What is the difference between dry needling and acupuncture?

What is dry needling?

Dry needling involves inserting a thin, solid needle into a myofascial trigger point, a tight, tender spot in a muscle that may cause local or referred pain. The term dry means that no medicine is injected. The needle may produce a brief muscle twitch, and the aim is to reduce pain and muscle tension and improve movement.

In many countries, dry needling is performed by physiotherapists and other clinicians trained in the technique, usually as part of a broader treatment plan that includes exercise.

What is acupuncture?

Traditional acupuncture originates from Chinese medicine and involves inserting needles at specific points along pathways called meridians, based on concepts of energy flow. Western medical acupuncture uses similar needles but explains effects through nerve stimulation and pain modulation.

Acupuncture may be used for a range of conditions, including chronic pain, headaches and nausea, and needles are often left in place for a period of time.

What does the evidence show for dry needling?

A systematic review and meta-analysis of 13 trials of dry needling performed by physical therapists for musculoskeletal pain found that, from immediately to 12 weeks after treatment, dry needling may decrease pain and increase pressure pain threshold compared with control, sham or other treatments 1.

At six to twelve months, dry needling was favoured for reducing pain, but the effect was not statistically significant 1. The quality of evidence ranged from very low to moderate 1.

What does UK guidance say?

UK guidance on chronic pain suggests considering a single course of acupuncture or dry needling, within a traditional Chinese or Western acupuncture system, for people aged 16 and over to manage chronic primary pain, under specific delivery conditions 2.

The same guidance does not recommend several other physical treatments, such as TENS, ultrasound or interferential therapy, for chronic primary pain 2.

Is dry needling or acupuncture safe?

When performed by trained practitioners using sterile single-use needles, both are generally safe. Common side effects include soreness, bruising and minor bleeding at the needle site, and some people feel tired or light-headed.

Rare but serious complications include infection and, when needling near the chest wall, a punctured lung. Tell the practitioner if you take blood thinners, have a bleeding disorder, a pacemaker, are pregnant or have a fear of needles.

Which one should I choose?

The choice depends on the condition, the practitioner's training and personal preference. For musculoskeletal pain with identifiable trigger points, dry needling is often used alongside exercise. For chronic primary pain, both are considered in UK guidance.

Neither should replace active treatments such as exercise, education and, where appropriate, psychological approaches.

What happens during a dry needling session?

The clinician first assesses the painful area and identifies tender points in the muscles related to symptoms. After explaining the procedure and obtaining consent, they clean the skin and insert a thin, sterile needle into the muscle, sometimes moving it gently to produce a brief twitch. Needles are usually removed after a short time.

Dry needling is typically combined with stretching, strengthening and advice on activity. Some soreness afterwards is common and usually settles within a day or two. Tell the clinician if you feel faint, anxious or unwell during treatment.

When should pain be assessed before needling?

Seek medical assessment for pain that follows an injury, is associated with fever, weight loss, night pain, numbness, weakness or bladder or bowel changes, before starting needling treatments.

Stop treatment and seek urgent help for sudden chest pain or breathlessness after needling around the chest or upper back.

Frequently asked questions