Dry Needling

Dry Needling is a physiotherapy treatment involving the careful insertion of fine, sterile needles into selected muscles or soft tissues. It may be considered for some people experiencing muscular pain, sensitivity, tightness or restricted movement.

At Core Physio, Dry Needling is never used as a substitute for a proper assessment. Your physiotherapist will first discuss your symptoms, medical history, movement and individual goals before deciding whether the treatment is appropriate.

Where Dry Needling is recommended, it will usually form one part of a broader treatment plan. This may also include education, movement, progressive exercise, strength rehabilitation and practical advice for managing the problem between appointments.

Dry Needling is available through our London Bridge clinic.

What Is Dry Needling?

Dry Needling involves inserting a very fine needle through the skin and into a selected muscle or soft-tissue area. It is described as “dry” because no medication or other substance is injected.

The needles are solid, sterile and intended for single use. They are considerably finer than the hollow needles normally used for injections or blood tests.

Your physiotherapist may use Dry Needling around an area of muscular tension, sensitivity or altered movement identified during the assessment. The precise location, depth and number of needles will depend on the body area, your symptoms and the practitioner’s clinical reasoning.

Some techniques involve leaving the needle in position briefly. Others may include careful movement or stimulation of the needle before it is removed.

How Does Dry Needling Work?

The exact mechanisms through which Dry Needling may influence pain and muscular symptoms are not fully understood.

Placing a needle into selected tissue may temporarily influence local sensitivity, muscle activity and the way pain signals are processed by the nervous system. Some people subsequently report reduced muscular discomfort or greater ease of movement.

However, responses vary between individuals. Dry Needling does not automatically correct the underlying reason a problem developed, rebuild strength or prepare your body for demanding activity.

Exercise, movement and progressive rehabilitation may therefore remain important parts of your treatment plan.

When May Dry Needling Be Considered?

Dry Needling may be considered when muscular pain or sensitivity is affecting movement, exercise, work or everyday activity.

It may form part of treatment when you experience:

Persistent muscular tightness or discomfort
Localised areas of muscular sensitivity
Restricted movement associated with muscular symptoms
Pain that makes rehabilitation exercises difficult
Recurring muscular discomfort linked to physical activity
Muscular symptoms associated with an injury or movement problem
Pain that has not improved sufficiently with initial management

Experiencing one of these problems does not necessarily mean that Dry Needling is suitable. The likely cause of your symptoms, general health and individual risk factors must all be considered first.

Areas That May Be Assessed for Dry Needling

Dry Needling may be used in selected muscles throughout the body, depending on the practitioner’s training and the findings from your assessment.

Commonly assessed areas can include:

Neck and shoulder muscles
Upper and lower back muscles
Hip and gluteal muscles
Thigh and hamstring muscles
Calf and lower-leg muscles
Muscles around the shoulder and arm
Forearm muscles
Selected areas associated with sports and exercise-related symptoms

The location of your pain does not always determine where treatment will be applied. Your physiotherapist will consider the wider assessment before selecting an appropriate area.

Your Dry Needling Assessment

The first appointment begins with a discussion about your symptoms, health and treatment goals.

Your physiotherapist may ask:

When and how the symptoms began
Where you feel pain, tightness or sensitivity
Which movements or activities aggravate the problem
How the symptoms affect work, sleep, exercise or daily life
Whether you have had a similar problem before
What treatment or rehabilitation you have already tried
Whether you have previously received Dry Needling or Acupuncture
Which medication you currently take
Whether you have any relevant health conditions
What you would like to achieve from treatment

A physical assessment may then examine movement, strength, muscular sensitivity and your response to activities associated with the problem.

Afterwards, your physiotherapist will explain whether Dry Needling appears suitable, how it could contribute to your wider treatment plan and what alternative options are available.

What Happens During Dry Needling?

You will be positioned comfortably so the relevant treatment area can be accessed safely. Depending on the location involved, you may be asked to remove or adjust some clothing.

The skin and treatment area will be prepared before a sterile, single-use needle is inserted into the selected tissue.

