Is Dry Needling Safe? Soreness, Risks and Who Should Wait

Yes, for most people. In trained hands, serious problems from dry needling are rare. Mild effects, such as soreness for a day or two or a small bruise, are common. A few situations call for waiting, or for telling your practitioner before the first needle goes in.

What the safety research shows

Dry needling is a specialized branch of acupuncture that requires additional training. It works directly in the muscle, with the same very fine, solid needles. A well-known prospective study followed 39 clinicians in Ireland who were trained in dry needling. Over ten months they recorded side effects across 7,629 treatments.

• Mild side effects came up in about 19 percent of treatments.
• The most common were bruising (7.6 percent), minor bleeding (4.7 percent), pain during treatment (3 percent) and pain afterward (2.2 percent).
• Less common were a flare of symptoms (0.9 percent), drowsiness (0.3 percent), and headache or nausea (about 0.1 percent each).
• There were no serious side effects. The authors put the risk of a serious event at 0.04 percent or less.

In plain terms, about one treatment in five came with something minor, usually a bruise or a drop of blood, and none came with anything serious.

What soreness is normal

Soreness is the side effect most people notice. The treated area can feel sore for a day or two, like after a hard workout. Light movement, water and heat usually help. I describe the sensations and the day after in What Does Dry Needling Feel Like?

Soreness that keeps getting worse after two days is not typical. Neither is spreading redness, warmth or swelling around a needle site, or a fever. Call me, and see your doctor if you feel unwell.

The rare, serious risks

The National Center for Complementary and Integrative Health, part of the NIH, notes that relatively few complications from acupuncture have been reported. When needling is not done properly, though, it can cause serious problems, including infections, punctured organs and injury to the central nervous system. Reported complications have come from nonsterile needles and poor technique.

Two things protect you. First, acupuncture needles in the United States are regulated as medical devices and must be sterile and labeled for single use only. Second, precise anatomy matters, especially over the ribs and near large nerves and blood vessels. That is where training and experience count most.

Who should wait or tell me first

An infection, rash or broken skin where I would treat. Wait until it heals. The UK's National Health Service lists a skin condition or skin infection as a reason acupuncture may not be safe, and the skin should be checked before any needling.

Blood thinners. Tell me first. A 2022 review concluded that taking blood thinners should not, on its own, rule out dry needling, as long as the plan accounts for it. It suggests asking about past bleeding, starting gently, avoiding deep muscles at first and pressing on each site longer afterward.

Pregnancy. Tell me if you are pregnant or might be. A review of 105 studies of acupuncture during pregnancy found few side effects when it was correctly applied, but pregnancy changes the plan, so I need to know.

Fainting with needles or blood draws. Say so. I go slowly, and you can rest before you leave.

See your doctor first if you have pain after a significant fall or accident; fever, chills or unexplained weight loss along with your pain; weakness, numbness or tingling that is spreading or getting worse; or new pain with a history of cancer. If you have any of these, contact your doctor or go to the nearest emergency department. My back pain and neck pain pages list the warning signs for each area.

How I keep treatment safe

Every treatment in my North New Hyde Park clinic is done by me. I am a Doctor of Acupuncture, licensed in New York State and board certified, with more than 18 years of dry needling experience, advanced certifications in dry needling and more than 40,000 documented dry needling visits. There are several ways to perform dry needling, and I choose the one that suits your body and your problem. I explain what I found and what I recommend before any treatment starts. I check in throughout the session and adjust to your comfort, and you can stop at any point.

If you are not sure what is causing your pain, try the My Symptoms tool.