Dry needling uses thin needles to calm tight, tender muscle spots. At Holsman, it is one tool inside a full physical therapy plan built around movement and exercise.
If a stubborn knot in your neck, shoulder or back keeps coming back no matter how much you stretch, your physical therapist may bring up dry needling. It is a common technique that many people find helpful when it is paired with the right exercises.
What Is Dry Needling?
Dry needling is a hands-on technique where a trained physical therapist places a very thin, solid needle into a tight or tender area of muscle. It is called "dry" because nothing is injected. The needle is the same type of thin filament used in acupuncture, not the hollow needle used for shots or blood draws.
The main target is often a myofascial trigger point. That is a small, tender spot in a tight band of muscle. Pressing on it can hurt right there or send pain to another area. For example, a trigger point in the upper shoulder muscle can cause pain that wraps up the side of the head.
When the needle reaches the right spot, the muscle often gives a quick twitch, and many people feel it loosen afterward. Researchers are still studying exactly how it works. Current thinking is that it changes pain signaling between nerves and muscles and eases muscle tension.
Dry Needling vs. Acupuncture: What's the Difference?
Both use thin needles, but the goals and thinking behind them differ.
- Why it's done. Acupuncture comes from traditional Chinese medicine and is based on energy pathways called meridians. Dry needling is based on modern anatomy and on how muscles and nerves work.
- Where the needles go. Acupuncture points follow set maps on the body. Dry needling targets the specific tight muscles, trigger points or tissues your therapist finds during your exam.
- Who does it. Acupuncture is done by licensed acupuncturists. Dry needling is done by physical therapists and other clinicians with additional training in the technique.
- How it fits in. In physical therapy, dry needling is never the whole plan. It is one part of a program that includes exercise, hands-on care and education.
Conditions Dry Needling Can Help as Part of a PT Plan
Dry needling is not right for every kind of pain. Your therapist will do a full evaluation first. It is most often considered for muscle-related pain, including:
Myofascial Trigger Points
Tender knots that cause local or referred pain are the classic reason to try dry needling. Releasing them can make it easier to stretch and strengthen.
Neck and Shoulder Pain
Desk work, stress and poor sleep posture can leave the neck and upper shoulders tight. Dry needling may ease that tension so posture and strength exercises can do their job.
Low Back Pain
Muscles along the spine and around the hips often guard and tighten when the back hurts. For some people, dry needling helps quiet that guarding so they can return to walking, bending and core work sooner. Learn more in our post on lower back pain relief.
Tension-Type Headaches
Trigger points in the neck, upper back and jaw muscles can feed tension-type headaches. Treating those muscles, along with posture and movement work, may help reduce how often headaches show up.
Plantar Heel Pain
Heel pain, often linked to plantar fasciitis, can involve tight calf and foot muscles. Dry needling of those muscles may be added to stretching, strengthening and footwear advice.
If you live with ongoing pain, our article on physical therapy for chronic pain explains how a full plan comes together.
Why Exercise Still Does the Heavy Lifting
This is the most important point: dry needling works best as a door-opener, not a stand-alone fix. Research generally supports dry needling for short-term pain relief, and it tends to work better when combined with active treatment.
The relief after a session gives you a window where moving feels easier. Your therapist uses that window for exercises that build strength, restore range of motion and change the habits that caused the problem. Without that work, tight spots often come back. That is why every dry needling visit at Holsman sits inside a broader physical therapy plan. For athletes, it may be part of sports physical therapy as well.
What Does a Dry Needling Session Feel Like?
Your first visit starts with an evaluation of your health history and how you move. If dry needling makes sense, your therapist will explain the plan and ask for your consent.
During treatment:
- The skin is cleaned and a new, sterile, single-use needle is placed.
- Most people barely feel the needle go through the skin.
- When it reaches a trigger point, you may feel a deep ache, a cramp or a quick muscle twitch. This usually lasts only a moment.
- Needles may stay in for a few seconds or a few minutes, depending on the approach.
- You can ask to stop at any time.
Soreness Afterward: What's Normal?
It is common to feel sore in the treated area for a day or two, a bit like after a hard workout. Small bruises can also happen. To feel better faster:
- Keep moving gently and do your home exercises unless told otherwise.
- Tell your therapist at your next visit how you felt.
Some people feel tired or lightheaded right after. Your therapist will make sure you feel steady before you leave.
Is Dry Needling Safe? Who Should Talk to Their Therapist First
When done by a trained clinician using sterile technique, dry needling is generally considered safe. Serious side effects are rare. As with any needle procedure, though, it is not for everyone. Tell your therapist before treatment if any of these apply to you:
- Pregnancy. Your therapist may avoid dry needling or limit where it is used.
- Bleeding disorders or blood thinners. If you have a bleeding condition or take anticoagulant medicine, needling may raise your risk of bruising or bleeding.
- Fear of needles. Needle phobia is common. Other treatment options can work well, and you never have to agree to needling.
- Infection or skin problems. Needles should not go into areas with infection, open wounds or skin conditions.
- Pacemaker or implanted devices. Some therapists add mild electrical stimulation to the needles. This is generally avoided if you have a pacemaker or other implanted electrical device.
Also mention recent surgery, a weakened immune system or a history of fainting. Needling near the chest wall carries a small risk of lung injury, which is one reason training matters.
When to see a doctor right away
Seek urgent medical care if you have:
- Shortness of breath, chest pain or trouble breathing after needling near the chest, upper back or shoulders
- Redness, warmth, swelling, pus or fever at a treated area
- A sudden, severe headache unlike any you've had before
- Neck pain with fever, a stiff neck, numbness, weakness, trouble speaking or vision changes
- Back pain with loss of bladder or bowel control, or numbness in the groin area
Training Matters: Dry Needling in New Jersey
In New Jersey, physical therapists must complete specific additional training before they can perform dry needling. At Holsman, dry needling is provided only by therapists who have completed that training.
Where to Get Dry Needling at Holsman
Dry needling is offered at three of our 17 clinics:
At our other clinics, therapists treat muscle pain with exercise, hands-on care and other tools.
You can schedule physical therapy, occupational therapy and speech therapy directly. Some insurance plans require a referral for coverage; our staff will verify your benefits. See our insurance page, call 1-855-465-7626 or contact us to book.
Frequently Asked Questions
Does dry needling hurt?
Most people feel little when the needle goes in. You may feel a brief deep ache or muscle twitch when a trigger point is reached. Soreness for a day or two afterward is common.
Is dry needling the same as acupuncture?
No. Acupuncture is based on traditional Chinese medicine. Dry needling is based on modern anatomy and targets tight muscles found during a physical therapy exam.
How many dry needling sessions will I need?
It depends on your condition and how you respond. Your therapist will check your progress at each visit and adjust the plan, which always includes exercise.
Can I exercise after dry needling?
Yes, gentle movement is usually encouraged, and your therapist will often guide you through exercises right after. Ask before a hard workout the same day.
Who should not get dry needling?
Talk with your therapist first if you are pregnant, have a bleeding disorder or take blood thinners, fear needles, have an infection in the area, or have a pacemaker.
Which Holsman clinics offer dry needling?
Dry needling is available at our Fair Lawn adult clinic, Lyndhurst and Caldwell.
This article is for general education and isn't a substitute for an evaluation by a licensed clinician.