Disclosure: As a BetterHelp affiliate, we receive compensation from BetterHelp if you purchase products or services through the links provided.

Massage therapy and dry needling are two distinct therapeutic approaches that share common goals: alleviating pain, promoting healing, and enhancing overall well-being. While massage therapists primarily use hands-on techniques to manipulate soft tissues, dry needling involves the insertion of thin needles into muscle trigger points to relieve muscle pain and tension. 

In this article, we will explore the practice of dry needling, its benefits, and whether massage therapists can legally and effectively incorporate dry needling into their treatments. Additionally, we’ll explore the training and qualifications necessary for practitioners interested in adding this technique to their repertoire.

Dry Needling: A Therapeutic Technique

Dry needling is a therapeutic technique used to relieve muscle pain and improve range of motion. It involves the insertion of thin needles (typically acupuncture needles) into specific trigger points within muscles.

These trigger points, also known as myofascial trigger points, are tight knots of muscle fibers that can cause pain, muscle dysfunction, and restricted movement. 

The precise insertion of needles into these trigger points can stimulate a healing response, relax muscle tension, and promote pain relief.

Dry needling is often used in conjunction with other therapeutic modalities, such as physical therapy, chiropractic care, or massage therapy. This combination allows for a holistic approach to addressing pain and dysfunction. 

For example, a patient may receive dry needling to alleviate muscle tension and pain, followed by physical therapy exercises to improve strength and flexibility.

An essential aspect of dry needling is its individualized approach. Practitioners assess each patient’s specific needs, identifying trigger points and designing a treatment plan tailored to their condition. This personalized approach ensures that the therapy targets the root causes of the patient’s pain and dysfunction.

How Does Dry Needling Work?

Dry needling is based on the principles of neurophysiology and Western anatomy. When a needle is inserted into a trigger point, it can have several effects:

1. Pain Relief: When a skilled practitioner inserts a thin needle into a trigger point, it stimulates sensory nerve fibers in the area. These nerve fibers relay signals to the brain, which then releases endorphins, the body’s natural painkillers. The increase in endorphin levels can significantly reduce pain perception, offering relief to the client.

2. Muscle Relaxation: The presence of the needle in the trigger point encourages the muscle to relax. Muscles often become tense and tight due to trigger points, and this tension can contribute to pain and restricted movement. 

By targeting these points, dry needling helps release muscle tension, allowing the muscle to return to its natural, relaxed state.

3. Improved Blood Flow: The insertion of needles into the muscle triggers a localized increase in blood circulation. This heightened blood flow delivers oxygen and essential nutrients to the treated area, facilitating the healing process. 

Additionally, it helps remove waste products and toxins that may have accumulated in the muscle tissue, further contributing to pain relief and improved muscle function.

4. Reduced Irritation: Trigger points often coincide with areas of inflammation and irritation. Dry needling can effectively reduce this inflammation by promoting circulation and facilitating the body’s natural healing processes. This reduction in irritation contributes to the overall relief experienced by clients.

Goals of Dry Needling

Image Credit: limitless-physical-therapy.com

One of the primary goals of dry needling is to alleviate pain and restore normal function. This technique has shown promising results in various conditions, including:

1. Musculoskeletal Pain: Dry needling is commonly used to treat musculoskeletal pain, such as neck pain, back pain, and shoulder pain. Combined with physical therapy, it can help relieve chronic tension and discomfort in these areas.

2. Sports Injuries: Athletes often turn to dry needling to address sports-related injuries like muscle strains or overuse injuries. By targeting trigger points, it aids in the rehabilitation process.

3. Headaches: Some tension-type headaches and migraines may be linked to muscle tension in the neck and upper back. Dry needling can be beneficial in reducing the frequency and severity of these headaches.

4. Chronic Pain Conditions: Individuals with chronic pain conditions, such as fibromyalgia or myofascial pain syndrome, may find relief through dry needling sessions that target their trigger points.

Dry Needling vs. Acupuncture

It’s essential to distinguish dry needling from acupuncture, as they share the use of needles but have different underlying principles and objectives.

Acupuncture is rooted in traditional Chinese medicine and focuses on rebalancing the body’s energy flow, known as Qi. Acupuncturists use a system of meridians and points along these meridians to treat a wide range of conditions.

