Dry needling is an increasingly popular physiotherapy tool, but what does the research actually say about how well it works, who it suits and what to expect? After completing the APA Level 1 Dry Needling course, I took a close look at the current evidence to understand where it fits in practice. The honest answer is that the evidence is promising but still developing, and the technique works best as an adjunct to active treatment rather than a standalone intervention.
What Is Dry Needling?
The procedure involves inserting a sterile, single-use stainless steel needle through the skin into the underlying muscle. It is most commonly used for myofascial trigger points, the taut, sensitive spots in muscle that can refer pain to other areas. The aim is to alter neural pathways from the brain, change the electrical activity in the surrounding muscle tissue, and help modulate pain and pressure sensitivity. It is not a primary physiotherapy treatment, but it can be a useful adjunct alongside exercise and education.
How Does Dry Needling Differ From Acupuncture?
While both use similar needles, the two practices are distinct. Dry needling is a western, anatomy-based practice focused on myofascial trigger points and neuromuscular effects, and it is performed within physiotherapy by appropriately trained practitioners. Acupuncture is based on traditional Chinese medicine and targets meridian points. The mechanisms and intent are different even though the tool looks the same.
Who Is It Suitable For?
It is not appropriate for everyone. Absolute contraindications include needle phobia, haemophilia disorders, metal allergy, inability to consent, needling over a joint replacement, acute skin infections and pregnancy. Relative contraindications, where it may still be used cautiously with clinical judgement, include controlled epilepsy, patients on blood-thinning medication, the presence of a joint replacement nearby, and flare-ups of autoimmune disorders. A thorough screen for these factors always happens before treatment.
What Are the Side Effects?
Around ten percent of people experience post-treatment side effects, most of which are mild and temporary. These can include drowsiness, nausea, fainting, local bruising or a temporary worsening of symptoms. More serious complications, such as organ puncture or pneumothorax, are very rare but possible, which is why the practitioner’s understanding of the anatomy surrounding the needled area is critical. This is why the technique is only performed by physiotherapists who have completed appropriate post-graduate training.
What Does the Evidence Say?
The most comprehensive review available is a systematic review and meta-analysis published in the Journal of Orthopaedic and Sports Physical Therapy in 2017 by Gattie, Cleland and Snodgrass. Of 218 screened studies, only 13 met the inclusion criteria. The conditions covered included neck pain, chronic whiplash, postoperative shoulder pain, chronic low back pain, total knee arthroplasty, myofascial pain and fibromyalgia. Eleven of the thirteen studies examined people with chronic musculoskeletal conditions, with follow-up periods ranging from immediately after treatment to twelve months. The results suggest very low to moderate quality evidence supporting dry needling over sham or no treatment for reducing pain and improving pressure pain threshold in the immediate to twelve-week period. There is a notable lack of evidence for long-term benefits, and quality is limited by small sample sizes, varied participant groups and differing comparison conditions.
What This Means in Practice
Dry needling can provide meaningful short-term relief from pain and muscle tension, and it is a reasonable adjunct when used alongside active rehabilitation and education. It is not a standalone cure and should not be positioned as one. The decision to use it is made on a case-by-case basis, following a careful screen for contraindications, and it always sits alongside rather than replacing the core of physiotherapy treatment. This service at BeFit is offered within this evidence-informed framework, as a complement to your rehabilitation programme.
Common Questions
Is the Treatment Painful?
The sensation varies. Most people feel a brief, dull ache or a muscle twitch response when the needle contacts a trigger point, followed by a feeling of release. Some soreness in the area can last a day or two afterwards, similar to post-exercise muscle soreness.
How Many Sessions Are Needed?
It depends on the condition and the individual. Some people notice improvement after one or two sessions; others benefit from more. It is reviewed regularly and discontinued if there is no meaningful response.
How Does It Differ From Acupuncture?
Though both use similar needles, dry needling is a western, anatomy-based technique targeting muscle trigger points, while acupuncture is grounded in traditional Chinese medicine. The approach, training and intent are distinct.
Is It Safe?
When performed by a trained physiotherapist following appropriate screening, it is generally safe. Mild, temporary side effects occur in around ten percent of people, and serious complications are rare.
How BeFit Can Help
At BeFit Training Physiotherapy, our physiotherapists offer dry needling as part of a comprehensive rehabilitation approach at both our Edgecliff and Coogee clinics. It is used as an adjunct alongside exercise, manual therapy and education, and only when indicated after a thorough assessment and screening. Every initial consultation runs for forty-five minutes, one-on-one. No referral is required to book.
Book an appointment at BeFit Training Physiotherapy — no referral needed.
Edgecliff: (02) 9327 7749 | Coogee: (02) 7205 2805 | befittrainingphysio.com/book-now
Related Services
Learn more about our dry needling, sports massage and physiotherapy in Sydney.
Further Reading
For more on manual therapy options, see The Truth About Massage, Dry Needling and Cupping.
References
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. J Orthop Sports Phys Ther. 2017;47(3):133–149.
Australian Physiotherapy Association. Clinical guidelines. physiotherapy.asn.au.
