• Dr. Jodi Hierholzer, DPT

What is Trigger Point Dry Needling?

Updated: May 2

So what is all the hype about dry needling? Since trigger point dry needling (DN) is a technique we commonly use at BWPT, we thought a blog to answer some of your questions would be beneficial.

Dry Needling to upper trap

Trigger point DN techniques use small, solid filament type needles which are inserted into myofascial trigger points (the painful knots in muscles) to stimulate a healing response with the goal of reducing pain and dysfunction.

It has been shown that our bodies can develop areas of hypersensitivity and tightness as a response to various stressors i.e. postural, repetitive movements, intense exercise, emotional stress etc.

Ever had a stressful day at work and feel like your traps are glued to your ears? Or how about the distance runner who keeps flaring up their achilles tendinitis because of tightness/overuse of their calf muscles. Or the CrossFit athlete who did high volume dead lifts and their back, glutes and hamstrings feel like rocks (and not in a good way haha). I bet you those muscles are FULL of active trigger points.

When trigger points are present, they cause the muscles they are in to neurologically tighten which serves to further disrupt the normal functioning due to increased pain and local compression of vascular structures and nerves. This can result in soreness, tightness, limited ROM, and hinders performance. PTs use dry needling to treat these dysfunctional tissues as an effective way to decrease those trigger points and allow our muscles and nervous system to return to baseline.

Dry Needling to Quadratus Lumborum


How does dry needling work and what does the needle actually do?

When performing intramuscular dry needling, we are looking to elicit that twitch response (LTR) of the muscle. This LTR is a quick contraction reflex of the muscle that can be both diagnostic and therapeutic. Research has shown that when the LTR is elicited, the tissue will have a decreased muscle spasm, reduced chemical irritation, improved flexibility and can provide short term pain relief. This can often immediately improve range of motion, improve function and decrease or eliminate pain. Eliciting a LTR is not imperative and often will not occur when performing needling aimed at other structures in the body besides muscles and trigger points. Besides "tigger point" dry needling, needles can also be placed into other tissues including tendons, ligaments, around scars or near nerves. Depending on the patient's particular pathology, the aim of DN may be different and therefore the desired physiological response is also different.

What type of pain does trigger point dry needling treat?

For myofascial pain, the technique is used to treat a number of areas. The most common trigger points lead to these issues (there are many more not listed): Neck/Scapular Pain Stress induced or postural induced muscle tension

Sciatica/Piriformis Syndrome Low/Mid Back Pain

Headaches & Migraines Pain in your Shoulders, Hips, Knees, Ankles, etc. (joints)

Golfer's or Tennis Elbow Plantar Fasciitis Achilles tendonitis

Why is it called “dry” needling?

It is called "dry" needling because no solution is injected into the tissue, as is the case with an injection with a hypodermic needle. The needles we use are acupuncture needles which are solid point, stainless steel, one-time use needles (definitely no garage tattoo needles ;)

Dry Needle in low back region

Is dry needling like acupuncture?

With DN, we actually do use acupuncture needles. Other than that, the two techniques are very different. DN is based on Western medical research and principles, whereas acupuncture is based on Traditional Chinese Medicine in which the purpose is to alter the flow of energy ("Qi") along traditional Chinese meridians for the treatment of diseases. So needles are placed at precise points along these interconnected pathways that map the whole body, including your head, trunk and limbs. The goal of placing needles into acupuncture points is to direct the flow of vital energy to trigger your body's healing response and restore physical, emotional and mental equilibrium.

Dry needling gets to the source of your pain — the myofascial pain caused by restrictions of your muscle tissue or the fascial layer of connective tissue that surrounds and supports the muscle. We identify the knots or taut bands that are causing you problems and place needles with the intent of producing a local twitch response (LTR). It's the LTR that leads to the resolution of this trigger point and therefore the reduction of your pain.

Does it hurt?

Each patient describes the processes of being needled differently depending on what tissues are being treated, pain tolerance, and degree of dysfunction. Most patients describe DN as a “deep ache, burn, and/or occasionally sharp” depending on the amount of active trigger points in their tissue. Typically, patients report not feeling the needle actually penetrate the skin and to most, the treatment is very tolerable. It honestly "just depends."

Once the needle has been inserted into the skin/muscle, the therapist will work the needle around trying to get the muscle to twitch. As mentioned above, these twitches are called the “local twitch response” (LTR) and means that we are positively affecting the desired tissue. These twitches can be sudden, startling, and sharp, but the LTR is what the therapist is hoping to see. When copious localized twitches are present in a muscle, this validates the patient's dysfunction and pain, and serves as a great diagnostic tool for the clinician when differently diagnosing our patients.

If you have copious amounts of twitches, you may be more sore than if you did not have any at all. We typically tell patients that it will feel like you just worked out really hard or that you got “frogged” in the treated muscle.

What should I expect after dry needling therapy?

Soreness is common after a dry needling session. It’s similar to the soreness you feel after a hard workout. The soreness typically resolves within 24-48 hours. You can help reduce it with heat, proper hydration, massage, and gentle stretching. You can continue to exercise but note you may feel weaker or more sore if you workout within the same day of being dry needled. ALWAYS consult with your therapist about the logistics of returning to your exercise/sports routine after being dry needled.

Still have questions? Give us a call at 325-261-0043 to see if dry needling may be something that could help you!

- Dr. Jodi Hierholzer, PT, DPT, CSCS, C-DN Certified Dry Needling Provider

Our mission at BODY WORX PT is to help active people stay active by optimizing recovery, performance, and injury reduction. If this sounds like a good fit for you give us a call at 325-261-0043 or email us at

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