Wondering does dry needling hurt? Learn what to expect during treatment, from first sensations to typical outcomes. Get expert answers and real clinical insights.
Does dry needling hurt and what is dry needling
When patients ask, does dry needling hurt, the answer often depends on their expectations and prior experiences with physical therapy. While the name may sound intimidating, dry needling is generally a well-tolerated and safe technique used to address muscle pain and dysfunction.
What is dry needling?
Dry needling is a modern therapeutic technique developed within the framework of Western medicine. It involves the insertion of thin, solid needles into myofascial trigger points—tight, sensitive areas in muscles that contribute to pain, limited mobility, and referred discomfort. Despite using needles, dry needling is not the same as acupuncture, which is based on Traditional Chinese Medicine.
The goal of dry needling is to:
- Release muscle tension
- Improve local blood flow
- Reduce neuromuscular pain
- Restore range of motion
Why does dry needling cause discomfort?
The sensation during dry needling varies from person to person. The needle itself is extremely thin and typically causes minimal pain during insertion. However, once it reaches a trigger point, a brief and involuntary muscle twitch may occur. This twitch can feel like a quick cramp or a deep ache, followed by a sensation of release or relief.
Patients often describe it as:
- A dull pressure
- A deep, cramp-like feeling
- Sometimes a radiating discomfort into surrounding areas
A study published in Nature highlighted that dry needling induces neurophysiological changes that may help downregulate pain receptors in the muscle, potentially improving both short- and long-term outcomes.
Does dry needling hurt and how the procedure is performed
Understanding how the treatment works can ease concerns about whether dry needling hurts. The technique follows a precise, standardized process carried out by trained professionals.
Step-by-step procedure of dry needling
1. Patient assessment:
The therapist conducts a detailed evaluation to identify muscular dysfunction, trigger points, and pain referral patterns.
2. Preparation:
The treatment area is cleaned, and the patient is positioned to allow easy access to the targeted muscles. No anesthesia is used, as discomfort is usually brief and manageable.
3. Needle insertion:
A sterile, single-use needle is gently inserted into the skin and muscle. When it hits a trigger point, the muscle may twitch or contract briefly—a sign that the needle has activated the dysfunctional tissue.
4. Needle manipulation:
In some cases, the needle may be moved slightly or left in place for several seconds to minutes, depending on the goal of treatment.
5. Post-treatment care:
After the session, the therapist may apply gentle stretching or soft tissue techniques to support recovery. Mild soreness similar to post-exercise fatigue is common and usually resolves within 24–48 hours.
Research published on PMC notes that the local twitch response is strongly associated with improved clinical outcomes, particularly in chronic myofascial pain.
Does dry needling hurt during the first session
For many patients, the first session brings both curiosity and apprehension. So, does dry needling hurt more during the initial treatment? The reality is, it may feel more intense due to unfamiliarity, but it’s typically tolerable.
What to expect at your first dry needling session
Initial consultation and consent:
Before the needling begins, the practitioner explains the purpose, expected sensations, and possible side effects. Patients are asked to report their pain history and medical background.
Needle sensations:
During insertion, some patients feel almost nothing, while others report a quick, sharp sensation followed by deep aching. When the needle activates a trigger point, the muscle contracts momentarily (the twitch response), which might be surprising but is not dangerous.
Post-needling soreness:
After the session, it’s common to experience mild muscle soreness, similar to the feeling after a strenuous workout. This reaction is normal and often indicates that the body is responding to the treatment.
Tips to ease first-session discomfort:
- Stay hydrated before and after treatment
- Apply heat or gentle stretching post-session
- Avoid intense exercise for 24 hours
- Communicate openly with your therapist during the procedure
Most patients tolerate the first session well and often report improved mobility and reduced pain within 1–2 days.
👉 Curious about the difference between acupuncture and dry needling?
Discover a detailed comparison and learn which approach might be right for you – read more here
Does dry needling hurt more than acupuncture
A common question among patients considering treatment is: does dry needling hurt more than acupuncture? While both techniques involve needle insertion into the body, their application, depth, and intended effect differ significantly — and so does the pain experience.
