Dry Needling

Dry needling is one of the most requested treatments at FX Physical Therapy, and one of the most misunderstood. It isn’t acupuncture, and it isn’t an injection. It is a thin, solid filament needle inserted by a licensed Doctor of Physical Therapy (DPT) directly into a muscular trigger point. Trigger points are tight, irritable knots within a muscle that can cause pain, restrict movement, or both. By addressing these specific areas, dry needling helps relieve pain, improve mobility, and restore normal muscle function. This brief, targeted treatment helps release deep muscle tension that massage, stretching, and foam rolling often cannot effectively reach. 

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Physical therapist performing dry needling on a patient's upper trapezius

If you’ve had a spot in your upper trap that won’t let go, a low back muscle that spasms every time you bend, or a calf that tightens up a mile into every run, these are the types of persistent muscle issues that dry needling is designed to treat. By addressing the trigger points that perpetuate muscle tightness, pain, and compensation, dry needling helps break the cycle that’s limiting your movement. Combined with manual therapy and corrective exercise, it provides your DPT with another effective tool to reduce muscle tension, restore normal movement, and support long-term recovery. 

How Dry Needling Works

A trigger point is a tight, irritable knot within a muscle that can be painful when pressed and often causes pain in other areas of the body. For example, a trigger point in your upper trap may refer pain into your temple, while one in your gluteal muscles can send pain down the back of your leg.  Trigger points commonly develop from overuse, prolonged or repetitive postures, injury, or the body’s protective response to pain or joint dysfunction. 

When the needle reaches a trigger point, it may produce a local twitch response, a brief and involuntary contraction of the muscle. This response often indicates that the needle found the right spot. The muscle tension decreases, blood flow to the area may improve, and the sensitivity of the trigger point decreases. Many patients experience reduced muscle tenderness, improved range of motion, and less referred pain, sometimes even after the first treatment.

In some cases, your physical therapist may combine dry needling with electrical stimulation. By connecting the needles to an e-stim unit, they can deliver a repeated stimulus directly to the trigger point. This technique helps relieve chronic muscle tension, increases the pain threshold, and allows the muscle to move through a greater range with less irritation.

Dry needling can reach deeper layers of muscle dysfunction that surface-level manual therapy may not fully address. Rather than replacing hands-on therapy or exercise, it enhances both, helping each treatment work more effectively to reduce pain, restore movement, and improve function. 

What a Dry Needling Session Involves

Assessment:

Your Doctor of Physical Therapy (DPT) won’t begin dry needling until they understand what’s contributing to the trigger point. Before any needles are used, your DPT performs a full evaluation, palpates the affected muscles, and identifies trigger points and their referral patterns. They then determine whether the trigger point is the primary source of your pain or a response to another underlying issue, such as joint stiffness, muscle weakness, or faulty movement patterns. 

If this is your first visit, you’ll go through a thorough initial evaluation (45 to 60 minutes) that covers your history, a movement assessment, and a treatment plan before any dry needling takes place.

The needling itself:

The needle is a thin, sterile, single-use filament. It is much thinner than a hypodermic needle, and it’s solid rather than hollow. There’s no medication on it, which is where the name “dry” comes from. Your DPT inserts the needle into the trigger point, often with a gentle pistoning technique to elicit the twitch response. The needle may remain in place for a few seconds or several minutes, depending on the muscle being treated. When electrical stimulation is used, the needles remain in place longer to deliver stimulation directly to the targeted muscle. This technique is different from acupuncture.

Most patients describe the sensation as a deep ache or brief muscle cramp when the twitch response occurs. While it may feel uncomfortable, it is typically short-lived and is often followed by a sense of relaxation or release in the muscle. Your DPT will check in with you throughout the treatment to ensure your comfort and adjust as needed.

Combined with other treatment:

Dry needling is rarely a standalone treatment. It is typically one part of a comprehensive therapy session that may also include joint mobilization, soft-tissue techniques, and corrective exercise. The needling helps release the trigger point, and manual therapy addresses the joint or tissue restrictions that may have contributed to it. Exercise retrains movement patterns to help prevent the issue from returning. Together, these treatments work to create lasting improvements rather than temporary relief.

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Conditions Dry Needling Can Treat

Dry needling can be used in many areas of the body to help address muscle tension, pain, and movement limitations. Common conditions we treat include:

  • Neck tightness and tension headaches: trigger points in the upper trapezius, levator scapulae, and suboccipital muscles are among the most frequent sources of referred head pain. See Neck Pain.
  • Low back pain and muscle spasms: trigger points in the multifidus, quadratus lumborum, and glutes can contribute to ongoing low back tightness, discomfort, and muscle spasms.  See Back Pain Physical Therapy.
  • Shoulder pain and rotator cuff tightness: trigger points in the infraspinatus, supraspinatus, and pec minor contribute to impingement-type symptoms. See Shoulder Pain Physical Therapy.
  • Knee and hip-related muscle guarding: trigger points in the quads, and hip flexors develop alongside patellofemoral pain, hip impingement, and post-surgical guarding. See Knee Pain Physical Therapy.
  • TMJ and jaw pain: trigger points in the masseter and temporalis muscles contribute to jaw tightness and referred facial pain.
  • Calf and hamstring tightness: trigger points in the gastrocs, soleus, and proximal hamstrings in runners, cyclists, and desk workers often don’t respond to stretching alone.
  • Plantar fasciitis: trigger points in the calf and intrinsic foot muscles hold tension through the plantar fascia.
  • Tennis and golfer’s elbow: trigger points in the forearm extensors and flexors drive persistent elbow pain.