During treatment, you may experience sensations such as:

A brief pinprick as the needle enters the skin
A dull ache
Pressure or heaviness
Tingling
A brief muscular twitch
A temporary reproduction of familiar discomfort

Some people feel very little, while others find particular areas more sensitive. The technique can be adjusted according to your comfort and response.

You remain in control throughout the appointment. Tell your physiotherapist immediately when you feel excessively uncomfortable, faint or unwell, or when you would like the treatment to stop.

What Is a Local Twitch Response?

A local twitch response is a brief, involuntary contraction of a muscle that can sometimes occur when a needle reaches a sensitive muscular area.

It may feel like a quick jump or flick within the muscle. Although this response can occur during Dry Needling, it is not essential for every treatment and does not guarantee a better result.

Your physiotherapist will select and adapt the technique according to your symptoms rather than repeatedly trying to provoke a twitch unnecessarily.

Does Dry Needling Hurt?

The needle used for Dry Needling is very fine, so insertion may produce only a brief sensation. However, needling a sensitive muscle can sometimes feel uncomfortable.

You may experience aching, pressure or a short muscular cramp during treatment. These sensations should remain manageable rather than becoming excessively painful.

More discomfort does not necessarily create a better clinical result. Communicate with your physiotherapist throughout the appointment so the depth, position or technique can be changed when required.

How May Dry Needling Help?

Some people experience temporary changes in muscular pain, sensitivity or ease of movement following Dry Needling.

Where it is appropriate, treatment may help to:

Reduce local muscular sensitivity
Ease selected areas of muscular discomfort
Improve comfort during movement
Support participation in rehabilitation exercises
Complement hands-on physiotherapy
Help manage symptoms during a progressive return to activity

These effects vary, and improvement cannot be guaranteed. Your response should be reviewed alongside meaningful outcomes such as movement, function, exercise tolerance and progress towards your goals.

Dry Needling and Exercise Rehabilitation

Dry Needling may provide temporary symptom relief for some people, but it cannot rebuild physical capacity on its own.

Your wider rehabilitation programme may include:

Exercises to restore comfortable movement
Progressive muscular strengthening
Balance and movement-control work
Gradual increases in physical activity
Advice about training and workload
Preparation for work, exercise or sport
Strategies for managing recurring symptoms

For example, Dry Needling might make a painful movement feel temporarily easier. Nevertheless, appropriate exercises may still be required to build the strength and tolerance needed to perform that movement repeatedly.

Dry Needling for Sports and Exercise-Related Symptoms

Training and repeated physical activity can sometimes lead to muscular soreness, tightness or sensitivity.

Dry Needling may be considered when these symptoms are affecting movement or making it difficult to progress with rehabilitation. However, treatment should also examine the wider context.

This may include:

Recent changes in training volume or intensity
Recovery between sessions
Strength and physical capacity
The demands of your sport
Previous injuries
The amount of repeated load placed on the area

Addressing these factors may be more important for lasting progress than repeatedly treating the sensitive muscle alone.

Dry Needling for Neck and Shoulder Muscular Pain

Neck and shoulder symptoms can be associated with muscular sensitivity, reduced movement and discomfort during work or everyday activity.

A physiotherapy assessment can consider neck and shoulder movement, strength, workload and any neurological symptoms before Dry Needling is discussed.

Needling around the neck, shoulder blade or chest requires particular knowledge and care because important nerves, blood vessels and the lungs may be nearby. Treatment in these areas must only be undertaken by a practitioner with suitable training and competence.

Dry Needling will not be appropriate when symptoms indicate that further medical or neurological assessment is required.

Dry Needling for Back and Hip Muscular Pain

Muscular sensitivity around the back, hips or gluteal region may accompany pain and restricted movement.

Your physiotherapist will assess how the area moves and whether strength, activity levels or other factors contribute to the symptoms.

Where Dry Needling is appropriate, it may be combined with exercises designed to restore movement and gradually build physical capacity.

Persistent or severe back pain accompanied by neurological or other concerning symptoms requires appropriate medical assessment rather than routine needling treatment.

Dry Needling for Lower-Limb Muscular Symptoms

Muscular pain and tightness can affect areas such as the calves, hamstrings, thighs and hips.

