FAQ on Dry Needling and Acupuncture

Clinical Effectiveness and Protocols

Q: What conditions are best treated with these techniques?

Both dry needling and acupuncture have been shown to be effective for a variety of musculoskeletal pain conditions, including:

• Myofascial pain syndrome

• Chronic neck and shoulder pain

• Low back pain

• Tension-type headaches and migraines

• Temporomandibular disorders
  Clinical research indicates that dry needling often provides immediate, short-term relief, while acupuncture can offer a more holistic approach to pain management (Chys et al., 2023; Dommerholt, 2019).

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Q: How many treatment sessions are typically required?

The number of sessions varies depending on the severity and chronicity of the condition. Many patients may experience noticeable relief after 3–5 sessions, although some chronic cases might require ongoing maintenance treatments.

Q: What are the common protocols used during treatment?

For dry needling, clinicians typically insert a needle into the trigger point until a local twitch response is elicited, then manipulate the needle slightly before removal. Acupuncture protocols may involve selecting a combination of points based on both traditional meridian maps and modern trigger point identification. Both techniques are often integrated with other interventions such as manual therapy and exercise for best results.

Safety and Side Effects

Q: Are there any risks associated with dry needling and acupuncture?

When performed by properly trained practitioners, both techniques are considered safe. The most common side effects are mild and temporary, including soreness, bruising, or slight bleeding at the insertion site. Serious complications are rare. However, it is important to ensure that treatments are performed using sterile techniques and that patients are properly screened for contraindications (Boyce et al., 2020).

Q: How do practitioners ensure safety during these procedures?

Practitioners follow strict hygiene protocols, use single-use sterile needles, and conduct thorough assessments of the patient’s medical history. They are also trained to recognize anatomical landmarks to avoid injuring nerves, blood vessels, or other critical structures.

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Comparison and Integration

Q: Can dry needling and acupuncture be used together?

Yes, many clinicians adopt an integrative approach that combines dry needling with acupuncture. This multimodal strategy leverages the immediate pain-relieving effects of dry needling with the holistic benefits of acupuncture to address both the symptoms and underlying causes of muscle pain.

Q: How do these techniques fit into a broader treatment plan?

Both techniques are often part of a comprehensive treatment plan that may include manual therapy, exercise, posture correction, and stress management. Their integration is aimed at providing short-term relief and supporting long-term functional improvements.

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Frequently Asked Questions (Extended)

Q: What exactly is a local twitch response, and why is it important?

A local twitch response is an involuntary contraction of muscle fibers when a trigger point is stimulated. Its presence confirms the activation of a trigger point and is associated with a reduction in muscle tension once the contraction subsides.

Q: How quickly can I expect to feel relief after treatment?

Many patients report immediate or near-immediate relief following a dry needling session. Acupuncture may take several sessions to produce significant effects. The response varies based on individual factors and the chronicity of the condition.

Q: What should I expect during a treatment session?

During a session, your practitioner will conduct a brief review of your symptoms and perform a physical examination. For dry needling, the needle is inserted directly into the trigger point, and you may feel a quick twitch followed by a brief sensation of relief or soreness. For acupuncture, needles are inserted into specific points and may be left in place for 20–30 minutes.

Q: Are there any conditions that might contraindicate these treatments?

Certain conditions, such as bleeding disorders, skin infections at the treatment site, or severe needle phobia, may contraindicate these treatments. It is important to inform your practitioner of your full medical history before starting treatment.

Dry Needling FAQs (Extended)

Q: Is dry needling legal in NY?

Dry needling is legal in New York, but only when performed by licensed acupuncturists or physicians. In New York State, physical therapists and chiropractors are not permitted to perform dry needling, as it falls under the scope of acupuncture. Always verify that your provider is licensed and trained in dry needling techniques.

Q: How much does dry needling usually cost?

Dry needling typically costs between $150 and $400 per session in New York City, depending on the provider’s experience, the length of the session, and whether additional therapies are included. At Morningside Acupuncture, individual sessions and package discounts are available.

Q: Does dry needling really work?

Yes, numerous clinical studies show that dry needling is effective for muscle pain, trigger points, sports injuries, and postural issues. It works by creating a local healing response in the targeted tissues and helping the nervous system reset dysfunctional muscle patterns.

Q: Will insurance cover dry needling?

Some insurance plans may cover dry needling if billed under acupuncture benefits. If you have out-of-network acupuncture coverage, dry needling sessions can often be reimbursed when properly documented. We provide superbills for insurance reimbursement.

Q: Why is dry needling banned?

Dry needling itself is not banned — but the practice is restricted in some states to ensure it's performed safely by properly trained professionals. In New York, for example, only licensed acupuncturists and physicians can legally perform it.

Q: Who should not get dry needling?

Dry needling may not be appropriate for:

• People with severe bleeding disorders

• Those with a strong needle phobia

• Pregnant individuals in certain cases (depending on location of needling)

• Patients with serious infections at the treatment site Always consult with a licensed acupuncturist to determine if dry needling is right for you.

Q: How painful is dry needling?

Most people describe dry needling as a mild to moderate sensation. You may feel a quick muscle twitch, a deep ache, or mild soreness afterward, similar to post-exercise soreness. Techniques can be modified to be gentler based on your comfort level.

Q: Is dry needling better than massage?

It depends on your condition. Dry needling can directly target acute, deep trigger points and dysfunctional muscles that massage may not always reach. For chronic pain, injuries, and stubborn muscle knots, dry needling can often produce faster, longer-lasting results compared to massage alone. With that said - dry needling and massage are complementary treatments that can work well together.

Q: How often should I get dry needling?

Most patients start with once per week until symptoms improve, then space sessions out as needed. Severe or chronic conditions may benefit from a series of 5–10 sessions. Your provider will customize a plan based on your goals and recovery speed.

