per week if your therapist or doctor determines this is necessary and beneficial.

If you have specific concerns or would like to explore alternative treatment methods, these options can be discussed with your doctor or therapist.

A Word From Verywell

Undergoing new procedures can be very anxiety-provoking. It is important to relay these concerns with your health care provider so they can assist in providing you the information you need to feel confident and assured in your health decisions. Dry needling is not a major or emergency procedure, so you can opt out at any time. This procedure is intended to relieve pain and discomfort in order to improve your quality-of-life, so if you are not feeling comfortable with the procedure, you should express these concerns. As always, consult your doctor before receiving any procedure or treatment to ensure your safety and well-being.

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Article Sources

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