If you have a persistent knot in your muscle that won’t release with massage, or a pattern of referred pain that follows a consistent route without a clear structural cause, dry needling may offer relief that other treatment hasn’t. At LPAW, dry needling is used by several of our physiotherapists as a targeted adjunct to physiotherapy treatment — not as a standalone alternative medicine approach, but as a clinical technique with a specific mechanism and specific indications.
Dry needling is available at both our Bow and Stratford East Village clinics.
Dry needling is a technique in which a thin, sterile acupuncture needle is inserted into a myofascial trigger point, a hypersensitive nodule within a taut band of skeletal muscle that generates local pain, referred pain, and restricted movement. The “dry” in the name distinguishes it from injection therapy: no substance is injected. The needle itself provides the stimulus.
Local twitch response when the needle contacts the trigger point, the muscle often produces a brief involuntary twitch. This is associated with a rapid normalisation of the abnormal electrical activity in the trigger point and relaxation of the taut band.
Neurophysiological effects needle insertion modulates pain signals in the spinal cord and brain, which contributes to pain relief beyond the immediate local effect.
Increased local circulation the controlled micro-trauma of needle insertion triggers a local healing response, improving blood flow and removing metabolic waste products that accumulate in ischaemic trigger points.
This is the most common question patients ask, and it’s a fair one — the needles look identical. The key differences are:
| Dry Needling | Acupuncture | |
|---|---|---|
| Framework | Western anatomical and neurophysiological model | Traditional Chinese Medicine meridian system |
| Target | Specific myofascial trigger points identified on physical examination | Acupoints along meridian channels |
| Evidence base | Peer-reviewed physiotherapy and sports medicine literature | Combination of TCM literature and Western research |
| Practitioners | Physiotherapists with post-graduate dry needling training | Registered acupuncturists, and some physios |
| Goal | Deactivate trigger points, reduce referred pain, restore muscle function | Broad range of outcomes within TCM framework |
| Dry Needling | Acupuncture |
|---|---|
| Framework | |
| Western anatomical and neurophysiological model | Traditional Chinese Medicine meridian system |
| Target | |
| Specific myofascial trigger points identified on physical examination | Acupoints along meridian channels |
| Evidence Base | |
| Peer-reviewed physiotherapy and sports medicine literature | Combination of TCM literature and Western research |
| Practitioners | |
| Physiotherapists with post-graduate dry needling training | Registered acupuncturists, and some physios |
| Goal | |
| Deactivate trigger points, reduce referred pain, restore muscle function | Broad range of outcomes within TCM framework |
Neither approach is superior in all contexts. Dry needling is specifically appropriate when the primary target is a myofascial trigger point identified through clinical examination. If you are interested in acupuncture as a broader therapeutic modality, we would direct you to a registered acupuncturist.
Dry needling is most effective for conditions where myofascial trigger points are a significant contributor to pain:
Neck and upper back:
Shoulder:
Lower back:
Lower limb:
Tennis and golfer’s elbow:
Jaw and face:
Dry needling is a technique in which a thin, sterile acupuncture needle is inserted into a myofascial trigger point, a hypersensitive nodule within a taut band of skeletal muscle that generates local pain, referred pain, and restricted movement. The “dry” in the name distinguishes it from injection therapy: no substance is injected. The needle itself provides the stimulus.
Local twitch response when the needle contacts the trigger point, the muscle often produces a brief involuntary twitch. This is associated with a rapid normalisation of the abnormal electrical activity in the trigger point and relaxation of the taut band.
Neurophysiological effects needle insertion modulates pain signals in the spinal cord and brain, which contributes to pain relief beyond the immediate local effect.
Increased local circulation the controlled micro-trauma of needle insertion triggers a local healing response, improving blood flow and removing metabolic waste products that accumulate in ischaemic trigger points.
Dry needling is performed with the same type of needle used in acupuncture — a fine, solid, monofilament needle, not a hollow injection needle. Sessions are quick, targeted, and typically integrated into a broader physiotherapy treatment appointment.
| Dry Needling | Acupuncture | |
|---|---|---|
| Framework | Western anatomical and neurophysiological model | Traditional Chinese Medicine meridian system |
| Target | Specific myofascial trigger points identified on physical examination | Acupoints along meridian channels |
| Evidence base | Peer-reviewed physiotherapy and sports medicine literature | Combination of TCM literature and Western research |
| Practitioners | Physiotherapists with post-graduate dry needling training | Registered acupuncturists, and some physios |
| Goal | Deactivate trigger points, reduce referred pain, restore muscle function | Broad range of outcomes within TCM framework |
Dry needling is almost always performed as part of a standard physiotherapy appointment, not as a separate dedicated session. Your physiotherapist will identify trigger points through palpation (feeling for the taut band and hypersensitive nodule) and confirm them with your feedback (trigger points typically produce a characteristic referred pain pattern when pressed).
Dry needling is most effective for conditions where myofascial trigger points are a significant contributor to pain:
Neck and upper back:
Shoulder:
Lower back:
Lower limb:
Tennis and golfer’s elbow:
Jaw and face:
LPAW’s clinical team includes 19 practitioners, many holding postgraduate qualifications from UCL, King’s College London, and Guy’s and St Thomas’. Lead clinician Mr Arjun Viswanath MSc, MCSP, MPPA – Co-Founder and Consultant Physiotherapist – brings 25+ years of NHS and private experience including BMI London Independent Hospital and Harley Street.
Every clinician joining LPAW completes a mandatory intensive shadowing placement with our Consultant Physiotherapist before seeing patients independently. This is not a standard practice at most clinics – it’s our way of maintaining clinical consistency across the team.
Priyanka Shah
Akshay Bangad
If dry needling is indicated as part of your treatment, it will typically be combined with one or more of the following: Sports Therapy, Physiotherapy, Osteopathy, or Manual Therapy. Your physiotherapist will advise which combination is most appropriate for your presentation.
Priyanka Shah
Akshay Bangad
If dry needling is indicated as part of your treatment, it will typically be combined with one or more of the following: Sports Therapy, Physiotherapy, Osteopathy, or Manual Therapy. Your physiotherapist will advise which combination is most appropriate for your presentation.
