Dry needling works by placing a thin, solid needle into a tight band of muscle, called a myofascial trigger point, which often makes the muscle twitch briefly and then relax, and may reduce pain signals from that area. Soreness after dry needling is normal: most people feel a deep ache, like after a hard workout, that often eases within a day or two. At East Coast Injury Clinic in Jacksonville, dry needling is one part of a physical therapy plan, performed by our dry-needling-certified physical therapist, and you should call us for soreness that keeps getting worse or for any of the warning signs below.
Key facts
- Dry needling places a thin, solid (filiform) needle into a myofascial trigger point; no medication is injected.
- In Florida, a physical therapist needs 2 years of licensed practice, 50 hours of face-to-face continuing education with a competency determination, and 25 supervised patient sessions before dry needling (F.S. 486.117).
- Florida law does not allow a physical therapist to delegate dry needling to a physical therapist assistant.
- Research suggests moderate short-term evidence for dry needling in myofascial neck and shoulder pain.
- Needling over the chest wall carries a rare risk of a collapsed lung (pneumothorax).
What Is Dry Needling?
Dry needling is a treatment for muscle pain and tightness. The word “dry” means nothing is injected. The needle is a thin, solid filament, much finer than the hollow needle used for a shot or blood draw. The target is usually a myofascial trigger point: a tight, tender knot in a band of muscle that can cause local pain and pain that spreads, or refers, to another area. A trigger point in the upper trapezius, for example, can refer pain up the side of the neck and into the head.
Dry needling is not a stand-alone fix. It works as one part of a physical therapy plan with exercise and manual therapy.
Dry Needling: How Does It Work?
Researchers are still studying the exact mechanisms, but the main explanations include:
- The local twitch response. When the needle reaches an active trigger point, the muscle often gives a quick, involuntary twitch. That twitch is followed by a drop in muscle tension in many patients.
- Local blood flow and chemistry. Trigger points are thought to be areas of poor circulation and irritated tissue. Needling may change blood flow and the chemical environment in that spot.
- Nervous system effects. Needling appears to change how the spinal cord and brain process pain signals from the area, which may explain why pain relief can extend beyond the needle site.
What the research supports: dry needling has moderate short-term evidence for myofascial neck and shoulder pain. Longer-term results are less certain, which is another reason it is paired with exercise. Individual results vary.
Dry Needling vs. Acupuncture
From the outside, they look similar. Both use thin, solid needles. The differences are in the reasoning, the placement and the rules:
- Origin. Acupuncture comes from traditional Chinese medicine. Dry needling is based on Western anatomy, neurophysiology and the physical exam.
- Placement. Acupuncture points follow meridians. Dry needling targets trigger points and tight muscles that the therapist finds by feel and by testing your movement.
- Licensing. In Florida, acupuncture is licensed under its own chapter of law, while dry needling by a physical therapist falls under the physical therapy practice act (F.S. 486.117). Florida chiropractors may perform dry needling only after separate certification by the Board of Chiropractic Medicine.
Florida Rules on Who Can Dry Needle
Under F.S. 486.117, a Florida physical therapist must meet the training requirements in the Key facts above before dry needling, must get your consent and document a plan of care, and may not delegate dry needling to anyone other than a qualified physical therapist. That means physical therapist assistants and certified chiropractic physician assistants do not perform it. At our clinic, dry needling is done by our dry-needling-certified physical therapist.
What a Session Feels Like
Your therapist first evaluates your history, movement and tender areas to decide whether dry needling fits. Then the skin is cleaned and a single-use sterile needle is inserted. You may feel:
- A quick pinch as the needle goes in, or nothing at all
- A deep ache, pressure or heaviness in the muscle
- A brief twitch or cramp when the needle reaches a trigger point
- Pain that briefly shows up in the area it usually refers to
Tell your therapist if anything feels too intense. The session is usually followed by movement or exercise.
Soreness After Dry Needling: What Is Normal
Soreness after dry needling is the most common side effect. Normal after-effects include:
- A deep ache, like after a hard workout, in the treated muscles
- Soreness that is often strongest in the first day and eases over the next day or two
- Small bruises or a drop of blood at a needle site
- Feeling tired, or briefly lightheaded right after the session
- A temporary flare of your usual pain before it settles
Soreness may be stronger after your first session or when more muscles were treated. Gentle movement, your home exercises, and heat or ice as your therapist suggests usually help.
