Dry Needling

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What Is Dry Needling?

John Miller Physiotherapist Erin Runge Physiotherapist
Article by John Miller & Erin Runge
Physiotherapist performing dry needling on shoulder muscle for trigger point pain

Dry needling treatment for shoulder muscle pain

Dry needling is a physiotherapy technique that uses fine, sterile needles to target sensitive muscle bands and trigger points. It may help reduce muscle pain, ease tightness, and improve movement when used as part of a broader treatment plan that can also include exercise, advice, and hands-on care. At PhysioWorks, dry needling is usually considered after a thorough assessment of your symptoms, movement, and likely pain source. For a broader overview of acupuncture and dry needling, or a deeper treatment page on dry needling physiotherapy, you can explore those guides as well. [/vc_column_text][/vc_column][/vc_row]

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What is dry needling physiotherapy?

Dry needling physiotherapy uses a thin filiform needle to treat irritated muscle tissue and trigger points without injecting any substance. It is based on modern anatomy, pain science, and clinical assessment rather than traditional Chinese medicine theory.

How does dry needling work?

Dry needling aims to settle sensitive muscle points, reduce guarding, and improve movement tolerance. Your physiotherapist selects treatment points based on your symptoms, movement tests, muscle tension, and the tissues that appear to be contributing to your pain.

Because dry needling usually forms part of a broader rehabilitation plan, it is often combined with other physiotherapy treatment techniques, such as exercise therapy, movement retraining, advice, and hands-on treatment.

What are the benefits of dry needling?

  • May reduce muscle pain and sensitivity
  • May help relax tight or overactive muscles
  • May improve movement and flexibility
  • May support recovery alongside exercise and physiotherapy
  • May reduce referred pain from trigger points

Important: Dry needling is usually an adjunct treatment. It often works best when your physiotherapist also addresses the reasons your symptoms developed, such as strength deficits, movement overload, posture, work demands, training errors, or recovery habits.

What conditions may dry needling help?

Dry needling is most often used as an adjunct treatment for muscle pain, trigger points, and movement restrictions linked to musculoskeletal conditions. It is usually one part of a full treatment plan rather than a stand-alone fix.

What body areas are commonly treated?

Dry needling is often used around areas where muscle tension and trigger points commonly contribute to pain or stiffness. These may include the:

  • neck and upper trapezius region
  • shoulder and shoulder blade muscles
  • lower back and gluteal muscles
  • hip muscles
  • thigh and calf muscles
  • jaw-related muscle tension in selected cases

If your symptoms are linked to local muscle tightness, your physiotherapist may also assess whether related issues such as headaches, sciatica, or general muscle pain are part of the pattern.

How does a dry needling session work?

1. Assessment
Your physiotherapist assesses your movement, pain patterns, and muscle tension.

2. Targeted treatment
Fine needles are inserted into specific trigger points or tight muscle bands.

3. Response
You may feel a twitch, ache, or release sensation in the muscle.

4. Follow-up
Treatment is usually combined with exercise, stretching, or hands-on therapy.

What does dry needling feel like?

Many people feel a brief ache, twitch, cramp-like response, or local heaviness when the needle reaches a sensitive trigger point. After treatment, the area may feel looser, mildly sore, or tired for a short time, similar to post-exercise soreness.

What should you expect after dry needling?

  • Mild muscle soreness for 24 to 48 hours
  • Improved movement or reduced tightness
  • Occasional fatigue in the treated muscle
  • Gradual improvement when combined with exercise

Following your physiotherapist’s advice after treatment can help you get the best result. For many people, that includes gentle movement, hydration, and continuing the exercises or self-management plan you were given.

Tip: If your pain keeps returning, your physiotherapist will usually look beyond trigger points alone. They may assess load management, strength, joint movement, work setup, sleep, training habits, and recovery capacity so your results last longer.

Is dry needling the same as acupuncture?

No. Dry needling and acupuncture use similar needles, but they are based on different treatment models. Dry needling generally uses western anatomical assessment and targets muscles, trigger points, and pain-related movement problems. You can read more in our guide to what acupuncture is and our treatment overview covering acupuncture and dry needling.