Dry Needling vs. Acupuncture

Both use thin needles. The similarities end there.

  • Dry needling is grounded in Western musculoskeletal anatomy and neuroscience.  During your evaluation, your DPT identifies dysfunctional myofascial trigger points using palpation, movement analysis, and pain referral patterns. 
  • Acupuncture comes from traditional Chinese medicine. It uses meridians and energy flow to guide needle placement, and its diagnostic process and treatment goals are different.
  • In Maryland, dry needling by physical therapists falls under the Maryland Board of Physical Therapy Examiners and requires specific post-graduate training beyond the DPT degree. Acupuncture is a separate licensed profession with its own board, education, and scope of practice.

For you, the difference is simple: dry needling is just one part of your treatment plan. Your DPT uses it to treat specific muscle dysfunction identified during your evaluation. It works alongside hands-on therapy, targeted exercises, and movement training to help address the underlying cause of your pain, decrease muscle tension, increase mobility, and improve function.

Who Performs the Treatment

Every dry needling session at FX Physical Therapy is performed by a licensed Doctor of Physical Therapy (DPT) with specific, advanced training in dry needling. In Maryland, physical therapists must complete specialized classroom and hands-on training before they can provide dry needling, and those requirements are overseen by the Maryland Board of Physical Therapy Examiners.  Dry needling is available at every FX Physical Therapy location. Find one near you on our full locations page.

Safety

Dry needling is a safe, well-tolerated treatment when performed by a trained and licensed physical therapist. Most people experience little discomfort during treatment, and serious complications are rare. The most common side effects are:

  • Soreness at the needle site, similar to a post-workout ache, lasting 24 to 48 hours 
  • Minor bruising at or near the insertion site 
  • Occasional lightheadedness during the session, especially on a first visit

Your DPT reviews your health history before any needling session. 

What to Expect Afterwards

It’s common for the treated muscle to feel sore for 24 to 48 hours after dry needling, similar to the soreness you might feel after a workout. Mild fatigue or a temporary ache that extends beyond the treatment area is also possible. These effects are normal and typically go away on their own. Light activity, staying hydrated, gentle stretching, and icing often help ease soreness, while minor bruising can occasionally occur and is usually nothing to worry about. 

Most people notice the benefits of dry needling build gradually over a series of treatments rather than after just one session. Your Doctor of Physical Therapy (DPT) will recommend the number of sessions that’s right for you based on your condition, your goals, and how your body responds to treatment.  For a breakdown of what’s expected, see our post Good Sore vs. Bad Sore: When to Keep Pushing.

Frequently Asked Questions

Most people feel a brief ache, cramp, or twitch when the needle reaches a trigger point. While it can be uncomfortable for a moment, the sensation is usually short-lived. Patients who are nervous about needles tend to find the treatment more comfortable than they expected.
Dry needling targets specific muscular trigger points based on Western anatomy and works as part of a physical therapy plan. Acupuncture uses meridians and energy flow from traditional Chinese medicine. Both use thin needles, but the reasoning, goals, and clinical training behind them are different. See the comparison section above for more
The number of sessions varies from person to person. It depends on your condition, how long you've had your symptoms, and how your body responds to treatment. Some people notice improvement after one or two sessions, while long-standing muscle tension or pain may require additional visits. Your DPT will reassess your progress at each appointment and adjust your treatment plan as needed to help you achieve the best results.
Yes, it can help some types of headaches, especially tension headaches and headaches that originate from the neck (cervicogenic headaches). Tight muscles and trigger points in the neck, shoulders, and base of the skull can contribute to these headaches. Dry needling can help relieve muscle tension and is often combined with hands-on therapy, posture correction, and targeted exercises to reduce headache pain and frequency.
Dry needling is billed as part of your physical therapy session. FX Physical Therapy is in-network with most major insurers, and coverage depends on your plan. Visit our Insurance Info page or call your insurer to confirm your benefits.
Your Doctor of Physical Therapy (DPT) will provide guidance based on your specific treatment plan. In many cases, light to moderate activity is appropriate after a session, even if the treated muscle feels a little sore. It's generally best to avoid heavy loading of the treated muscle group right away. Your DPT may also include specific exercises during your visit to help reinforce the changes from treatment.
Dry needling can be used during pregnancy, but your DPT avoids certain needle locations and adjusts the treatment to your stage. Let your therapist know if you're pregnant or think you may be.
Being uncomfortable with needles doesn't automatically mean dry needling isn't an option. The needles used for dry needling are very thin and feel different from the needles used for injections or blood draws. Your comfort matters, and your DPT will never pressure you into a treatment you don't feel comfortable with. If dry needling isn't the right fit for you, your therapist can discuss other hands-on treatment options and create a plan that matches your goals and preferences.
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Where to Get Dry Needling Near You

Every FX Physical Therapy location offers dry needling, performed by DPTs with post-graduate certification. See the full locations directory to find the closest clinic and request an appointment online. We’re Built to Make You Better.

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Call (443) 609-8009

Medically reviewed by Amanda Hodgetts, PT, DPT, Cert. DN, [August 17, 2026]

Sources 

Dunning J, Butts R, Mourad F, Young I, Flannagan S, Perreault T. Dry needling: a literature review with implications for clinical practice guidelines. Physical Therapy Reviews. 2014;19(4):252–265. 

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;47(3):133–149. 

Maryland Board of Physical Therapy Examiners. Dry Needling. https://health.maryland.gov/bphte/pages/dryneedling.aspx