Dry Needling Science

Understanding the Physiology Behind the Needle

Dry Needling is more than just a physical therapy technique—it is a targeted intervention that interacts directly with the neuromuscular system. Research has shown that it can lead to measurable changes on a muscle, cellular, and neurological level, ultimately helping restore normal function, reduce pain, and promote healing.

1. What Physiologically Happens in the Body During Dry Needling?

When a filament needle penetrates a myofascial trigger point (MTrP)—a hyperirritable area within a taut band of skeletal muscle—it triggers several local and systemic physiological reactions.

Key Mechanisms Include:

• Disruption of dysfunctional motor endplates: Inserting the needle mechanically disrupts abnormal acetylcholine release, quieting the excessive electrical activity associated with the MTrP

• Eliciting Local Twitch Responses (LTRs): A rapid contraction of muscle fibers in response to needle insertion helps release the taut band and improves circulation in the affected area

• Micro-trauma induction: The needle causes minor, localized tissue injury, which signals the body to initiate a repair cascade.

• Activation of afferent nerve fibers: Needling stimulates Aδ and C fibers, which in turn modulate central pain pathways via the spinal cord and brainstemTrigger_Point_Dry_Needl….

• Vasodilation and improved blood flow: Triggering neurogenic inflammation can increase local perfusion, flushing out biochemical waste and delivering nutrients.

2. Why Do Muscles Respond to Dry Needling?

• Muscles affected by chronic overload, poor biomechanics, or neuromuscular dysfunction often harbor latent or active trigger points. These areas are in a persistent contractile state and show abnormal motor endplate activity (i.e., spontaneous electrical discharges).

  Dry Needling Affects Muscle Tissue Through:

  • Restoring neuromuscular communication: Needle insertion into an MTrP can desensitize sensory nerves and recalibrate motor input/output signaling.

  • Interrupting the pain-spasm cycle: By reducing pain and breaking feedback loops, muscles are less likely to remain in a shortened, guarded state.

  • Triggering spinal cord reflexes: Local twitch responses are believed to be spinally mediated and may reset aberrant reflex arcs contributing to myofascial dysfunction

3. How Does Dry Needling Accelerate Healing at the Cellular Level?

One of the most compelling aspects of dry needling is its cellular impact on the musculoskeletal system. When a needle is inserted into soft tissue, it acts as a mechanical signal that the body translates into biochemical activity.

Cellular-Level Effects Include:

• Activation of Satellite Cells
  These are precursor cells involved in muscle repair. When damaged fibers are disrupted by needling, satellite cells proliferate, migrate, and differentiate to repair or replace the injured myofibers

• Connective Tissue Remodeling
  Studies show that needle manipulation causes collagen fibers to wrap around the needle, mechanically stimulating fibroblasts. This leads to:

  • Structural changes in connective tissue

  • Modified gene expression

  • Altered extracellular matrix composition

• Modulation of Neurotransmitters and Inflammatory Mediators
  Needle stimulation leads to release of:

  • Endogenous opioids (e.g., enkephalins)

  • Serotonin and norepinephrine

  • Acetylcholine (modulated at neuromuscular junctions)

• Normalization of Endplate Noise
  Abnormal spontaneous electrical activity in affected muscle areas is reduced post-needling, which decreases involuntary muscle firing

• Improved Mitochondrial Function
  Through enhanced oxygen delivery and reduced metabolic waste buildup, tissues exhibit more efficient energy metabolism and recovery potential.

4. Why Is Dry Needling So Effective?

The effectiveness of dry needling is multifactorial, relying on both biomechanical and neurophysiological responses:

Mechanisms Supporting Its Effectiveness:

• Precision targeting of trigger points: Accurate needle placement into taut bands leads to immediate change in tissue tone and pain patterns.

• Activation of the Descending Pain Inhibitory System: This central mechanism involves the hypothalamus and periaqueductal gray, modulating pain perception by releasing natural opioids and neuromodulators

• Peripheral and Central Desensitization: Reducing local nociceptor input helps prevent spinal sensitization and cortical pain processing associated with chronic pain

• Improved Biomechanics: As trigger points are inactivated, patients experience:

  • Increased joint mobility

  • Improved muscle recruitment patterns

  • More normalized posture and movement

Clinical Outcomes Frequently Observed:

• Decreased pain intensity

• Increased pressure pain thresholds

• Greater functional range of motion

• Faster return to activity in orthopedic and sports patients

Is Dry Needling Right for You?

Dry Needling is not for everyone, but it can be a powerful tool in restoring pain-free movement. If you're unsure, our team is happy to consult with you and determine whether this treatment aligns with your condition and overall care plan.

If you’re struggling with muscle tension, limited mobility, or lingering pain, dry needling may help accelerate your recovery. We’re happy to discuss your goals and determine whether this treatment fits your plan of care.

👉 Schedule a consultation today or speak with your therapist at your next visit.

Dry Needling Trained Therapists

Risks and Safety Considerations

Dry Needling is considered safe when performed by trained professionals. However, as with any medical procedure, there are potential risks:

• Pneumothorax (lung puncture) – Very rare but serious; typically occurs only if needling near the chest or upper back.

• Bruising or bleeding – Minor and temporary.

• Infection – Extremely rare due to use of sterile equipment and techniques.

• Nerve or tissue irritation – Rare and typically temporary.

• Allergic reactions – Occasionally, patients may react to nickel in needles, please inform your PT of any alergies.

Please Inform Your Therapist If You:

• Are pregnant

• Take blood thinners

• Have a pacemaker or electrical implants

• Have a compromised immune system or metal allergies

• Have a history of fainting or seizures

References

1. Dommerholt, J., Fernández-de-Las-Peñas, C. (2013). Trigger Point Dry Needling: An Evidence and Clinical-Based Approach. Churchill Livingstone.

2. American Physical Therapy Association (APTA). (n.d.). Dry Needling in Physical Therapy Practice.
   Retrieved from https://www.apta.org

3. Dunning, J., Butts, R., Mourad, F., Young, I., Flannagan, S., Perreault, T. (2014). Dry needling: a literature review with implications for clinical practice guidelines. Physical Therapy Reviews, 19(4), 252–265.
   https://doi.org/10.1179/1743288X14Y.0000000111

4. Kietrys, D. M., Palombaro, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., Tucker, M. (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.
   https://doi.org/10.2519/jospt.2013.4668

5. Simons DG, Travell JG, Simons LS. Myofascial Pain and Dysfunction: The Trigger Point Manual.

6. Langevin HM et al. Mechanical signaling through connective tissue: a mechanism for the therapeutic effect of acupuncture. FASEB J. 2001;15:2275–2282.

7. Hong C-Z. Lidocaine injection versus dry needling to myofascial trigger point. Am J Phys Med Rehabil. 1994;73:256-263

8. Gunn CC. The Gunn Approach to the Treatment of Chronic Pain. Churchill Livingstone.

9. Trigger Point Dry Needling. Journal of Manual & Manipulative Therapy. 2006. [PDF Reference]