Dry Needling: The Science Behind the Needle
Understanding what happens inside your body and why we use it
Have you ever experienced a muscle that just won't seem to relax? Maybe it's persistent neck tension, recurring headaches, or an area of discomfort that doesn't seem to improve no matter how much you stretch.
Our muscles, connective tissues, and nervous system are constantly communicating. When pain develops, the problem can become more complicated than simply having a tight muscle.
At LIFEstrength Health Center, we're excited to offer dry needling, a treatment that may help manage pain, improve movement, and influence how the nervous system responds to discomfort.
But what exactly is dry needling, and what does science tell us is happening beneath the skin?
Let's take a closer look!
What Is Dry Needling?
Dry needling is a treatment that uses very thin, sterile, single-use needles inserted into specific muscles or other soft tissues.
Unlike injections, dry needling doesn't introduce medication or any other substance into the body. That's where the term dry comes from.
Although the needles resemble those used in acupuncture, dry needling is generally performed within a Western medical framework, focusing on anatomy, musculoskeletal conditions, and pain physiology.
Depending on your condition, treatment may target sensitive areas of muscle, commonly called trigger points, or other carefully selected tissues.
But here's what makes dry needling particularly interesting:
It's not just about relaxing a tight muscle. It's also about how your body processes and responds to pain.
Researchers have investigated how needling influences local tissue chemistry, circulation, sensory nerves, and the nervous system's natural pain-regulating mechanisms.
A 2014 literature review by Dunning and colleagues explores these different treatment targets and their proposed physiological effects.
What Actually Happens Inside Your Body?
Pain is more than a signal coming from a sore muscle. It's an experience influenced by communication between your tissues, spinal cord, brain, and nervous system.
Dry needling may affect that communication through several overlapping mechanisms.
1. A Chemical Response Begins
When a needle enters tissue, it creates a small mechanical stimulus.
This stimulation may influence local circulation, sensory nerve activity, and the release of naturally occurring chemicals involved in pain regulation.
One particularly interesting chemical is adenosine.
Adenosine is a naturally occurring molecule involved in cellular communication. Experimental studies suggest that needling can increase local adenosine signaling, which may help reduce pain sensitivity.
Researchers have also investigated how needling may influence inflammatory mediators and other chemical messengers involved in pain.
In simpler terms, the needle provides a stimulus that may change how surrounding tissues communicate with the nervous system.
Much of the research identifying these individual chemical pathways comes from laboratory and animal studies, so scientists are still investigating how directly these findings translate into clinical outcomes in humans.
2. Your Body Has Its Own Pain-Relief System
Did you know your body produces its own chemicals that help regulate pain?
You've probably heard of endorphins, but they're only one part of a much larger system.
Researchers have proposed that needling may influence several naturally occurring pain-modulating pathways, including:
Endogenous opioids: Naturally produced substances that interact with opioid receptors and help regulate pain.
Serotonin and norepinephrine: Neurotransmitters involved in communication between the brain and spinal cord, including pathways that can reduce pain signaling.
Endocannabinoids: Naturally occurring molecules involved in pain regulation and inflammatory signaling.
Sensory nerve pathways: Networks that carry information between your tissues, spinal cord, and brain.
These mechanisms may help explain why some patients experience changes in pain following treatment.
However, they are still being investigated, and not every needling session produces the same physiological or clinical response.
For those interested in the deeper science, Butts and colleagues published a fascinating 2016 review examining the peripheral and spinal mechanisms of dry needling-mediated pain relief.
3. Changes in Muscle Sensitivity and Movement
Sometimes muscles develop areas of increased sensitivity and tenderness, commonly referred to as myofascial trigger points.
You may recognize these as tender spots that reproduce familiar discomfort when pressure is applied.
Dry needling is sometimes used to target these areas as part of a broader treatment plan.
During treatment, a muscle may briefly contract or twitch. This is known as a local twitch response.
Although this response can occur during treatment, it isn't required for dry needling to be effective.
The goal isn't simply to make a muscle twitch. It's to improve pain, movement, and overall function.
Why Do We Sometimes Leave Needles in for Several Minutes?
This is one of my favorite parts of the research because it helps explain why different dry needling techniques exist.
Some approaches involve briefly inserting and removing a needle, while others involve leaving several needles in place for a period of time.
So why the difference?
Researchers have investigated whether the number of needles used and how long they remain in place influence treatment outcomes.
A 2021 literature review by Butts, Dunning, and Serafino examined these questions.
The authors discussed research suggesting that protocols involving multiple needles retained for approximately 20–30 minutes may produce greater or longer-lasting improvements in certain conditions compared with brief, single-needle techniques.