When to Call Us, and When to Go to the ER
Go to the ER or call 911 for shortness of breath, chest pain, or pain with breathing after needling of the chest, upper back, shoulder or neck. These can be signs of a collapsed lung, a rare but serious complication.
Call our office if you notice:
- Soreness that keeps getting worse after 2 or 3 days instead of better
- Redness, warmth, swelling or drainage at a needle site, or a fever
- New numbness, tingling or weakness
- A large or spreading bruise
- Fainting, or dizziness that does not pass after you sit and rest
Before treatment, tell your therapist if you are pregnant, take a blood thinner, have a bleeding disorder, a weakened immune system, a metal allergy, an infection or skin problem in the area, or a strong fear of needles. Dry needling may not be the right fit, and there are other ways to treat the same muscles.
Dry Needling in Jacksonville at East Coast Injury Clinic
We use dry needling within physical therapy for patients recovering from car accidents and work injuries, often for neck and upper back muscle pain after whiplash, headaches that start in tight neck muscles (see our headache care page), and shoulder, low back and hip muscle pain. It is combined with exercise and manual therapy, and our chiropractic and medical teams coordinate on the same plan.
We will be honest: dry needling helps some people more than others, and it is not the right tool for every patient. If it is not helping after a fair trial, your therapist will change the plan.
If you are recovering from a neck injury after a crash, our guide on how long whiplash lasts explains the usual recovery stages. If headaches are part of your recovery, see our guide to headaches after a car accident.
Coverage and Paying for Care
Coverage for dry needling in particular depends on your payer and plan, so ask our front desk to check before your first session rather than assuming it is covered.
Most injury care at East Coast Injury Clinic is covered through one of four paths: auto insurance PIP after a car accident, a personal injury attorney’s Letter of Protection, state workers’ compensation for a work injury, or federal workers’ compensation (OWCP or Longshore) if you are a federal or maritime employee. We also see patients under Medicare, Tricare, VA Community Care, and a limited number of private plans. Our front desk verifies coverage before your first visit and explains exactly what is and is not covered for your specific case, so there are no surprises. Call 904-513-3954 or visit eastcoastinjury.com to start.
Frequently Asked Questions
How long does soreness last after dry needling?
Soreness after dry needling usually feels like the ache after a hard workout and often eases within a day or two. It can be stronger after the first session or when a larger area was treated. Soreness that keeps getting worse after a few days, or that comes with the warning signs listed on this page, is a reason to call.
How does dry needling work?
A thin, solid needle is placed into a tight band of muscle called a myofascial trigger point. The muscle often responds with a brief twitch, then relaxes. Dry needling is thought to reduce local muscle tension and change how the nervous system processes pain in that area. Research is still working out the exact mechanisms.
What is the difference between dry needling and acupuncture?
Both use thin, solid needles. Acupuncture comes from traditional Chinese medicine and places needles along points and meridians. Dry needling is based on anatomy and a physical exam, targeting trigger points and tight muscles found during the evaluation. In Florida they are separate practices with separate licensing rules.
Does dry needling hurt?
You may feel a quick pinch as the needle goes in, then a deep ache, pressure or a brief muscle twitch or cramp. Most people find it tolerable. Tell your therapist if it is too intense; the depth, number of needles and time can be adjusted or the session stopped.
Who can perform dry needling in Florida?
Under F.S. 486.117, a Florida physical therapist must have at least 2 years of licensed practice, 50 hours of face-to-face continuing education with a competency determination, and 25 supervised patient sessions before performing dry needling. It may not be delegated to a physical therapist assistant. Florida chiropractors may perform dry needling only after separate Board certification.
Getting Care at Our Jacksonville Clinics
If you have tight, painful muscles after an injury, our physical therapy team can evaluate you and tell you honestly whether dry needling is likely to help. Dry needling is performed by our dry-needling-certified therapist, so ask when you book which clinic and day fit your schedule. You can be seen at our Southside clinic at 10550 Deerwood Park Blvd, Suite 609 (32256), near JTB and I-295, or at our North Jacksonville clinic at 13453 N Main St, Suite 302 (32218), north of I-295. Both clinics offer the same services and the same hours, Monday through Friday, 9 AM to 6 PM. Call (904) 513-3954 or request an appointment.
