Dry Needling

14 Major Triger Points

Dry needling is a therapeutic technique in which a trained physical therapist inserts small, sterile filament needles into the skin and muscle directly at a myofascial trigger point. This generates a twitch response, helping release muscle tension and pain.

Dry needling can be used to treat a variety of musculoskeletal issues, including: neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer's elbow); headaches (migraines and tension type); jaw and dental pain; buttock and leg pain (sciatica, hamstring strains, calf tightness/spasms).

Although the exact mechanisms of dry needling are not known, the technique has demonstrated both the mechanical and biochemical effects. Pioneering studies by Dr. Jay Shah and his colleagues at the National Institutes of Health have shown that inserting a needle into trigger points can cause favorable biochemical change that can assist in reducing chronic pain issues.

Trigger points are known to have abnormal electrical activity and are surrounded by numerous chemicals known to cause inflammation. Research has shown that when a needle is successfully inserted into a trigger point and generates a local twitch response, over time, it can return the electrical and chemical environment within the muscle to its normal, relaxed state. Deactivated trigger points draw white blood cells and plasma cells into the area and create a healing response. Clinically, we see improved muscle length, strength, flexibility and a corresponding decrease in pain with our patients following dry needling treatment.


  • Inadequate practical knowledge
  • Consent denied by patient
  • Compromised equipment
  • 1st trimester of pregnancy
  • Scalp area of infants
  • Nipples, umbilicus, and external genitalia
  • Uncontrolled anticoagulants usage
  • Compromised immune system
  • Local infection or active tumor
  • History of lymph node removal
  • Occipital region of patients with Arnold Chiari Malformation
  • Area over a cardiac pacemaker
  • Areas over the ribcage or thoracic spine without advanced training

Relative Contraindications

  • Controlled anticoagulants
  • Post surgical but cleared by surgeon
  • Autoimmune diseases
  • History of lymph node removal (depends on presence of lymphedema and clearance from oncologist)
  • Respiratory illness (acute, subacute, recovering, etc.)

Monica Lucido-Clay, DPT

Six Points Physical Therapy | Monica Lucido-Clay, DPT