Dry Puncture: What is it? Treatment History, Action Mechanism, Techniques and Side Effects

The nervous system performs complex communication functions in the human body, including controlling how people experience pain.

For this reason, addressing chronic pain can be a challenge and, at times, difficult to pinpoint.

Dry needling is a therapeutic method increasingly used in the treatment and rehabilitation of neurological and musculoskeletal injuries and disorders.

Dry needling is also known as ” Western acupuncture ” because it uses similar techniques and the same tiny solid filament needles as acupuncture in Traditional Chinese Medicine.

However, dry needling is a unique therapy derived from modern anatomical and neurophysiological principles.

Dry puncture is a highly effective technique that uses an acupuncture needle to “deactivate” or “turn off” painful or knotted areas in the muscles. By stimulating the Central and Peripheral Nervous Systems, the modulating mechanisms of pain are released.

History of the treatment

The basis of dry needling is based on medical science that is supported by orthopedic, neurological, and pain control physicians.


While traditional acupuncture has its roots in ancient Chinese philosophy and takes advantage of acupuncture points to unblock energy channels in the body.

Dry needling is a sophisticated clinical approach that leverages current research and understanding of human anatomy.

Dry needling was introduced by the Czech-born doctor Karel Lewit in 1979.

In his research, Lewit reported that the response to pain relief when trigger points were injected was effective with or without analgesics.

The technique targets specific muscle tissues to promote recovery and restore normal functioning and other neurological treatments.

Uses of dry needling for the treatment of pain

Dry needling can be an effective treatment for various musculoskeletal problems, such as acute injuries and muscle imbalances, spasticity in incomplete tetraplegias, and infantile cerebral palsy.

The technique can also improve gait and movement in patients with hamstring strains and muscle spasms.

Patients are suffering from chronic conditions such as plantar fasciitis, sciatica, neck and back pain, pain in the elbow and shoulder of the tennis player, headaches, migraines, and carpal tunnel syndrome.

Usually, patients who use this method have found relief with dry needling in the following cases:

  • Provides lasting pain relief from head to toe.
  • Heal injuries from overuse and sports injuries.
  • Get rid of the knots in the muscles.
  • It helps the muscles to heal after an injury.
  • Releases tense muscles.
  • Accelerates the healing time of an injury.
  • Improves blood flow to a deep level.
  • It stimulates a force so that it works better.
  • Heals chronic injuries of muscles, tendons, and joints.

Mechanism of action

When inserting fine needles into a myofascial trigger point, a trigger point will provoke a local contraction response followed by immediate and lasting relaxation.

This contraction is an involuntary reflex produced by the spinal cord, causing the tight band of muscle to contract and indicating that the needle was correctly placed on the trigger point.

Dry needling works by blocking the transmission of pain signals to the spinal cord and triggering the release of analgesics into the brain.

The insertion of the needle sends a message of “injury” to the brain that initiates the body’s physiological processes to repair damaged tissue with new tissue.

The insertion of the needle also causes the muscle fibers of the site to relax, which reduces inflammation and improves circulation so that the body can heal.

Dry needling therapy is combined with other interventions to help speed up the healing process and reduce pain.

The term “dry” is used to differentiate this therapy from other methods of pain rehabilitation, such as injections with analgesics.

The acupuncture needles are inserted into the tissue under the skin during a dry puncture session.

Patients generally do not feel the insertion of the needle, only the slight sudden muscle contraction that may seem like a quick cramp.

Often, patients feel relaxed and may experience a pleasant and heavy feeling in their arms and legs.

Dry needling has a cumulative effect, so patients will usually notice a difference in their pain after several dry puncture sessions.

In general, a healthy muscle feels minimal discomfort with the insertion of the needle.

However, if the muscle is sensitive and contracted or has active trigger points within it, the patient may feel a very similar sensation to a muscle cramp.

The contraction response also has a biochemical characteristic that will likely affect muscle reaction, symptoms, and tissue response.

Patients soon learn to recognize and even welcome this sensation, resulting in deactivation of the trigger point, which reduces pain and restores the average length and function of the involved muscle.

Dry puncture techniques

There are three dry puncture techniques, these are:

Surface Puncture

This consists of the insertion of the needle into the skin of the trigger point at the subcutaneous level, at a depth no greater than 1 cm, without it penetrating the muscle.

Occasionally, stimulation of the needle within the subcutaneous tissue may be necessary.

Deep Puncture

This consists of the puncture of the trigger points located in the deep muscles, which is why it is required that the needles are introduced deeper until reaching the trigger point.

The needle must be stimulated by what is usually inserted, and the hand is removed from the trigger point or rotated.


This is also a deep-puncture technique, which involves applying an electrical current through the needles that function as electrodes.

Once the puncture is performed, it is necessary to perform an additional manual and superficial treatment such as cold sprays and massage, among others, to improve the technique’s effectiveness.

The size of the needle is determined by the depth and type of muscle in which the trigger point is located.


Typically, positive results are evident in 2 to 4 treatment sessions but may vary depending on the cause, the duration of symptoms, the general health of the patient, and the level of professional experience.

Dry needling is an effective treatment for relieving acute and chronic pain, rehabilitating injuries, and even preventing pain and injuries.

This technique is unmatched in searching for and eliminating neuromuscular dysfunction that leads to pain and functional deficits.

Side effects of dry needling

Side effects after a dry puncture session may vary; patients may feel some muscle pain for a day or two or bruising on the skin.

This technique is generally considered very safe when performed by an expert, and few complications have been reported.

The health of the tissue and the experience of the professional can vary the results and the discomfort that occurs after treatment.

Serious side effects are infrequent and include infections and organ perforations.