Research on Dry Needling

After dry needling combined with therapeutic exercises, patients who had chronic pain following TKA showed clinically significant improvements in pain, range of motion, function, and myofascial trigger points. Future randomized clinical trials should further investigate the effectiveness of this protocol under similar conditions.

Núñez-Cortés R et al. Dry Needling Combined With Physical Therapy in Patients With Chronic Postsurgical Pain Following Total Knee Arthroplasty: A Case Series. J Orthop Sports Phys Ther. 2017 Mar;47(3):209-216. doi: 10.2519/jospt.2017.7089. Epub 2017 Feb 3.


Moderate evidence showed that dry needling of MTrPs, especially if associated with other therapies, could be recommended to relieve the intensity of Low Back Pain (LBP) at postintervention; however, the clinical superiority of dry needling in improving functional disability and its follow-up effects still remains unclear.

Liu L et al. Evidence for Dry Needling in the Management of Myofascial Trigger Points Associated With Low Back Pain: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2018 Jan;99(1):144-152.e2


Based on the best current available evidence (grade A), we recommend dry needling, compared to sham or placebo, for decreasing pain immediately after treatment and at 4 weeks in patients with upper-quarter MPS. Due to the small number of high-quality RCTs published to date, additional well-designed studies are needed to support this recommendation.

Kietrys DM et al. Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2013 Sep;43(9):620-34. doi: 10.2519/jospt.2013.4668.


This study found changes in shoulder ROM and pain sensitivity, but not in muscle function, after dry needling to the infraspinatus muscle in participants with unilateral subacromial pain syndrome. These changes generally occurred 3-4 days after dry needling and only in the symptomatic shoulders.

Koppenhaver S et al. Effects of dry needling to the symptomatic versus control shoulder in patients with unilateral subacromial pain syndrome. Man Ther. 2016 Dec;26:62-69. doi: 10.1016/j.math.2016.07.009. Epub 2016 Jul 21.


Very low-quality to moderate-quality evidence suggests that dry needling performed by physical therapists is more effective than no treatment, sham dry needling, and other treatments for reducing pain and improving pressure pain threshold in patients presenting with musculoskeletal pain in the immediate to 12-week follow-up period.

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 Mar;47(3):133-149. doi: 10.2519/jospt.2017.7096. Epub 2017 Feb 3.


The evidence suggests that tendon needling improves patient-reported outcome measures in patients with tendinopathy. There is a trend that shows that the addition of autologous blood products may further improve theses outcomes.

Krey D, Borchers J, McCamey K. Tendon needling for treatment of tendinopathy: A systematic review. Phys Sportsmed. 2015 Feb;43(1):80-6.


Three treatments of Dry Needling (Lat. pterygoid m. vs methocarbamol/paracetamol) on TMJ demonstrated better pain reduction and improved mouth movements compared with methocarbamol/paracetamol treatment 70 days after treatment. No adverse effects were observed with respect to Dry Needling, while the medication group reported unpleasant drowsiness.

Gonzalez-Perez et al. 2015. RCT


In three studies, cerviogenic headaches had statistically significant improvements following dry needling treatments. No significant difference between lidocaine, but was significant compared to superficial Dry Needling. Two studies showed significant improvements in headaches over 4-5 weeks.

France et al. 2014


In a double-blinded, placebo controlled study of six sessions in four weeks of Dry Needling vs. "sham" needling the Dry Needling group showed significant decreases in pain, improved quality of lfie, and decreased need for medications as compared to the sham treatment.

Tekin et al. 2013


A case study was conducted to evaluate the short-term efficacy of Dry Needling therapy in patients severely affected by Fibromyalgia. Weekly, one-hour sessions of Dry Needling were done for six weeks. Dry Needling showed significant differences in pain, fatigue, Short Form-36 (SF-36), myalgic score, pressure pain threshold, and global subjective improvement. Six weeks post treatment, Dry Needling still showed significant differences in most of these tests.

Casanueva et al. 2014. RCT


A case study was done to determine effectiveness of Deep Dry Needling on spasticity, pressure sensitivity, and plantar pressure in patients who have had a Stroke. In this study, 34 patients were randomized into two groups; experimental group received one session of Dry Needling and control group received no intervention.

Outcomes: Deep Dry Needling patients demonstrated significant decreases in spasticity and increases in bilateral pain pressure thresholds (decreased pressure sensitivity) compared to control group. Also, Dry Needling patients experienced bilateral increases in forefoot support surfaces, and unilateral increases in support surface of rearfoot, as well as decreases in mean pressure when compared to control group.

Deep Dry Needling decreases poststroke spasticity and widespread pressure sensitivity as well as effecting changes in plantar pressure by increasing the support surface and decreasing mean pressure.

Salom-Moreno et al. 2014. RCT


In a double blind randomized controlled trial, Dry Needling was found to evoke a short-term segmental anti-nociceptive effect in measuring pain pressure thresholds. These results suggest that trigger point (sensitive locus) stimulation may evoke anti-nociceptive effects by modulating segmental mechanisms, which may be an important consideration in the management of myofascial pain.

J Rehabil Med 2010; 42: 463–468


In a double-blinded case study, a Physical Therapist anesthetized then treated with Dry Needling, sham treatment, and nothing. Dry Needling resulted in reduced pain during the first month of recovery, same degree of pain reduction in one month as as control patients achieved in six months, and significantly decreased the need for postsurgical analgesics.

International Journal of General Medicine 2008:1 3–6


In a single blinded, controlled trial there was good evidence that dry needling evoked inactivation of a primary (key) myofascial trigger points (MTrPs) and inhibited the activity in satellite MTrPs. This supports the concept that activity in a primary MTrP leads to the development of activity in satellite MTrPs and the suggested spinal cord mechanism responsible for this phenomenon.

Am. J. Phys. Med. Rehabil. Vol. 86, No. 5 May 2007


In a case study reporting on lateral epicondylitis (tennis elbow), dry needling in conjunction with joint mobilization techniques, was found to resolve a 6 year history of lateral epicondylitis with significant improvements in pain, functional scores, grip strength and pain pressure thresholds.

Journal of Musculoskeletal Pain, Vol. 17(4), 2009


A systematic review comparing dry needling with injection of different substances found no difference in effect. The authors concluded that direct needling of myofascial trigger points appears to be an effective treatment. Any effect of these therapies is likely because of the needle or placebo rather than the injection of either saline or active drug.

Arch Phys Med Rehabil Vol 82, July 2001


A pragmatic, single blind, randomized, controlled trial concluded that dry needling followed by active stretching is more effective than stretching alone in deactivating TrPs (reducing their sensitivity to pressure), and more effective than no treatment in reducing subjective pain.

Acupuncture In Medicine 2003;21(3):80-86


A randomized clinical trial that assessed the long-term effect of dry needling on chronic low back pain patients that had failed to respond to traditional therapy, demonstrated a significant number of patients who returned to their usual work compared to their control group.

Spine Vol. 5 (3) May/June 1980


In a case study reporting on an 87-year-old patient with a 6 month history of severe hip pain, trigger point dry needling allowed her to reduce the use of all pain medicines and significantly improved her quality of life.

International Journal of General Medicine 2008:1 3–6

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