Needle depth and purpose
- Dry needling targets myofascial trigger points, often located deep within muscles. The needle may penetrate several centimeters, depending on the muscle’s size and depth.
- Acupuncture, on the other hand, inserts needles into superficial layers of skin and subcutaneous tissue, typically only a few millimeters deep, along specific meridian pathways.
Because dry needling stimulates a muscle twitch response, patients may experience a sharp, quick contraction followed by a deep ache. This is usually described as intense but brief. Acupuncture is generally painless or causes a subtle tingling or warmth sensation.
Sensory experience: what patients say
- Patients often report that dry needling feels more like a muscle cramp, especially when the twitch response occurs.
- Acupuncture is commonly associated with a more relaxing and calming sensation.
Research from Nature suggests that dry needling has a stronger neuromuscular effect, which may explain the temporary increase in discomfort but also the more rapid pain reduction in some conditions.
So, does dry needling hurt more than acupuncture? In many cases, yes — but the sensation is short-lived and often leads to quicker muscle release and functional gains.
Does dry needling hurt depending on the treated muscle
The sensation of dry needling varies widely depending on the anatomical location of the muscle being treated. So when asking does dry needling hurt, it’s important to consider which muscle is targeted.
Surface vs deep muscles
Superficial muscles (e.g., upper trapezius, gluteus medius):
- Tend to be easier to access
- Cause less discomfort during needling
- Twitch responses are usually mild and well-tolerated
Deep muscles (e.g., piriformis, psoas, suboccipitals):
- Require longer needles and deeper insertion
- More likely to provoke stronger twitch responses
- May cause temporary deep aching or pressure
Muscle density and sensitivity
Muscles that are overused, tight, or inflamed tend to react more strongly. In contrast, healthy or well-conditioned muscles may not produce any twitch or discomfort at all.
According to findings published on PMC, deeper tissues may have a greater density of pain receptors, especially near joint capsules or nerve-rich areas, which may enhance the discomfort — but also the therapeutic effect.
Therefore, does dry needling hurt more in deeper muscles? Generally, yes — but this also depends on the technique used, needle depth, and patient positioning.
Does dry needling hurt if you have a low pain threshold
For individuals with a low pain tolerance, the question does dry needling hurt is especially relevant. The good news is that the technique is highly adaptable, and therapists can modify it based on patient comfort.
Pain perception and individual response
Pain tolerance varies based on several factors:
- Nervous system sensitivity
- Previous injury or trauma
- Anxiety, stress, or lack of sleep
- Expectations and prior experiences with needles
People with a low threshold may feel:
- More intense twitch responses
- Lingering soreness after treatment
- Anxiety-related tension, which may amplify perception
How therapists adjust the approach
Skilled clinicians can modify dry needling to minimize discomfort:
- Using shorter needles in sensitive areas
- Targeting superficial muscles first before deeper layers
- Applying gentle needling techniques without aggressive stimulation
- Monitoring facial expressions and verbal feedback throughout the session
It’s also helpful to combine dry needling with breathing techniques, relaxation, and clear communication. Many patients report that discomfort lessens with each session as they become more accustomed to the sensations.
So while the answer to does dry needling hurt if you have a low pain threshold may be yes — it’s manageable, and the approach can be tailored for safety and comfort.
Does dry needling hurt and how often should it be done
One of the most common concerns is not only does dry needling hurt, but also how frequently it should be performed and whether discomfort increases or decreases with repeated sessions.
Recommended frequency of dry needling
Dry needling is usually performed 1–2 times per week, depending on the condition being treated, therapist assessment, and patient response. In most cases:
- Acute conditions (e.g., muscle strain, recent injury): 2–3 sessions over 1–2 weeks
- Chronic pain (e.g., myofascial pain syndrome, tension headaches): 4–6 sessions spaced over 3–4 weeks
- Postural or biomechanical dysfunctions: integrated into a broader physiotherapy plan over several weeks
The frequency is tailored to balance therapeutic effect with muscle recovery time, as excessive needling without proper rest may delay healing.
