Dry Needling
Reviewed by Andrew Schox, BSc(Hons) PGradDipPod MPod, October 2026
Dry needling is a treatment where a trained practitioner puts a thin, solid needle into a tender spot in a muscle. Nothing is injected. It is mostly used for muscle and tendon pain, and it has been looked at most for heel pain. The best-supported benefit is short-term pain relief, and it seems to work better alongside exercise than on its own. It suits some people more than others, and a few people should avoid it. Side effects are usually mild, such as soreness and bruising, but rare serious problems can happen.
What is it?
Dry needling is a treatment where a trained practitioner puts a thin, solid needle through your skin into a muscle or other soft tissue. Nothing is injected, which is why it is called "dry". The needle is usually aimed at sore spots in a muscle called myofascial trigger points (tight, tender knots in a band of muscle). The goal is to ease pain and help you move better.
How it relieves pain isn't clear. Ideas include less inflammation, better blood flow and less pressure inside the tissue, as well as changes in the body's pain chemicals. These are changes inside the body, not proof that the treatment helps. Trigger points can also be hard to pick out reliably, so some experts prefer to treat wider areas of muscle that aren't working well.
People disagree about whether dry needling is a separate treatment or a form of acupuncture.
What is it used for?
Dry needling is mainly used for muscle and tendon pain linked to trigger points. For foot problems, it is most often used for plantar fasciitis (also called plantar heel pain), which is pain under the heel from irritation of the thick band of tissue along the sole of your foot. It is usually added to exercise or other active care, not used on its own.
It is also used for neck, shoulder and low back pain, and for tennis elbow (pain on the outer side of the elbow). For a sore rotator cuff (the tendons around the shoulder), exercises alone may be a reasonable first step.
How strong the support is varies. It is moderate for plantar fasciitis and limited for the other conditions.
Is it right for me?
Dry needling may suit you if you have pain linked to tender spots in your muscles, or heel pain that hasn't settled, and you are happy to do exercises as well.
Some people shouldn't have it. These include:
- people who can't give informed consent (for example because of age, memory or thinking problems, or difficulty communicating)
- people in the first three months of pregnancy, or with a high-risk pregnancy
- people with a severe fear of needles
- people with an active infection, including a sore or infection in the skin where the needle would go
- people with sepsis (a life-threatening reaction to infection), or with diabetes that isn't well controlled
- people with an allergy to stainless steel
- people with symptoms that haven't been explained
Other things call for extra care, not a ban. Your podiatrist may adjust the method or ask you to see a doctor first. Tell them if you:
- take blood thinners or have a bleeding problem
- have weakened immunity or take medicines that lower it
- have diabetes
- have a pacemaker or similar heart device
- have a metal allergy
- have fainted during a needle procedure before, such as a blood test
Advice on blood thinners isn't consistent, so don't stop any prescribed medicine yourself. Talk to the doctor who prescribes it and to your podiatrist. If you have diabetes and foot pain, check with your GP before having the lower leg or foot needled, because reduced feeling, poor circulation and infection risk need care.
Your podiatrist should look at the whole picture, not only where it is tender. Some problems, such as an early kidney infection, can feel like muscle pain, and these need a doctor's assessment first.
What happens?
Your podiatrist will ask about your health and medicines, check your skin, and explain the risks. You will be asked to agree to treatment before it starts.
A thin needle is then put into a sore part of the muscle. It is left in for a few minutes and may be moved gently to make the muscle twitch. Sometimes a small electrical current is added. Exercise or hands-on treatment is often given as well, and this seems to improve results.
How many sessions you need isn't clear yet. Your podiatrist should be able to tell you how many they plan and when they will review how you are going.
Needling the chest, upper back or neck, and other high-risk areas such as near major nerves and blood vessels, needs specific training. In deeper or higher-risk areas, practitioners are advised to place needles cautiously.
How well does it work?
The best-supported benefit is short-term pain relief. For heel pain, adding dry needling to a home exercise program gave clearer short-term pain relief than the exercises alone. It may take at least a month to take effect. From about a month on, people who had it tended to have less pain and better foot function than those who didn't.
The benefit isn't always large. In one measure of heel pain, dry needling relieved pain more than a fake (sham) needle, but the difference was smaller than the smallest change that would matter in daily life. Another finding was that pain wasn't clearly different from other treatments, though foot function was better.
For neck, shoulder and low back pain, dry needling gives short-term pain relief but is generally no better than other common treatments such as exercise. It isn't yet clear whether the benefit goes beyond a placebo effect (the good response some people have just from being treated). Dry needling is also linked to better movement and muscle strength.
Risks and side effects
Dry needling is an invasive treatment, so it carries some risk. Most side effects are mild and settle by themselves. They include pain during the treatment, soreness afterwards, bleeding and bruising.
Rare serious problems can happen. Needling around the chest or upper back can cause a collapsed lung. A skilled practitioner who knows the anatomy can avoid this. If you take medicines that weaken your immunity, infection is a higher risk, so extra care is needed.
Because other treatments may work as well with fewer risks, it is worth weighing the possible benefit against the risks with your podiatrist.
Afterwards
Expect some soreness or bruising for a while. Tell your podiatrist if it is more than you expected.
Keep up the exercises your podiatrist gives you. Dry needling works best as part of a plan with exercise, and moving and exercising is not harmful for your foot and ankle joints.
Agree on a review point before you start. If nothing has meaningfully changed by then, ask your podiatrist to rethink the plan rather than carrying on the same way. Pain relief from dry needling is mainly short-term and may not last beyond 6 months.
When to see a podiatrist
Book an appointment if
Book an appointment with your podiatrist or GP if your heel or foot pain hasn't improved within 2 weeks of looking after it yourself, or if you've had dry needling and the soreness is more than you expected or you aren't getting any meaningful change after the review point you agreed.
Seek prompt assessment if
Call your local emergency number if you get chest pain or trouble breathing after dry needling, especially if the needles went near your chest or upper back. This needs urgent medical assessment: see your GP today, or go to an urgent care clinic or the nearest emergency department, if you have a hot, red, swollen, painful foot or ankle with a fever; if you have diabetes and an open wound, ulcer or hot swollen foot; or if after needling you have signs of infection or symptoms that are unusual or getting worse. Don't wait for dry needling to work.
Frequently asked questions
Does dry needling hurt?
Some people feel pain during the treatment, and the muscle may twitch when the needle reaches a sore spot. Soreness afterwards is common. Tell your podiatrist straight away if you feel unwell, or if you need to cough, sneeze or move, so the needle can be dealt with safely.
Who can do dry needling?
It should be done by a trained practitioner who knows the anatomy of the area and is working within their scope of practice. It is fine to ask your podiatrist about their training in dry needling before you agree to treatment. High-risk areas such as the chest, neck and pelvic floor need specific training.
What should I ask my podiatrist before starting?
Ask them to explain in plain words what they will do, where the needle will go and why. Ask what result to expect and when you will review it, and whether it is part of a plan that includes exercise. Ask what the other options are, such as exercise on its own, and how they would judge whether it is helping.