Dry Needling: What It Is, How It Differs from Acupuncture and What It Feels Like

Dry needling has become one of the techniques we are asked about most. Some patients come in asking for it by name. Others are nervous the moment they see a needle. Both reactions are reasonable, so here is a clear explanation of what it is, what it is not, and what to expect.

This is general information. Whether dry needling suits you is decided after an individual assessment.

What dry needling is

Dry needling uses very thin, solid, single-use needles, similar to those used in acupuncture, inserted into muscle. It is called dry because nothing is injected. It is most often aimed at myofascial trigger points: tight, tender spots within a band of muscle that can cause local pain or pain felt elsewhere. The aim is to reduce pain and muscle tension so that you can move more freely and get more out of exercise and the rest of your treatment.

Dry needling and acupuncture

The needles look alike, but the reasoning is different. Acupuncture comes from traditional Chinese medicine and places needles on points along channels described in that tradition, although some modern medical acupuncture also uses anatomical reasoning. Dry needling is based on Western anatomy and a physiotherapy assessment: the needle goes into a specific muscle that has been examined and found to be tight, tender or reproducing your pain.

What the evidence says

A systematic review and meta-analysis in the Journal of Orthopaedic & Sports Physical Therapy (Gattie and colleagues, 2017) found that dry needling by physical therapists reduced pain more than no treatment or sham needling in the short term, up to around 12 weeks, although the quality of the evidence was rated very low to moderate. An earlier JOSPT review of neck and upper back muscle pain (Kietrys and colleagues, 2013) reached a similar short-term conclusion. Longer-term effects are less clear.

Our honest reading: dry needling can be a useful tool to ease pain and muscle tension, especially early in treatment. It is most useful as part of a plan that includes exercise and load management, not as a standalone treatment. For some conditions it is not recommended: the NICE osteoarthritis guideline (NG226), for example, advises against acupuncture or dry needling to manage osteoarthritis, and we follow that.

What it feels like

The needle is much thinner than one used for injections or blood tests, and many people barely feel it go in. When it reaches a tight area, the muscle may twitch briefly, or you may feel a deep, dull ache, sometimes a familiar version of your pain. These sensations usually pass within seconds. Tell your physiotherapist how it feels: they can adjust or stop at any time.

Afterwards, the area may feel sore for a day or two, a bit like after a hard workout. A prospective survey of chartered physiotherapists in Ireland (Brady and colleagues, 2014) found that minor reactions such as bruising, brief bleeding and soreness after treatment were common, while significant adverse events were rare. Gentle movement and normal activity usually help.

Who should avoid it or check first

Tell your physiotherapist before treatment if any of these apply, as needling may need to be adapted, postponed or avoided:

• A strong fear of needles. That is a perfectly valid reason to choose another technique.
• A bleeding disorder, or taking blood-thinning medication.
• Pregnancy, or the possibility that you are pregnant.
• An infection, wound or skin problem at or near the area.
• A weakened immune system, or a medical condition that is not well controlled.
• An allergy to metals such as nickel.
• Recent surgery in or near the area, or lymphoedema in the limb.

Rare but serious risks, such as a needle over the chest wall affecting the lung, are why dry needling should only be performed by a clinician trained in the technique, with a sound knowledge of anatomy, after a full assessment and with your consent.

When to see a doctor first

Dry needling is for muscle-related pain. It is not the right first step if you have:

• Pain after a significant fall or accident.
• Weakness that is getting worse, spreading numbness, or any change in bladder or bowel control.
• Fever, unexplained weight loss or severe pain at night.
• A hot, swollen, red joint.

How dry needling works at MVP

Dry needling is not a separate appointment. If your physiotherapist assesses that it suits your problem, and you agree, it is used within your 45-minute physiotherapy session (600 QAR) at no extra cost, alongside hands-on therapy and exercise. If it does not suit you, other techniques are available in the same session. Common reasons it is used include neck and upper shoulder tension, lower back pain with tight muscles, and shoulder or hip pain where the surrounding muscles are guarding.

Dry needling in Doha at MVP→

Physiotherapy at MVP→

Sources

• Gattie E, Cleland JA, Snodgrass S. The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 2017.
• Kietrys DM, et al. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 2013.
• Brady S, et al. Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. Journal of Manual & Manipulative Therapy, 2014.
• NICE guideline NG226. Osteoarthritis in over 16s: diagnosis and management, 2022.