When is dry needling not appropriate?

Dry needling may not be suitable for everyone. Your physiotherapist will consider factors such as needle tolerance, bleeding risk, infection, skin condition, general health, pregnancy considerations, and the location being treated before deciding whether it is appropriate.

Private health fund rebates

Private health fund cover for dry needling varies. In many cases, it is billed as part of a physiotherapy consultation rather than as a separate item. It is sensible to check your level of cover and any limits with your insurer before booking.

Who may benefit from dry needling?

People with muscle tightness, myofascial pain, recurrent trigger points, or pain that limits normal movement may benefit from dry needling when it is clinically appropriate. It is often combined with exercise, load management, and hands-on treatment for a more complete result.

If your main issue is more soft tissue tightness than injury diagnosis, some people also explore options such as trigger point therapy, myofascial release massage, or remedial massage depending on their goals and presentation.

When should you consider dry needling?

You may consider dry needling if muscle pain, tightness, or trigger points are slowing your recovery despite usual treatment. A physiotherapist can assess whether dry needling fits your presentation or whether another treatment approach is likely to suit you better.

Related information

FAQs about dry needling

Is dry needling painful?

Dry needling can feel uncomfortable for a moment, especially when a sensitive trigger point is treated. However, most people tolerate it well, and any soreness usually settles within a day or two.

How long does dry needling take to work?

Some people feel easier movement or reduced pain soon after treatment, while others notice change over the next 24 to 48 hours. The response varies depending on the condition, irritability, and what else is included in your treatment plan.

Can dry needling help muscle knots?

Dry needling is commonly used to treat trigger points, which many people describe as muscle knots. It may help reduce muscle guarding and improve comfort when combined with stretching, exercise, and load management.

Do physiotherapists use dry needling on its own?

Usually not. Physiotherapists often use dry needling as one part of a broader plan that may include diagnosis, exercise, hands-on treatment, ergonomic advice, and guided return to activity.

Is dry needling safe?

Dry needling is generally considered safe when performed by a properly trained clinician using sterile technique and appropriate screening. Like any procedure, it carries some risks, so your physiotherapist should explain these before treatment.

What should you do after dry needling?

Light movement, hydration, and following your physiotherapist’s advice are usually sensible after dry needling. It is also common to combine treatment with mobility work or exercises while the muscle is easier to move.

What to do next

If you are wondering whether dry needling is suitable for your pain, stiffness, or trigger points, a physiotherapy assessment is the best first step. Your clinician can identify the tissues involved, explain whether dry needling is appropriate, and build a plan around your goals.

If dry needling is not the right fit, your physiotherapist can guide you towards other options such as exercise therapy, manual therapy, load management, or a more targeted rehabilitation plan.

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References

  1. Dach F, Ferreira KS. Treating myofascial pain with dry needling: a systematic review for the best evidence-based practices in low back pain. Arq Neuropsiquiatr. 2023;81(12):1169-1178. doi:10.1055/s-0043-1777731
  2. Chys M, Schneider S, Smith CA, et al. Clinical effectiveness of dry needling in patients with musculoskeletal pain—an umbrella review. J Clin Med. 2023;12(4):1397. doi:10.3390/jcm12041397
  3. 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. J Orthop Sports Phys Ther. 2017;47(3):133-149. doi:10.2519/jospt.2017.7096
  4. Sánchez-Montoya M, Arias-Buría JL, Fernández-de-Las-Peñas C, et al. Safety and anatomical accuracy of dry needling procedures in musculoskeletal system: a systematic review of cadaveric studies. J Man Manip Ther. 2026;34(1):78-95. doi:10.1080/10669817.2025.2536818

What Conditions Can Acupuncture Help With?


John Miller Physiotherapist


Shane Armfield Physiotherapist

Article by
John Miller,
Shane Armfield
Acupuncture treatment to upper back and neck in physiotherapy clinic

Acupuncture may help some people manage persistent back pain, neck pain, knee osteoarthritis and certain headache conditions. However, the evidence varies between conditions, and not everyone responds to treatment.