Q: What is better than dry needling?

There is no "one size fits all" answer. For some, combining dry needling with manual therapy, corrective exercise, acupuncture, or electrostimulation produces even better results. An integrated approach often outperforms any single technique.

Q: Why do I feel worse after dry needling?

Feeling sore or slightly fatigued after dry needling is normal and temporary. It’s part of the body's inflammatory healing response. This soreness typically resolves within 24–72 hours and is often followed by improved mobility and reduced pain.

Q: Does dry needling get rid of inflammation?

Dry needling can help regulate local inflammation.
By improving blood flow, reducing muscle tightness, and signaling healing responses, it often decreases chronic low-grade inflammation in muscles and soft tissues over time.

Q: Who is a candidate for dry needling?

Good candidates include individuals with:

• Muscle pain or stiffness

• Trigger points ("knots")

• Sports injuries

• Tendonitis or tendinopathy

• Postural dysfunction

• Stress-related muscle tension 

Dry needling is highly customizable for athletes, active individuals, and those managing everyday pain.

Q: Does Blue Cross Blue Shield cover dry needling?

Coverage depends on your specific plan. Blue Cross Blue Shield may cover dry needling if it is billed under acupuncture services and you have out-of-network acupuncture benefits. Always check with your insurance company or ask us for help verifying your benefits.

Q: Why is dry needling illegal in NY?

Dry needling is not illegal in New York — but only licensed acupuncturists or physicians can legally perform it. It is illegal for physical therapists or chiropractors to offer dry needling without a license to practice acupuncture.

Q: How much does dry needling cost?

Dry needling costs typically range from $150 to $400 per session in NYC. Pricing may vary based on session length, treatment complexity, and provider expertise.

Q: Can dry needling cause damage?

When performed by a trained, licensed professional, dry needling is extremely safe. However, rare risks include:

• Minor bruising or bleeding

• Temporary soreness

• Very rarely, nerve irritation or pneumothorax (if performed improperly)

Choosing a qualified provider dramatically reduces risks.

Q: Are there any negatives to dry needling?

Possible drawbacks include:

• Temporary soreness

• Mild bruising

• Fatigue after treatment

• Very rare risk of nerve irritation

Most side effects are minor and self-limiting.

Q: Why do I feel sick after dry needling?

A small percentage of people experience a vasovagal response (temporary dizziness, nausea, or lightheadedness) after dry needling. This is usually mild and passes quickly. Proper hydration and post-treatment rest help prevent it.

Q: What happens if dry needling hits a nerve?

If a needle contacts a nerve, you might feel a sharp, electrical sensation.
This is usually temporary and not dangerous when performed properly. Trained providers can safely redirect the needle to avoid sustained nerve contact.

Q: How many minutes is dry needling?

Dry needling treatments usually last between 30–60 minutes, depending on the number of areas treated and the complexity of your condition.

Q: What is the alternative to dry needling?

Alternatives include:

• Manual trigger point release

• Deep tissue massage

• Cupping therapy

• Acupuncture

• Physical therapy exercises Each approach has unique benefits. Many patients benefit from combining dry needling with other therapies for comprehensive recovery.

Q: Can barely walk after dry needling?

If you feel extremely sore or stiff after dry needling, it’s usually a temporary response. If you have alot of work done in the hips, legs, and calf area, there may be soreness that makes your legs feel heavy like you did an intense workout. Gentle movement, hydration, light stretching, and heat can help ease symptoms. If soreness persists, follow up with your provider.

Conclusion

Dry needling and acupuncture are valuable tools in the management of muscle pain. Both techniques offer distinct benefits and can be used separately or in combination as part of a broader treatment plan. By understanding their mechanisms, safety protocols, and clinical applications, patients and clinicians can work together to achieve optimal pain relief and functional improvement. For additional information on treatment protocols and diagnostic approaches, please visit our Treatment and Management Options for Muscle Pain and Diagnostic Tools for Muscle Pain subpages.

Ready to Feel Better with Dry Needling?

At Morningside Acupuncture, we specialize in advanced acupuncture and dry needling techniques tailored to your needs — whether you're an athlete recovering from injury or simply seeking pain relief. Book Your Consultation Today!

Sources:

• Boyce, D., Wempe, H., Campbell, C., Fuehne, S., Zylstra, E., Smith, G., Wingard, C., & Jones, R. (2020). Adverse events associated with therapeutic dry needling. The International Journal of Sports Physical Therapy, 15(1), 103–104. https://doi.org/10.26603/ijspt20200103

• Chys, M., De Meulemeester, K., De Greef, I., Murillo, C., Kindt, W., Kouzouz, Y., Lescroart, B., & Cagnie, B. (2023). Clinical effectiveness of dry needling in patients with musculoskeletal pain—An umbrella review. Journal of Clinical Medicine, 12(3), 1205. https://doi.org/10.3390/jcm12031205

• Dommerholt, J. (2019). Needling: is there a point? [Editorial]. Journal of Manual & Manipulative Therapy. https://doi.org/10.1080/10669817.2019.1620049

• Shah, J. P., & Gilliams, E. A. (2008). Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: An application of muscle pain concepts to myofascial pain syndrome. Journal of Bodywork and Movement Therapies, 12, 371–384. https://doi.org/10.1016/j.jbmt.2008.06.006

• Travell, J. G., & Simons, D. G. (1983). Myofascial pain and dysfunction: The trigger point manual (2nd ed.). Williams & Wilkins.

• Wang, M., Zhao, T., Liu, J., & Luo, S. (2024). Global trends and performance of dry needling from 2004 to 2024: A bibliometric analysis. Frontiers in Neurology, 15, Article 1465983. https://doi.org/10.3389/fneur.2024.1465983