Who should avoid dry needling?

Author: Martina O'Keefe  |  Last update: Tuesday, December 2, 2025

Dry needling (DN) therapy should be avoided in patients under the following circumstances: Unwilling or unable to give consent due to fear, believes, communication, cognitive, age-related factors. Medical emergency or acute medical condition. Local infection.

Who is not a candidate for dry needling?

Dry needling may not be appropriate for everyone, particularly individuals with certain medical conditions or risk factors. For example, individuals with bleeding disorders, compromised immune systems, or a fear of needles may not be suitable candidates for dry needling.

Are there any dangers in dry needling?

Since dry needling involves a needle penetrating the skin, iatrogenic injury to vessels, nerves, spinal cord, internal organs, implanted devices, or infection are possible hazards for patients.

Who shouldn't get dry needling?

Dry needling is not for those with unmanaged blood-clotting or immune-system disorders. Plus, the American Physical Therapy Association does not recommend dry needling for children younger than 12. Always check with your medical provider or physical therapist if you have concerns.

What are the absolute contraindications for dry needling?

DN should not be administered in the following patient scenarios: 1) a patient with needle phobia; 2) an unwilling patient; 3) a patient who is unable or unwilling to give consent; 4) a patient with a history of abnormal reaction to needling or injection; 5) in a medical emergency; 6) a patient who is on anticoagulant ...

What Is Dry Needling?: Benefits And How Dry Needling Works

Why is dry needling prohibited?

As we know, dry needling targets the trigger points that are running closer to the nerves; there are chances that the needle may trigger the nerves accidentally. Such accidents may cause immediate pain and discomfort, nerve irritation or damage, inflammation and swelling, and potential complications.

What happens when dry needling hits a nerve?

When a needle grazes or “hits” a nerve during dry needling, you might feel a quick, sharp sensation. It's often described as a zapping or shooting feeling that travels along the nerve pathway. This happens because nerves are essentially your body's electrical wiring—they're designed to send signals to your brain.

When dry needling goes wrong?

So very rare 2 in 100,000 treatments. Nerve Damage: Nerve damage is a potential risk associated with dry needling. If a needle is inserted too deeply or into the wrong area, it can damage a nerve and cause pain, numbness, or tingling in the affected area.

What is better than dry needling?

There are several alternative treatments that may be more effective than dry needling, depending on your condition and preferences. Some of these alternatives include acupuncture, physical therapy, massage therapy, and chiropractic care.

How much does dry needling cost per session?

The average cost of dry needling is about $60 per session, and most physical therapists will recommend 3 to 6 sessions. However, this will usually be part of a treatment plan and used in conjunction with other services, so it may not be itemized in this way.

Why do I feel worse after dry needling?

Dry needling has the potential to temporarily increase pain in some patients, primarily due to the body's natural healing response, technique sensitivity, and individual pain thresholds. However, with proper technique, patient education, and post-treatment care, these adverse effects can be managed and minimized.

Does insurance cover dry needling?

The good news is that some insurance plans do cover dry needling, but there are limitations to this coverage. The types of insurance that may cover dry needling include health insurance. However, coverage may vary depending on the specific plan and the reason for seeking treatment.

Can dry needling cause blood clots?

If the needle pierces the blood vessel, there can be a droplet or two of blood that comes after the needle is removed. Generally, the blood clots quickly due to the small gauge of the needle and your blood's ability to clot.

Are there any negatives to dry needling?

It May Cause Muscle Soreness

Muscle soreness is a common side effect of dry needling. Dry needling can even make your body feel worse than before the treatment. It's important to know that your body might need to learn to respond better to treatment before you start to feel the benefits.

Who is not eligible for Microneedling?

Microneedling can cause bleeding so it may not be suitable for people with clotting or bleeding disorders, or who take medicine to thin their blood.

What is the age limit for dry needling?

Dry needle treatment is generally suitable for people of all ages and genders, but not for children under 12-15 years of age. Different diseases in the person do not constitute an obstacle to this treatment, and thanks to the minimum level of needle sensation, it can also be applied to those who are afraid of needles.

Do doctors recommend dry needling?

Dry needling is a safe technique for treating many musculoskeletal conditions, including shoulder pain, rotator cuff pain, biceps tendinitis, iliotibial band syndrome, Achilles tendinitis, low back pain, tennis elbow, whiplash or neck pain, headaches, muscle strains, hip pain and temporomandibular pain, also called TMJ ...

Does Medicare cover dry needling?

Medicare Part B covers up to 12 dry needling treatments in 90 days for cLBP. If the patient shows improvement, an additional 8 sessions may be covered, with a maximum of 20 treatments in a 12-month period [3].

How long should you rest after dry needling?

It is advisable to avoid intense physical activities or strenuous exercise 24 to 48 hours after a dry needling session.

Why do I feel sick after dry needling?

It is common to feel tired, nauseous, emotional, giggly or “loopy”, and/or somewhat “out of it” after treatment. This is a normal response that can last up to an hour or two after treatment. If this lasts beyond a day contact your provider as a precaution.

Should you drink a lot of water after dry needling?

Keep yourself hydrated

Drinking plenty of water is another way to reduce muscle soreness after dry needling, just like how keeping yourself hydrated after an intense workout session is essential.

What is an alternative to dry needling?

Joint mobilization — When it comes to tight fascia that's impacting the range of motion of your joints, such as in your shoulder, joint mobilization may be an effective alternative to dry needling. This manual therapy technique involves the physical therapist gently moving the joint in repeated movements.

Why did dry needling hurt so much?

We believe the primary reason that some patients report dry needling hurts more than acupuncture is that dry needling is typically performed in response to a particular injury. As such, the dry needling is very localized to an injured joint or source of pain, and typically those areas are more sensitive by default.

Is sciatica worse after dry needling?

Can dry needling make sciatica worse? While rare, some patients may experience temporary discomfort after treatment, but this usually subsides as the muscles adjust.

How do you tell if a needle hit a nerve?

Pain is the most frequent symptom of a nerve injury. It is usually described as a severe shooting or burning sensation at the injection site with radiation to the dorsum of the forearm and hand. Patients could also present numbness, paresthesia, hypoesthesia and other sensory disturbance.

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