Dry needling for headaches is a procedure that involves inserting thin needles into tight areas of muscle. It may help relieve headaches.

Dry needling targets tight areas of muscle in the upper back, neck, and head area that may be contributing to headaches or migraine.

This article considers the research behind dry needling for headaches, as well as its potential benefits and risks.

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Dry needling is a physical therapy in which a practitioner inserts threadlike, thin needles into muscle trigger points or soft tissue.

Dry needling for headaches aims to release muscle tension around the head and neck area to reduce headache pain intensity.

A practitioner can alter the depth of needle insertion to stimulate tissue or target trigger points. Trigger points are painful knots within a tight band of muscle.

Inserting the needle into a trigger point may create an involuntary twitch, or contraction, of the trigger point that may alter the perceived pain sensation and reduce inflammatory chemicals, helping to relax the trigger point.

Dry needling vs. acupuncture

Dry needling is a type of acupuncture procedure.

However, while dry needling and acupuncture both use the same needles, locations, and often the same techniques, they differ in the length of training of the practitioners and the terminology they use to explain their therapy.

Dry needling does not require a license to practice and involves less training. For this reason, some groups, such as the American Medical Association (AMA), wish to limit the use of dry needling to professionals with appropriate training.

As a result, some states prohibit the use of dry needling. These include California (CA), Oregon (OR), Washington, and New York.

According to a 2020 study, trigger points in the area where the skull joins the spine may contribute to migraine symptoms and pain.

Muscle tension in the upper muscles of the back, shoulders, and neck may also contribute to migraine.

Dry needling may help reduce pain and range of motion and may reduce the intensity, duration, and frequency of headaches.

However, a 2021 journal article found that dry needling is only conclusively effective for the short-term relief of tension headaches.

It is best for a person to discuss dry needling with a medical professional to determine if it is suitable for them.

According to a 2021 systematic review, dry needling appears to be a safe therapy. However, the procedure may have some risks that people will need to be aware of before undergoing treatment.

A 2020 study notes that major risks with dry needling are rare but may include:

According to case studies from 2018 and 2019, another risk of dry needling is pneumothorax, or a collapsed lung.

A 2021 systematic review looked at how effective dry needling is for pain intensity and headache-related disability in people with migraine, tension-type headaches, or cervicogenic headaches.

The review found that the research so far suggests dry needling is no better than other treatments in reducing headache pain intensity in the short term.

For tension-type headaches and cervicogenic headaches, dry needling may be more effective than other treatments at improving headache-related disability in the short term.

The review notes that this evidence is low quality, and researchers require further high quality studies to fully understand the effectiveness of dry needling for headaches.

People can consult a physical therapist, licensed acupuncturist, or medical doctor for dry needling. It is best to look for someone with experience and training in dry needling, specifically for treating headaches and migraine.

However, people may not be able to access dry needling from physical therapists in certain areas. Laws in California (CA), Oregon (OR), Washington, and New York prohibit physical therapists from performing dry needling.

These states have the highest population of acupuncturists in the United States. Some acupuncturists argue that experts with adequate training should only perform dry needling and that physical therapists do not receive enough training in the procedure.

For example, the training standards for physical therapists may be lower than that of doctors and acupuncturists.

Therefore, it may be best for a person to contact a licensed acupuncturist or doctor about dry needling for headaches.

The American Physical Therapy Association provides a map that shows which states allow physical therapists to perform dry needling.

This section answers some common questions about dry needling and headaches.

Who should not get dry needling?

According to 2022 research, dry needling is not suitable during the first trimester of pregnancy or for children under 12 years old.

Dry needling may also not be suitable for people with:

  • a local or widespread infection
  • swelling in the area of treatment
  • vascular disease
  • a compromised immune system
  • significant cognitive impairment, which may result in a lack of understanding of the procedure
  • a needle phobia

If people have a medical condition or are taking any medications, such as blood-thinning drugs, they will need to check with a healthcare professional if dry needling is safe for them.

How long will it take for dry needling to work?

According to a 2020 study, research reports that people may experience a reduction in headache symptoms immediately after treatment to target trigger points.

In a small-scale 2020 study, treatment for cervicogenic headache over four dry needling sessions significantly improved headache intensity, frequency, and duration in the follow-up 2 weeks after treatment.

What are the negative side effects of dry needling?

Potential adverse side effects of dry needling may include:

  • bruising
  • bleeding
  • pain during and after the procedure

Reports of side effects also include fainting and nausea, which may affect people if they have a fear of needles or injections.

What happens when dry needling hits a nerve?

Injury to a nerve is a potential risk of dry needling, although this is rare.

According to a 2021 article, if a needle hits a nerve during dry needling, it may cause neuropraxia, which is a mild form of peripheral nerve damage.

People will usually recover from mild nerve damage within a few days or weeks.

People may experience a sharp, electrical sensation if a needle hits a nerve. Other symptoms may include tingling, numbness, pain, or loss of sensation.

Dry needling for headaches uses very fine needles to target trigger points in the upper back, shoulder, neck, and head area that may be contributing to headaches or migraine.

People can consult a licensed acupuncturist or medical doctor for dry needling. A person can also contact a physical therapist for the procedure, but some states prohibit this profession from practicing dry needling.

Although research suggests dry needling is generally safe, people may experience some side effects, such as bruising, bleeding, or short-term pain. Severe side effects may include infection, injury to blood vessels, or nerve damage.

If people are taking any medications, such as blood thinners, or have a medical disorder, such as a vascular condition, it is best to consult a healthcare professional before undergoing dry needling.