Dry Needling: A Non-Pharmacologic Option for Pain Management

Deborah Rushing, DNP, FNP-C, RN

While medications remain essential for many conditions, nurses increasingly advocate for multimodal, non-pharmacologic strategies to reduce medication burden, adverse effects, and long-term dependence. One intervention gaining traction in rehabilitation and pain settings is dry needling. From a nursing perspective, dry needling aligns closely with holistic, client-centered pain care. Nurse educators can incorporate information about dry needling when teaching pain management, helping to expand students' understanding of complementary treatment options.

Dry needling with strategic needle insertion.

What Is Dry Needling?

Dry needling is a clinical technique that involves inserting a thin, solid filament needle into myofascial trigger points, taut muscle bands, or dysfunctional neuromuscular tissue. The term "dry" indicates that no medication or injectate is used. Dry needling targets the neuromuscular source of pain rather than masking symptoms and has been found beneficial for various areas of body pain, tension-type headaches, tendinopathies, and myofascial pain syndromes. It is based on Western anatomy, physiology, and pain science, not traditional Chinese medicine principles using acupuncture and meridian pathways.

How Does It Work?

Dry needling reduces pain through local tissue effects and central nervous system modulation. When the needle is inserted into a trigger point, it may elicit a local twitch response, a brief, involuntary muscle contraction. This twitch response reduces muscle tension, improves blood flow, and decreases chemical mediators associated with pain and inflammation. Dry needling also influences pain pathways by decreasing peripheral nociceptor sensitivity and enhancing endogenous pain-inhibitory mechanisms in the brain. Studies have shown that it can improve range of motion, lessen pain, and increase activity tolerance.

Who Can Perform Dry Needling?

While physical therapists most commonly perform dry needling, other healthcare professionals, such as nurses, physicians, or chiropractors, may also be qualified to provide this treatment. The ability to perform dry needling varies based on training and state regulations, which differ from state to state.

Safety and Client Education

Dry needling is generally safe when performed by a trained provider. However, clients may experience temporary soreness or bruising and mild fatigue after treatment. Clients with bleeding disorders, those using anticoagulants, pregnant individuals, or those who are immunocompromised need to discuss the risks and benefits with their primary provider before dry needling is performed.

Conclusion

Dry needling is a valuable tool in modern pain management. As a nurse educator, understanding this intervention enhances teaching of non-pharmacological pain management, interdisciplinary collaboration, and supports safer, less medication-dependent approaches to pain.

For additional information, please visit:

Rabanal-Rodríguez, G., Navarro-Santana, M. J., Valera-Calero, J. A., Gómez-Chiguano, G. F., Kocot-Kępska, M., Fernández-de-las-Peñas, C., & Plaza-Manzano, G. (2025). Neurophysiological effects of dry needling: A systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation. https://doi.org/10.1016/j.apmr.2025.08.019

Tolbert, M., Leach, K. S., Condo, M. P., Mancini, A., & Tinius, R. (2025). Patient‑perceived benefits and adverse events of dry needling. International Journal of Sports Physical Therapy, 20(9), 1355–1363. https://doi.org/10.26603/001c.143187

Valera-Calero, J. A., Plaza-Manzano, G., Rabanal-Rodríguez, G., Díaz-Arribas, M. J., Kobylarz, M. D., Buffet-García, J., Fernández-de-las-Peñas, C., & Navarro-Santana, M. J. (2024). Current state of dry needling practices: A comprehensive analysis on use, training, and safety. Medicina, 60(11), Article 1869. https://doi.org/10.3390/medicina60111869

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February 16, 2026