These symptoms may develop following exercise, changes in training or recovery from an injury. However, pain in the leg can also have other causes that require assessment.

Your physiotherapist may examine movement, strength and the demands placed on the lower limb before deciding whether Dry Needling could form part of the treatment plan.

Dry Needling and Acupuncture

Dry Needling and Acupuncture both involve inserting fine needles through the skin, but the terminology and treatment approaches can differ.

Dry Needling commonly focuses on muscles, local sensitivity and musculoskeletal symptoms identified during a physiotherapy assessment. Acupuncture may use a combination of local and more distant points within a Western medical or traditional treatment framework.

Treatment	Common focus
Dry Needling	Selected muscles and sensitive muscular areas associated with pain or movement problems
Acupuncture	Selected local or distant points used within a broader pain-management approach

There can be overlap between the techniques, and terminology varies according to practitioner training. Your physiotherapist will explain the method being recommended and why it may be relevant to your symptoms.

Dry Needling and Sports Massage

Dry Needling and Sports Massage are separate treatments, although both may sometimes be used to address muscular discomfort.

Treatment	Primary approach
Dry Needling	Fine needles inserted into selected muscular or soft-tissue areas following clinical assessment
Sports Massage	Hands-on pressure and movement applied to muscles and other soft tissues

Sports Massage may be suitable for general muscular tightness, training recovery or soft-tissue comfort. Physiotherapy assessment is usually the more appropriate starting point when pain is unexplained, recurring or linked to weakness, injury or loss of movement.

Dry Needling and Trigger Points

The term “trigger point” is often used to describe a sensitive area within a muscle that may reproduce local or referred discomfort when pressure is applied.

Dry Needling practitioners may use the assessment to identify and treat selected sensitive muscular areas. However, pain is rarely explained by a single point or muscle alone.

Movement, activity, sleep, stress, previous injury, physical capacity and the nervous system can all influence how pain is experienced. Treatment should therefore consider the whole presentation rather than assuming that needling one point will resolve every contributing factor.

What Happens After Dry Needling?

Temporary muscular soreness is relatively common after treatment. The area may feel similar to the soreness experienced following exercise.

Other short-term effects can include:

Minor bleeding
Bruising
Temporary tenderness
Fatigue
Feeling light-headed or faint
A temporary increase in familiar symptoms

Your physiotherapist will advise whether normal activity and exercise can continue afterwards. In many cases, gentle movement is appropriate, although strenuous activity involving the treated area may need to be adjusted temporarily.

Contact the clinic when you experience a significant, unexpected or worsening reaction.

Possible Risks of Dry Needling

Dry Needling pierces the skin and therefore carries possible risks, even when performed by an appropriately trained healthcare professional.

Possible complications include:

Pain during or after treatment
Bleeding and bruising
Fainting or feeling unwell
Skin irritation
Infection
Temporary irritation of a nerve
Injury to nearby tissue, nerves or blood vessels
A retained or damaged needle

When needling is performed around the chest, upper back, shoulder or lower neck, there is a rare risk of puncturing the lung. This is known as a pneumothorax.

Your physiotherapist should explain risks relevant to the proposed treatment area before asking for your consent. You can decline Dry Needling and discuss alternative treatment options.

When Dry Needling May Not Be Suitable

Dry Needling may need to be modified, delayed or avoided depending on your health and individual circumstances.

Tell your physiotherapist if you:

Take anticoagulant, antiplatelet or other blood-thinning medication
Have a bleeding or clotting disorder
Have an infection, wound or skin condition near the treatment area
Have a weakened immune system
Have diabetes
Have reduced sensation or peripheral neuropathy
Are pregnant or may be pregnant
Have epilepsy or a history of seizures
Have a severe fear of needles
Have previously fainted during needling or medical procedures
Are allergic or sensitive to metals
Have recently undergone surgery
Have a pacemaker or another implanted medical device
Feel unwell on the day of your appointment

These factors do not automatically prevent treatment in every case. However, your physiotherapist must know about them before deciding whether Dry Needling is safe and appropriate.

Do not stop or change prescribed medication to receive Dry Needling unless the clinician responsible for that medication has specifically advised you to do so.