Acupuncture is one possible part of a broader pain management plan. At PhysioWorks, a physiotherapy assessment can help determine whether acupuncture, dry needling, exercise or another treatment approach suits your symptoms and goals.

Learn more about the treatment in our acupuncture guide.

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Which Conditions May Acupuncture Help?

Acupuncture is used for several pain presentations, although its effectiveness differs between conditions. The most relevant question is whether needling may offer a useful benefit for your particular symptoms.

Chronic low back pain

Acupuncture may improve pain-related function and provide symptom relief for some people with persistent low back pain.

Neck pain

Some people experience short-term pain relief. Treatment may complement movement exercises and activity advice.

Knee osteoarthritis

Acupuncture may offer modest improvements in pain and function for some people, alongside exercise-based management.

Headaches

Evidence suggests acupuncture may help prevent some recurring migraine and tension-type headaches.

Shoulder and muscle pain

Needling may be considered for selected presentations, although evidence is less consistent and treatment suitability varies.

Other persistent pain

Acupuncture may be considered as an additional pain management option after assessment, rather than a universal treatment.

For related information, see our guides to lower back pain, neck pain and headaches.

What Does the Evidence Say About Acupuncture?

Research suggests acupuncture may help some pain conditions, but results depend on the condition, treatment approach and comparison treatment. Some studies report improvements compared with usual care, while benefits compared with sham acupuncture are often smaller.

Chronic low back pain

Acupuncture has been studied extensively for chronic low back pain. A 2025 randomised clinical trial involving 800 older adults reported improvements in back pain-related disability with acupuncture added to usual medical care. These findings support acupuncture as a possible treatment option, although the results may not apply equally to every patient.

For people with persistent back pain, acupuncture may form part of a plan that also addresses movement, strength, activity tolerance and pain management.

Knee osteoarthritis

Systematic reviews suggest acupuncture may provide pain relief and some functional improvement for people with knee osteoarthritis. However, the size and duration of benefit vary.

Exercise, strength training, suitable physical activity and weight management where relevant remain important parts of osteoarthritis care.

Neck pain and headaches

Acupuncture may reduce symptoms for some people with neck pain. Research also supports a possible preventive role in certain migraine and tension-type headache presentations.

However, headaches require an appropriate diagnosis. Neck stiffness does not automatically mean that a headache originates in the neck.

Our cervicogenic headache guide explains how neck-related headaches are assessed.

How Does Acupuncture Work for Pain Relief?

Acupuncture involves inserting fine, sterile needles at selected points in the body. Researchers believe needling may influence how the nervous system processes pain and may affect local and central pain-related responses.

However, the mechanisms are not completely understood, and different explanations have varying levels of scientific support.

For some people, a reduction in pain may make it easier to participate in normal activities and rehabilitation exercises. Acupuncture itself does not rebuild muscle strength, correct every cause of pain or replace an appropriate exercise program.

Can Acupuncture Help Back Pain and Sciatica?

Acupuncture may be considered for persistent low back pain, particularly when discomfort affects movement, sleep or daily activities. Treatment response varies, and acupuncture is not necessary for everyone with back pain.

Sciatica requires more careful consideration. Pain travelling into the leg can have several causes, including irritation of a spinal nerve. Acupuncture may help some people's pain, but it does not necessarily resolve nerve compression or another underlying cause.

New or progressive weakness, changing sensation or worsening neurological symptoms warrant clinical assessment. Problems with bladder or bowel control, or numbness around the saddle region, require urgent medical assessment.

When Might Acupuncture Fit Into Physiotherapy?

Acupuncture may be worth discussing when persistent pain limits activity and other appropriate strategies have not provided enough relief. It may also be considered when a person prefers a non-medicine pain management option.

Your physiotherapist can consider:

  • the likely source and nature of your symptoms;
  • how long the pain has been present;
  • previous treatment and your response;
  • your medical history and needling-related precautions;
  • the quality of evidence for your condition; and
  • whether symptom relief could support progress towards meaningful activity goals.