Dry needling, on the other hand, is firmly grounded in Western medicine. It primarily targets myofascial trigger points to alleviate muscle pain and dysfunction. While both practices employ thin needles, their philosophies, diagnostic methods, and treatment goals are distinct.

Who Can Perform Dry Needling?

The practice of dry needling is a subject of regulatory variation depending on the location and the profession of the practitioner. In the United States, for instance, regulations surrounding dry needling can differ from state to state. 

Licensed healthcare professionals such as physical therapists, chiropractors, and medical doctors are often permitted to perform dry needling, provided they have received the necessary training.

Training and Certification for Dry Needling

To perform dry needling, healthcare professionals typically undergo specialized education and training. While requirements can vary, certain commonalities exist:

1. Basic Healthcare Licensure: Most states require practitioners to hold a basic healthcare license, such as that of a physical therapist or chiropractor.

2. Dry Needling Courses: Completion of accredited dry needling courses is essential. These courses cover relevant anatomy, needling techniques, safety protocols, and hands-on practice.

3. Clinical Training: Practical experience is crucial. Many courses include clinical components where practitioners apply their knowledge under supervision.

4. Certification: Some states may require certification in dry needling as a condition of practice.

Can Massage Therapists Perform Dry Needling?

While the practice of dry needling is typically associated with healthcare professionals, there has been a growing interest in whether massage therapists can incorporate this technique into their services. 

The permissibility of massage therapists performing dry needling varies widely based on jurisdiction, state regulations, and the therapist’s qualifications.

Massage Therapists can perform dry needling, provided they meet specific qualifications and requirements. To practice dry needling, massage therapists must have the necessary qualifications and be a member of a governing body. 

Those who have already attained a Level 4 qualification in Massage Therapy, which includes an anatomy module, have a solid foundation to pursue Dry Needling. They can further qualify by undertaking a specific Continuing Professional Development (CPD) course in Dry Needling.

For massage therapists without the Level 4 qualification, an alternative route involves enrolling in a 3-year relevant degree course. 

This comprehensive program not only equips them with the skills and knowledge required for dry needling but also allows them to use the protected term “Acupuncturist.” This route provides a more extensive education and professional recognition

Training and Certification for Massage Therapists

Massage therapists interested in incorporating dry needling into their practice should consider the following steps:

1. Check State Regulations: Understand the specific regulations governing massage therapy and dry needling in your state.

2. Enroll in Accredited Courses: Seek out accredited dry-needling courses designed for massage therapists. These courses should provide comprehensive training in anatomy, needling techniques, safety, and hands-on practice.

3. Obtain Certification: If required by your state, pursue certification in dry needling after completing the necessary training.

4. Collaborate with Other Professionals: Consider collaborating with licensed healthcare professionals who are authorized to perform dry needling to ensure the best possible care for your clients.

Benefits and Considerations

When used together strategically, massage therapy and dry needling can offer numerous benefits for clients:

1. Comprehensive Pain Relief: This combined approach can address both muscular tension and myofascial trigger points, providing more comprehensive pain relief.

2. Improved Range of Motion: Clients with limited range of motion due to muscle tightness or trigger points may find greater improvement through the synergy of these techniques.

3. Enhanced Well-Being: Clients often report enhanced relaxation and well-being when both massage and dry needling are incorporated into their treatment plans.

Client Safety and Informed Consent

Client safety is of paramount importance when considering the combination of massage therapy and dry needling. Practitioners must adhere to strict safety protocols and ensure that clients are well-informed and actively involved in their treatment decisions. Here are essential considerations in this regard:

1. Thorough Assessment: Prior to any treatment, massage therapists must conduct a thorough assessment of the client’s medical history, current health status, and any preexisting conditions.

This assessment helps identify contraindications and ensures that dry needling is an appropriate treatment option.

2. Informed Consent: Informed consent is a fundamental ethical principle in healthcare. Practitioners must clearly explain the nature of dry needling, its potential benefits, risks, and alternatives to clients.

Clients should be provided with an opportunity to ask questions and express any concerns before giving their informed consent to proceed.