However, the ideal duration and number of needles haven't been established for every condition, and more high-quality comparative research is needed.
The takeaway?
Dry needling isn't necessarily about inserting as many needles as possible or leaving them in for as long as possible.
Treatment should be individualized based on your condition, tolerance, examination findings, and goals.
For a deeper explanation, explore the 2021 review on needle number and retention time.
What Conditions Can Dry Needling Help With?
Dry needling has been studied as a treatment option for several musculoskeletal conditions, including:
Neck and upper-back pain
Muscle tension and myofascial pain
Certain types of headaches
Shoulder pain
Low-back pain
Some tendon-related conditions
Jaw pain and temporomandibular joint disorders (TMJD)
Pain-related movement restrictions
Research suggests that some patients may experience short-term pain relief or improvements in movement, particularly when dry needling is combined with other conservative treatments (DON’T FORGET YOUR ADJUSTMENTS!!!)
However, the strength of evidence varies by condition.
A large 2026 umbrella review examining 75 systematic reviews found that many reviews reported favorable outcomes, but limitations in research quality prevented definitive conclusions about effectiveness.
This is why we view dry needling as one possible component of an individualized treatment plan, rather than a guaranteed solution.
What Does a Dry Needling Appointment Look Like?
If you've never experienced dry needling, the idea of needles might sound intimidating.
Fortunately, the process is generally straightforward.
First, we talk.
We'll review your symptoms, health history, medications, and treatment goals to determine whether dry needling is appropriate for you.
Next, we examine.
We'll assess your movement and identify areas that may benefit from treatment.
Then, we begin.
Using sterile, single-use needles, your clinician carefully inserts the needles into selected treatment areas.
Some patients barely notice the insertion. Others experience a brief pinch, dull ache, pressure, or occasional muscle twitch.
Depending on the treatment approach, needles may be removed relatively quickly or remain in place for several minutes.
Throughout the process, communication is encouraged. You're always welcome to ask questions, request a break, or stop treatment.
What Should You Expect Afterward?
One of the most important things to understand is that everyone responds differently to dry needling!
Some patients notice improvement in their discomfort or movement shortly after treatment.
Others experience temporary muscle soreness, like what they might feel after a workout.
And some people feel absolutely nothing unusual afterward!
You may experience:
No noticeable change
Mild or significant improvement in symptoms
Temporary muscle soreness or tenderness
Minor bruising or bleeding
A temporary increase in discomfort
Serious complications are uncommon but possible. These include infection, nerve or tissue injury, and pneumothorax (collapsed lung), particularly when needling around the chest, shoulder, or upper back. New chest pain or difficulty breathing after treatment requires emergency medical evaluation.
Following treatment, we generally encourage patients to drink adequate water, continue comfortable movement as tolerated, and rest if they feel it's needed.
Most importantly, pay attention to how your body responds over the following days.
Whether you notice improvement, no change, or increased discomfort, that information helps us evaluate your response and guide future care.
Why We Offer Dry Needling at LIFEstrength
At LIFEstrength, we believe healthcare should be about more than temporarily chasing symptoms.
We want to understand how your body moves, how your nervous system responds, and what may be contributing to your discomfort.
Dry needling gives us another tool to consider when developing an individualized approach to care.
It doesn't replace chiropractic adjustments, exercise, movement, or other therapies. Instead, it may complement these approaches by helping certain patients manage pain and participate more comfortably in their daily activities.
Our goal is to help you understand your body, explore your options, and make informed decisions about your health.
Curious whether dry needling might be right for you?
We'd love to answer your questions and help you determine whether this treatment could be a useful addition to your care.
Written by Destiny Prine, DC
LIFEstrength Health Center
For Those Who Love the Science
Want to dive a little deeper? Here are some of the research papers that helped inform this article.
1. Dry Needling: A Literature Review With Implications for Clinical Practice Guidelines (2014)
Dunning et al.
Explores dry needling techniques, treatment targets, and the physiological mechanisms discussed in the literature.
2. Peripheral and Spinal Mechanisms of Pain and Dry Needling Mediated Analgesia (2016)
Butts et al.
Examines proposed biochemical and neurological mechanisms involved in dry needling, including endogenous opioids, inflammatory signaling, and pain modulation.
3. Dry Needling Strategies for Musculoskeletal Conditions: Do the Number of Needles and Needle Retention Time Matter? (2021)
Butts, Dunning & Serafino
Investigates how the number of needles and duration of treatment may influence clinical outcomes.
4. How Effective Is Dry Needling? An Umbrella Review (2026)
Kużdżał et al.
Evaluates findings from 75 systematic reviews, highlighting both potential benefits and important limitations in the available clinical evidence.