Dry needling, what the needle is for and what it is not

Dry needling is the placement of a thin, solid filament needle into a taut band of muscle or a trigger point, with nothing injected. At Source Chiropractic it is performed by a chiropractic physician, and it is used as one part of a plan for muscular and soft-tissue findings, not as a treatment on its own. This guide covers what it is, what it feels like, its risks, and what the evidence does and does not support.

Is dry needling the same as acupuncture?

No. The needle is similar, and the two are often confused for that reason. Acupuncture is a distinct practice with its own theory and training; in Tennessee a chiropractic physician may practice it only after 250 hours of accredited acupuncture education, a national examination and a letter from the Board (Rule 0260-02-.02(4)). Dry needling is a musculoskeletal technique: the target is a specific muscle finding identified by examination, and the aim is a local response in that tissue. This page describes dry needling only. If you want acupuncture, ask, and we will tell you whether it is offered here and by whom.

Who may perform dry needling in Tennessee, and who does here?

Tennessee's rules for chiropractic physicians state that a chiropractic physician has the authority to utilize physical agent modalities and perform an adjustment, manipulation, manual therapy, dry needling, rehabilitation, or treatments to the human frame and soft tissues (Rule 0260-02-.02(2)(b)). At Source Chiropractic, dry needling is performed by a chiropractic physician. Ask the doctor about their dry needling training before your first session; that is a fair question and it has a specific answer.

What findings is it used for?

In the practice's own words, dry needling may be used to address appropriate muscular and soft-tissue components of a neuromusculoskeletal condition. In practice that means taut bands and trigger points found on examination in the neck, upper back and shoulder, the low back and hip, and the muscles that contribute to some headaches. The needle is aimed at a finding, not at a diagnosis. If the examination does not find a muscular component, there is nothing for a needle to do, and it is not offered.

What does a session feel like?

A thin, solid needle is inserted through the skin into the target muscle. Most people feel a brief pinch, then a deep ache or heaviness at the target, and sometimes a short involuntary twitch of the muscle; those are the responses the technique looks for. Needles are single-use and sterile, and are disposed of after the session. Soreness at the site for a day or two afterwards is common, and mild bruising can occur. A session is usually combined with other care in the same visit, such as an adjustment or exercise guidance, rather than given alone.

What are the risks?

Minor effects are common and expected. In a prospective survey of 7,629 treatments by trained physiotherapists, bruising, bleeding and pain during or after treatment were the common ones, and no significant event occurred. A 2026 systematic review of 59 studies found minor adverse events reported at rates from 0% to 48% of treatments, depending on the study and what was counted (see the research below).

Serious harm is uncommon but real. The same review found major adverse events reported in 0% to 0.43% of treatments, and case reports document pneumothorax, a punctured lung, after needling of muscles over the chest wall and around the shoulder blade. That risk is specific to needle placement near the lungs. It is the reason the technique, the angle and the depth matter. If chest pain or shortness of breath starts during or after a session, call 911 or go to an emergency department and tell them where the needles were placed. Do not wait to reach the practice.

Before the first session, tell the doctor if you take blood-thinning medication, have a bleeding disorder, an implanted device or a compromised immune system, are pregnant, or have a fear of needles. The doctor needs each of those before deciding whether dry needling is appropriate for you.

What does the research support?

Reviews of trials, mostly of dry needling performed by physical therapists, find that it can reduce pain and tenderness in the weeks after treatment compared with no treatment or sham needling, with the quality of that evidence rated very low to moderate. The same reviews find that it is not clearly better than other hands-on or exercise-based care, and that benefits beyond three months are uncertain. For low back pain with trigger points, dry needling combined with other treatment did better than dry needling alone. For chronic neck pain, it reduced pain but was not superior to physical or manual therapy for function.

Read that as a description of a modest, short-term tool that belongs inside a plan, not a promise about your result. The studies also involve a mix of techniques and clinician training, so a result from one trial does not describe every needle placed anywhere.

What other options should I consider?

For a muscular finding, the alternatives are the rest of the plan: exercise and loading, massage therapy for hands-on soft-tissue work by a licensed therapist, manual therapy and adjustment where a joint finding is part of the picture, and time, since many muscular complaints settle. NICE's low back pain recommendations put activity and exercise first. Medical care and physical therapy answer different needs. A persistent muscular complaint that does not fit the examination findings is a reason to look again, not to needle harder.

What should I ask before booking?

• What finding are we treating, and how will we know it has changed?
• What training do you have in dry needling, and how often do you perform it?
• Why needle this rather than treat it by hand, or with exercise alone?
• What will I feel, and what should make me stop you?
• What does each session cost, and when will we review progress?

If we are not able to help you with your problem or are unable to reduce your pain levels, we will make sure to give you a recommendation to another experienced provider.

Contact the team to discuss availability and fees. The new-patient chiropractic offer has its own terms; ask about the cost of additional services before agreeing to them.