Does pain change over time?
The sensation of does dry needling hurt often decreases with successive sessions. Initial treatments may produce more soreness or twitch responses, while later sessions are often perceived as less intense due to:
- Desensitization of trigger points
- Reduced local inflammation
- Improved tissue mobility and neuromuscular control
This progressive response supports the idea that pain diminishes as dysfunction resolves.
Does dry needling hurt and what pain mechanisms are involved
To understand why dry needling may hurt, it’s important to examine the physiological mechanisms behind the discomfort. Dry needling activates multiple pain-related systems, both locally and centrally.
Nociceptive pain response
The insertion of a needle into a trigger point stimulates nociceptors — specialized sensory receptors that detect potential tissue damage. This can produce:
- Sharp or cramping pain during twitch response
- Dull aching or burning as the tissue adapts to needle stimulation
This response is normal and represents a controlled irritation intended to trigger healing mechanisms.
Local twitch response (LTR)
An involuntary contraction of the muscle fibers, the local twitch response is one of the hallmarks of effective dry needling. Although brief, the LTR can cause a temporary spike in discomfort, followed by release.
As noted in studies such as PMC, LTR is correlated with reduced pain and better outcomes, despite short-term discomfort.
Central sensitization
In chronic pain conditions, the nervous system may develop central sensitization, where pain perception is amplified. In such cases, even minimal stimulation like dry needling may cause:
- Hyperalgesia (increased sensitivity to pain)
- Allodynia (pain from stimuli that aren’t usually painful)
By modulating these responses, dry needling may gradually desensitize the central nervous system, helping to reset abnormal pain pathways.
So, does dry needling hurt because of nerve activation? Partly yes — but that’s exactly what makes it effective in certain cases.
Does dry needling hurt or feel like muscle soreness afterward
Another frequent question is: does dry needling hurt after the session? While most people tolerate the procedure well, muscle soreness is a common post-treatment effect.
What post-needling soreness feels like
After a session, you may experience:
- Mild to moderate soreness in the treated area
- A sensation similar to delayed onset muscle soreness (DOMS)
- Tightness or heaviness in the muscle
- Rarely, light bruising
This discomfort typically appears within a few hours and peaks at 24–48 hours, gradually subsiding.
Why does soreness happen?
Soreness occurs due to:
- Microtrauma from needle insertion
- Inflammatory response that promotes healing
- Breakdown of contracted sarcomeres in tight muscle fibers
This is a positive therapeutic response, indicating that the muscle is reacting and beginning to recover.
How to manage post-needling pain
- Apply heat (not ice) to encourage circulation
- Perform gentle stretching
- Stay hydrated
- Avoid heavy exercise for 24 hours
- Use over-the-counter anti-inflammatories if advised by a clinician
So while the answer to does dry needling hurt afterward is often yes, it is short-lived and manageable, especially when appropriate recovery strategies are followed.
5 most common questions about does dry needling hurt
1. Is dry needling painful for everyone?
No. While some patients experience discomfort, others report only mild pressure. Pain perception is highly individual.
2. Does dry needling hurt more than getting a shot or vaccine?
Usually less. The needles used are much finer than those used for injections and don’t carry liquid into the tissue.
3. Can the therapist adjust the technique to reduce pain?
Yes. Techniques, depth, and number of insertions can all be modified to suit your comfort level.
4. Does the pain mean the treatment is working?
Not always — but the presence of a twitch or soreness often indicates the targeted tissue is reacting as expected.
5. How long does pain or soreness last after treatment?
Most post-needling discomfort resolves within 24–48 hours and can be managed with gentle self-care.
All health-related information and recommendations provided here are based on the professional experience of a licensed physiotherapist and kinesiologist with several years of international and local clinical practice. These insights aim to support general well-being and rehabilitation, but they do not replace medical advice.
Each individual is unique, and responses to treatment or exercise may vary. Therefore, it is strongly recommended to consult with a medical doctor or healthcare professional before starting any new therapy, exercise program, or making changes to your current health routine. These guidelines are intended for educational and informational purposes only.