Dry Needling During Pregnancy

Tell your physiotherapist when you are pregnant, think you may be pregnant or are trying to become pregnant.

Pregnancy can affect whether Dry Needling is appropriate, which treatment areas may be considered and how you should be positioned.

Dry Needling provided within musculoskeletal physiotherapy does not replace maternity, obstetric or medical care.

Dry Needling and Blood-Thinning Medication

Medication that affects blood clotting can increase the likelihood of bleeding or bruising.

Provide an accurate list of medication before treatment. Your physiotherapist will consider the medicine, dosage, treatment location and your wider health before deciding whether Dry Needling is suitable.

Never stop anticoagulant or antiplatelet medication solely for a Dry Needling appointment without medical advice.

How Many Dry Needling Sessions Will I Need?

There is no fixed number of appointments that suits everyone.

Your physiotherapist should review:

Whether your symptoms have changed
Whether movement or activity feels easier
How long any improvement lasts
Whether you experience unwanted effects
Whether Dry Needling helps you progress with rehabilitation

Some people notice a temporary change after one treatment, while others experience little or no benefit.

Dry Needling should not continue indefinitely without a clear clinical reason. When it is not creating a meaningful improvement, the treatment plan should be reviewed or changed.

When Is Further Medical Assessment Required?

Dry Needling should not delay appropriate investigation when symptoms suggest a more serious or unrelated medical problem.

Medical or specialist assessment may be required when you experience:

Severe or rapidly worsening pain
A significant loss of strength or movement
New or increasing numbness or tingling
Symptoms following a serious accident
A high temperature or signs of infection
Unexplained weight loss
Persistent night pain unrelated to movement
Chest pain or difficulty breathing
Loss of bladder or bowel control
Other symptoms that cause concern

Your physiotherapist can advise whether treatment is appropriate or whether you should contact your GP, NHS 111 or another healthcare professional.

Dry Needling at Core Physio

Core Physio provides Dry Needling as part of personalised physiotherapy for selected muscular pain, sensitivity and movement problems.

Every treatment includes appropriate assessment and clinical reasoning. Where Dry Needling is recommended, it may be combined with advice, exercise, hands-on physiotherapy and progressive rehabilitation.

Our Dry Needling London Bridge service is available from our central London clinic.

Select an available clinic below to view the practitioners and live online appointment availability.

Frequently Asked Questions About Dry Needling

Is Dry Needling the same as an injection?

No. Dry Needling uses a solid fine needle, and no medicine or other substance is injected into the body.

Do I need a physiotherapy assessment first?

Yes. Your physiotherapist must assess your symptoms and health before deciding whether Dry Needling is appropriate and how it should fit into the wider treatment plan.

Is Dry Needling painful?

You may feel a brief pinprick, aching, pressure or a muscular twitch. Treatment should remain manageable, and the needle can be adjusted or removed when necessary.

Will I feel sore afterwards?

Temporary muscular soreness can occur following treatment. It may feel similar to discomfort after exercise and will commonly settle gradually.

How quickly does Dry Needling work?

Responses vary. Some people notice a temporary change after one or several treatments, while others experience little benefit. Results cannot be guaranteed.

Can Dry Needling cure my condition?

Dry Needling should not be presented as a cure. It may help manage selected symptoms, but exercise, rehabilitation and changes to activity may still be needed.

Can I exercise afterwards?

This depends on the area treated, your condition and how you feel. Your physiotherapist will advise whether normal exercise can continue or should be modified temporarily.

Can I have Dry Needling while taking medication?

Many medicines do not prevent treatment, but your physiotherapist requires an accurate medication list. Blood-thinning medication requires particular consideration.

Can Dry Needling be combined with physiotherapy?

Yes. Dry Needling is normally provided as one possible technique within a broader physiotherapy and rehabilitation plan.

What should I wear?

Wear comfortable clothing that allows the treatment area to be accessed safely. Shorts may be helpful for lower-limb treatment, while a vest or loose top may be useful for the shoulder or upper body.

What happens if Dry Needling does not help?

Your physiotherapist can review your symptoms, assessment and rehabilitation programme. Treatment should be changed or discontinued when it is not providing a meaningful benefit.