3. Client Education: It is incumbent upon the practitioner to educate the client about what to expect during the dry needling session. This includes describing the sensation of needle insertion, potential discomfort, and the expected therapeutic outcomes. Realistic expectations should be set to avoid any misconceptions.

4. Choice and Autonomy: Clients have the right to choose whether they wish to incorporate dry needling into their massage therapy sessions. Practitioners should respect the client’s autonomy in making this decision and not pressure them into trying the technique if they are uncomfortable.

5. Safety Precautions: Massage therapists performing dry needling should strictly adhere to safety precautions, including using sterile needles for each session. Proper hand hygiene and skin disinfection are crucial to prevent infection.

6. Monitoring and Feedback: During the dry needling session, practitioners should continuously monitor the client’s comfort level and inquire about any discomfort or adverse effects. Open communication is essential, and clients should feel comfortable expressing their sensations.

7. Emergency Preparedness: While complications from dry needling are rare, practitioners must be prepared for any unforeseen adverse reactions, such as fainting or excessive bleeding. Adequate training should include emergency response protocols.

8. Post-Treatment Care: After a combined massage therapy and dry needling session, practitioners should provide clients with post-treatment care instructions. This may include guidance on managing potential soreness, staying hydrated, and monitoring for any delayed reactions.

9. Documentation: Detailed records of each session, including the specific techniques used, client responses, and any adverse events, should be meticulously documented. This documentation serves as a reference for future sessions and ensures continuity of care.

10. Continuing Education: To maintain safety and efficacy in their practice, massage therapists should pursue continuing education related to dry needling. Staying updated on the latest techniques, research, and safety guidelines is essential.


While the practice of dry needling is traditionally associated with licensed healthcare professionals, some states permit qualified massage therapists to incorporate this technique into their services. The permissibility and requirements for massage therapists to perform dry needling vary by location and state regulations. 

For massage therapists interested in offering dry needling, comprehensive training, certification, and a clear understanding of state laws are essential.

The combination of massage therapy and dry needling can provide clients with a well-rounded approach to pain relief and improved muscular health when performed by qualified and licensed practitioners. 

It is crucial for both practitioners and clients to prioritize safety and open communication throughout the treatment process.


1. Is Dry Needling the same as Acupuncture?

No, they are distinct practices. While both involve the insertion of thin needles into the body, Dry Needling is primarily focused on releasing trigger points and musculoskeletal issues, while Acupuncture is rooted in traditional Chinese medicine and aims to balance the body’s energy flow or “qi.”

2. Is Dry Needling covered by insurance?

Coverage can vary depending on your location and insurance provider. Some health insurance plans may cover Dry Needling when performed by qualified healthcare professionals, while others may not. It’s advisable to check with your insurance company to determine coverage.

3. Are there any side effects of Dry Needling?

Common side effects of Dry Needling may include temporary soreness, bruising, or minor bleeding at the needle insertion site. Serious adverse effects are rare when performed by a qualified practitioner.

4. How many Dry Needling sessions are typically needed?

The number of sessions required varies based on individual needs and the specific condition being treated. Some people experience relief after just one session, while others may need several sessions for more chronic issues. Your therapist will discuss a personalized treatment plan with you.

5. Can Dry Needling help with conditions other than musculoskeletal pain?

While Dry Needling is primarily used for musculoskeletal issues, some practitioners have reported positive outcomes in managing certain neurological and chronic pain conditions. However, it’s essential to consult with a qualified therapist for an accurate assessment and treatment plan.

6. Is Dry Needling painful?

Sensations during Dry Needling can vary from person to person. While some individuals may experience minimal discomfort, others may feel a brief, sharp sensation followed by muscle relaxation. Your therapist will aim to keep you as comfortable as possible during the procedure.

Additional Posts:

  1. How To Find a Therapist For Dissociative Identity Disorder
  2. What is a Developmental Therapist
  3. Should Your Individual Therapist Be Your Couples Therapist
  4. Can Multaq Cause Anxiety
  5. Best Therapists in Kansas City



Therapists that Understand You!

Find a therapist that fully understands ALL of you. Speaking with someone who has a similar cultural background and view on the world can be very comforting.

Find a Therapist that get YOU!