When patients hear the word needling, it’s common for them to picture acupuncture. While dry needling may look similar at first glance, the two approaches are quite different in purpose and philosophy.

Let’s break it down, explore how chiropractors use dry needling, and look at the evidence behind its benefits.

What is Dry Needling?

Dry needling is a treatment technique where a very thin, solid filament needle (similar to an acupuncture needle) is inserted directly into a muscle or trigger point—an area of tight, sensitive muscle tissue often responsible for referred pain. The goal isn’t to balance energy, as in traditional acupuncture, but rather to deactivate trigger points, improve blood flow, reduce muscle tension, and restore normal movement patterns.

Think of it as a way of pressing your body’s “reset button” on overactive, tight muscles.

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Dry Needling vs. Acupuncture

• Dry needling: Rooted in Western medicine, anatomy, and physiology. The focus is on musculoskeletal dysfunction and pain relief.
• Acupuncture: A traditional Chinese medicine practice based on balancing energy (“Qi”) along meridians in the body.

So while the tools may look similar, the intention, technique, and theoretical background are quite different.

When a needle is inserted into a trigger point, the muscle may “twitch”—a quick contraction followed by relaxation.

This is a good sign!

It means the muscle is releasing tension.

Research suggests dry needling works through several mechanisms:

• Pain modulation: It reduces local and referred pain by influencing both the nervous system and chemical mediators of pain.
• Improved range of motion: By reducing muscle tightness, it helps restore movement and flexibility.
• Enhanced blood flow and healing: Needling stimulates circulation to the affected tissue, supporting recovery.

Which Injuries and Conditions Respond Best?

Chiropractors commonly use dry needling alongside other treatments such as spinal adjustments, rehabilitation exercises, and manual therapy. Evidence supports its use for:

• Neck pain – including tension-related stiffness and referred headaches
• Low back pain – both acute and chronic
• Shoulder problems – particularly rotator cuff–related pain and frozen shoulder
• Tendinopathies – such as tennis elbow and Achilles tendon issues

Research generally shows the best results when dry needling is combined with exercise and other therapies rather than used alone.

When Do Chiropractors Use Dry Needling?

In our clinic, dry needling is often recommended when:

• A patient has stubborn muscular tension that isn’t resolving with stretching or massage.
• Trigger points are contributing to pain and limiting movement.
• We want to speed up recovery and complement other chiropractic care such as adjustments, rehab, or shockwave therapy.

It’s not a one-size-fits-all treatment, but when used appropriately, it can be a powerful tool for pain relief and functional improvement.

Curiously Aligned Take:

Dry needling may sound a little intimidating, but most patients describe it as a quick pinch followed by noticeable relief. By targeting the source of muscular dysfunction, it helps restore balance and allows you to move more freely. As part of a broader chiropractic treatment plan, it can be a game-changer for conditions ranging from everyday tension to stubborn sports injuries.

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References

1. Dunning, J. et al. (2014). Dry needling: A literature review with implications for clinical practice guidelines. Physical Therapy Reviews, 19(4), 252–265.
2. Kietrys, D. M. et al. (2013). Effectiveness of dry needling for upper-quarter myofascial pain: A systematic review and meta-analysis. Journal of Orthopaedic & Sports Physical Therapy, 43(9), 620–634.
3. Sánchez-Infante, J. et al. (2021). Is dry needling effective for the management of musculoskeletal pain? A systematic review and meta-analysis. Pain Research and Management, 2021, 1–12.
4. Cagnie, B. et al. (2013). Evidence for the use of ischemic compression and dry needling in the management of trigger points of the trapezius muscle. Clinical Journal of Pain, 29(5), 454–460.
5. Liu, L. et al. (2015). Evidence for dry needling in the management of myofascial trigger points associated with neck and shoulder pain: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation, 96(5), 944–955.
6. Gattie, E. et al. (2017). 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, 47(3), 133–149.
7. Arias-Buría, J. L. et al. (2018). Inclusion of trigger point dry needling in a multimodal physical therapy program for postoperative shoulder pain: A randomized clinical trial. Journal of Shoulder and Elbow Surgery, 27(6), 1036–1045.
8. Dragoo, J. L. et al. (2014). Dry needling for tendinopathy: A systematic review and meta-analysis. Journal of Shoulder and Elbow Surgery, 23(2), 356–364.
9. Fernández-de-Las-Peñas, C. et al. (2014). Myofascial trigger points and their relationship to headache clinical parameters in chronic tension-type headache. Pain Medicine, 15(6), 1001–1010.