Dry Needling for Chronic Pain: How It Works and What to Expect

It’s obvious that chronic pain is physically exhausting. But unfortunately, it’s also mentally exhausting as well. When pain lingers for weeks, months or years, it often means the muscles, nerves, and surrounding tissue have adapted in ways that keep the pain cycle going, even long after the original injury has healed. Dry needling is one tool that physical therapists use to help interrupt that cycle.

To learn what dry needling is, read this post here.

Why Chronic Pain Is Different From Acute Pain

Acute pain is your body's alarm system responding to an immediate or recent injury. Chronic pain, on the other hand, often persists after tissue has healed when the nervous system becomes sensitized, meaning it sends pain signals with little to no stimulation. Muscles surrounding the area frequently develop trigger points,  small, oxygen poor, tight banded areas of muscle that stay contracted and irritated.

This is where dry needling comes in.

Practitioner with red painted nails inserting an acupuncture needle into a patient’s left hand.

How Dry Needling Targets Chronic Pain

During a session, a thin needle is inserted into the affected area, often directly into a trigger point, a tendon, or ligament. This can:

• Trigger a local twitch response, which may help release the tight muscle band

• Increase blood flow to an area that's been chronically restricted

• Interrupt the pain-spasm cycle that keeps a muscle guarded and tense

• Provide input to the nervous system that may help "reset" how it's interpreting signals from that area

For people who've tried stretching, massage, or rest without lasting results, dry needling can offer a different angle, literally going directly to the muscle tissue that's driving the pain pattern. There’s no other way to directly target the affected internal structures.

Common Areas Treated

Dry needling is frequently used for chronic pain in the:

• Head, neck and shoulders

• Low back and spine

• Hips and glutes

• Jaw (TMJ-related tension)

• Legs, feet, arms and hands

• Pelvic floor and sacroiliac joint (SIJ)

As you can see, dry needling can be used almost anywhere in the body. It can even be utilized to treat conditions that result in global pain like endometriosis, fibromyalgia, and chronic pain syndrome.

What the Research Suggests

Clinical research on dry needling is still developing, as there’s always room to grow and expand the practice. But a growing number of studies point to short to medium-term reductions in pain and improvements in range of motion when dry needling is used alongside other physical therapy treatments, especially exercise and manual therapy. It's generally considered most effective as part of a plan, usually not a standalone treatment, but it certainly can be done.

What to Expect After a Session

Soreness for a couple of days is common, similar to post workout muscle fatigue, post therapeutic massage, or cupping. Gentle movement, hydration, massage, and heat can help. Most providers will often use dry needling in combination with stretches or strengthening exercises to help extend the time of relief and maintain the changes between sessions.

Is Dry Needling a Long-Term Solution?

When it comes to chronic pain, dry needling tends to work best as a part of a bigger plan—addressing the muscle tension while also working on strength, posture, movement patterns, stress, and nervous system regulation. Providers typically recommend a short series of sessions to assess how your body responds before determining a longer-term plan.

Frequently Asked Questions

How is dry needling different from a massage for chronic pain? Massage works on the surface and broader muscle groups; dry needling can access deeper, more specific trigger points that may not respond as well to manual pressure alone. Remember, there is no other way to directly treat internal structures.

Will one session fix chronic pain? It’s very unlikely. Chronic pain patterns usually take time to develop and typically take a combination of treatments and time to resolve. If chronic pain took weeks, months, or years to develop, it will take some time for the nervous system to reset and feel safe again.

Can dry needling be combined with physical therapy or other care such as chiropractic care? For sure! It’s commonly used alongside these approaches rather than in place of them. It complements many other modalities or treatments.

What questions do you have?

If you’re new here, I’m Dr. Kenael Segal, PT, DPT, and I’m certified in dry needling (cert. DN), treating general orthopedic conditions and pelvic floor dysfunction in New Jersey.

This article is for general educational purposes and isn't a substitute for individualized medical advice. If you're dealing with chronic pain, talk with a provider about whether dry needling is right for you.

Dealing with stubborn pain that won't quit? Book a free consultation with Dr. Kenael Segalto talk about your options.