Dry needling: what it is, and whether it's for you.

If you've seen a myotherapist in the past few years, there's a good chance they've offered to "pop a few needles in". For some people that's a welcome suggestion. For others it's a reason to cancel the next appointment.

Both reactions make sense. Dry needling is useful for some problems and unnecessary for others, and you should never feel pushed into it. This guide explains how it works so you can make the decision yourself.

What dry needling is

Dry needling uses very fine, solid needles, the same kind used in acupuncture, inserted into areas of muscle that are tight, tender or contributing to your pain. These areas are often called myofascial trigger points. Pressing on one can reproduce your familiar ache, sometimes in a different place, such as a spot in the upper shoulder that sends pain into the side of the head.

"Dry" simply means nothing is injected. The needle itself does the work. The therapist may leave it in place for a short time, move it gently, or insert and remove it quickly to bring on a small muscle twitch.

In Australia it's mostly offered by myotherapists and physiotherapists, and by some remedial massage therapists, who have done additional dry needling training on top of their main qualification.

Dry needling vs acupuncture

The needles may look the same, but the thinking behind the two techniques is different.

In Australia, the title "acupuncturist" is protected and practitioners must be registered through AHPRA. Dry needling isn't a registered profession in the same way, so it's worth asking about your therapist's training (see the questions below).

What it feels like

The needles are much thinner than the ones used for injections or blood tests. Most people barely feel them go through the skin. They might notice a light tap from the guide tube the therapist uses to insert the needle.

What you do notice is the muscle response. That might be a dull, heavy ache, a feeling of pressure or a quick involuntary twitch in the muscle. Twitches can feel strange the first time. They're brief, and many therapists see them as a sign the needle has reached the right spot.

Most people describe it as a deep ache or a twitch rather than a sharp pain, and less unpleasant than they'd feared.

You can ask your therapist to stop at any time. A good therapist will tell you what they're about to do, check in as they go and start with fewer needles at your first session.

What it can help with

Research suggests dry needling can reduce pain and improve movement in the short term for some muscle-related pain, particularly neck and shoulder pain, some types of headache and some low back pain. Results vary between studies and between people. For most problems it works best combined with other treatment, such as hands-on work and exercise, rather than as a replacement.

It isn't a cure for structural problems such as a disc injury, arthritis or a torn tendon. It may ease the muscle tension that comes with them, but it doesn't change the underlying condition.

Side effects and safety

When done by a trained practitioner using single-use sterile needles, dry needling is generally considered low risk. Common, short-lived effects include:

• Soreness in the treated area for 24 to 48 hours, similar to the day after a workout

• Small bruises or a spot of bleeding where a needle went in

• Feeling tired, light-headed or faint, particularly in your first session or if you haven't eaten

Serious complications are rare. The most important is a pneumothorax (collapsed lung) from needling over the chest wall or upper back. This is one reason training matters: a well-trained therapist knows which areas need extra care, and adjusts the needle angle and depth or avoids those areas.

When to skip it

Tell your therapist if any of these apply. Dry needling may not be suitable, or may need to be adapted:

What to ask your therapist

• What dry needling training have you done, and how recently? Courses vary, so a specific answer is a good sign.

• Why do you think it will help my problem specifically?

• How many needles, and where?

• What would you do instead if I'd rather not? There should always be an alternative.

• Do you use single-use sterile needles and dispose of them in a sharps container? The answer should be yes.

On the directory, you can select Dry needling under "Browse by therapy" to see therapists who offer it, then read each profile to see how they describe their approach.

This guide is general information, not medical advice. Whether dry needling is suitable for you depends on your health history, so discuss it with your therapist, and with your GP if you have a medical condition or take blood thinners.