Acupuncture is optional. Some people prefer education, graded exercise, manual therapy, pacing or other conservative treatments.

Where joint pain is a concern, our joint pain treatment guide outlines additional management options.

What Is the Difference Between Acupuncture and Dry Needling?

Both approaches use fine needles, but their treatment frameworks and point-selection methods may differ.

Acupuncture commonly uses points selected according to an acupuncture treatment framework. Contemporary clinical acupuncture may also incorporate musculoskeletal and pain science reasoning.

Dry needling generally follows a musculoskeletal assessment and may focus on painful muscles, trigger points or other relevant soft tissues.

There is overlap in how the techniques are performed and in some proposed physiological effects. Neither approach is automatically better for every pain condition.

You can compare the approaches in our acupuncture and dry needling overview.

When Might Acupuncture Not Be Appropriate?

Acupuncture is not suitable for everyone. A clinician should review your health history, symptoms and potential risks before treatment.

Tell your treating clinician if you:

  • take anticoagulant medicines or have a bleeding disorder;
  • are pregnant or may be pregnant;
  • have an infection or skin condition near a proposed treatment area;
  • have a history of fainting or significant reactions to needles;
  • have reduced sensation or relevant neurological symptoms; or
  • have a significant medical condition, recent surgery or other concern that may affect treatment safety.

Common minor adverse effects can include temporary soreness, bruising or bleeding. Serious complications are uncommon but can include infection or injury to deeper structures. Appropriate training, sterile single-use needles and safe technique are important.

For further Australian consumer information, see Healthdirect's acupuncture safety guide.

Frequently Asked Questions

Can acupuncture help chronic pain?

Acupuncture may help some people with chronic musculoskeletal pain, particularly persistent low back pain. The level of benefit varies, and treatment should be considered alongside other appropriate pain management strategies.

Does acupuncture help knee osteoarthritis?

Acupuncture may provide modest pain relief and functional improvement for some people with knee osteoarthritis. It does not reverse arthritis and should not replace strengthening, suitable exercise and other recommended care.

Can acupuncture help headaches?

Acupuncture may help reduce the frequency of some migraine and tension-type headaches. However, headache types differ, and new, severe or unusual headaches require appropriate medical assessment.

Is acupuncture the same as dry needling?

No. Both use fine needles, but acupuncture and dry needling may use different assessment frameworks and point-selection methods. Your treating clinician can explain their approach and whether needling is appropriate for you.

What Should You Do Next?

If persistent pain is affecting your work, sleep, exercise or everyday activities, a physiotherapy assessment can help clarify the likely causes and suitable management options.

Your physiotherapist can discuss whether acupuncture is appropriate, whether another approach may suit you better and how treatment can support your activity and rehabilitation goals.

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Select a PhysioWorks clinic to continue to live booking, an appointment request or reception assistance.

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View all clinic locations and phone numbers

What Is Acupuncture?

Learn what happens during acupuncture treatment, how it is used and what to consider before an appointment.

Dry Needling

Understand how physiotherapists may use dry needling for selected musculoskeletal pain presentations.

References

  1. Ho L, Lai CNT, Chen H, et al. Systematic review of clinical practice guidelines on acupuncture for chronic musculoskeletal pain. BMC Complement Med Ther. 2025;25:322. doi:10.1186/s12906-025-05070-y.
  2. DeBar LL, Wellman RD, Justice M, et al. Acupuncture for chronic low back pain in older adults: a randomized clinical trial. JAMA Netw Open. 2025;8(9):e2531348. doi:10.1001/jamanetworkopen.2025.31348.
  3. Liu CY, Duan Y, Zhou H, et al. Clinical effect and contributing factors of acupuncture for knee osteoarthritis: a systematic review and network meta-analysis. BMJ Evid Based Med. 2024;29(6):374-384. doi:10.1136/bmjebm-2023-112626.
  4. Chen H, Lin X, Huang X, et al. Durable effects of acupuncture for knee osteoarthritis: a systematic review and meta-analysis. Curr Rheumatol Rep. 2024;26:158-167. doi:10.1007/s11926-024-01139-7.