Dry Needling & Electro-Needling (E-Stim) – Release, reset, and restore.
Dry Needling and Electro-Dry Needling (also called “E-Stim”) are advanced therapeutic techniques that I use to help relieve musculoskeletal pain and tension.
These methods involve inserting very fine, sterile needles into specific points in your muscles – often those tight “knots” known as myofascial trigger points – to stimulate a healing response.
Electro-Needling (or E-Stim) takes the process a step further by delivering a gentle electrical current through the needles, often at levels below the ability to perceive them.
Both approaches are backed by modern medical science and clinical research, and I integrate them into remedial massage or myotherapy sessions when appropriate to target pain at its source and speed up your recovery.
In simple terms, dry needling aims to reset over-tight muscles from within. Think of it like rebooting your computer to solve a glitch. The needles mechanically interrupt the nerve signal to the muscle, forcing a re-set.
The needle creates a tiny therapeutic injury in the muscle, prompting increased blood flow and encouraging the fibres to relax. You might feel a brief twitch – that’s a good sign, indicating a trigger point has been stimulated and is releasing.
Many people notice their muscle ache or tight spot easing up shortly after. When we add Electro-Needling, the mild electrical pulses cause the muscle to contract and relax in a controlled way, further enhancing the release. This added stimulation can improve circulation and activate your body’s natural pain-relief mechanisms in the nervous system. E-stim is a fantastic way to relax chronically or stubbornly tight muscles.
In fact, using electrical current with the needles can produce therapeutic muscle twitches with less tissue irritation and soreness afterward, when compared with straight dry needling.
Okay cool but what is dry needling?
Is it the same as acupuncture? Not really.
It is similar to but different from acupuncture. We use the same needles, but that’s where the similarity begins and ends. Where acupuncture works with meridians and chi/qi, dry needling is more focused on the physical structures and nervous system. Acupuncture comes from an East Asian tradition thousands of years old; dry needling was developed within Western biomedicine during the last 50 years.
Dry needling technique involves inserting thin filament needles (I use 0.25 to 0.3 mm guage) into trigger points – tender nodules within taut bands in your muscles – to alleviate pain and improve function. It’s called “dry” because no “wet” liquid medication is injected; the needle itself is the treatment and simply stimulates the tissue.
The goal is to provoke a small response in the muscle – often a twitch – which helps reset electrical activity where the nerve meets the muscle, releasing the tight knot.
Reduced pain and better flexibility
This often leads to a reduction in pain and improved flexibility in that area. For instance, if you have a very stiff neck with tender spots, dry needling those points can help loosen the muscle and reduce referred pain (like tension headaches). The technique is rooted in Western anatomy and physiology: we identify trigger points based on your pain pattern and musculoskeletal exam, then target them directly. It’s important to clarify that dry needling is not the same as acupuncture, even though the tools (fine needles) are similar. Acupuncture is a distinct practice based on Traditional Chinese Medicine, focusing on restoring the flow of “Qi” along meridians and treating a broad range of ailments (from internal issues to stress). Dry needling, by contrast, is based on modern biomedical understandings of muscle trigger points and nerve pathways.
As a Clinical Myotherapist, I use it specifically to treat muscle pain and movement problems. In other words, acupuncture treats the person’s overall energy balance and can address many conditions, whereas dry needling is a precise, localised intervention for musculoskeletal problems – for example, releasing a knotted shoulder muscle or calming an overactive hip flexor. Dry needling is also typically just one part of your treatment plan, rather than a stand-alone therapy
In my practice, I almost always combine dry needling with other techniques like massage, stretching, or exercise therapy to get the best results for you.
When a needle hits a sensitive trigger point, you may feel a quick twitch or a mild aching sensation. This is normal and usually very brief. After the needle is removed, that spot often feels less tense than before. Many of my clients describe a sensation of release or relief in the area, sometimes almost immediately. It’s not unusual for range of motion to improve as well – for example, you might find you can turn your head further, or lift your arm higher, after dry needling has relaxed a previously tight muscle.
What is Electro-Needling (E-Stim)?
Electro-Needling (also known as intramuscular electrical stimulation, or IMS) involves applying a low-frequency electrical current to the needles while they are in place. I do this by attaching small electrode clips to one or more acupuncture-style needles after insertion. The current is very gentle – you’ll feel it as a mild buzzing, tapping, or tingling in the muscle. This causes the muscle fibres to contract and relax rhythmically. The idea is to amplify the effects of dry needling: the repeated muscle contractions can help further loosen the knot, increase blood flow in and around the muscle, and stimulate the nervous system for pain relief.
Essentially, we’re boosting the needle’s therapeutic impact with electrical energy. From a physiological perspective, electro-needling can produce effects similar to a deep tissue massage or a TENS machine, but targeted right at the problem spot. The continuous gentle pulsing encourages the muscle to “let go” even more than a single needle alone might do. It also triggers the release of endorphins and engages central pain inhibition pathways – one study noted electrical needling activated areas in the brainstem that help dampen pain signals.
Research shows that adding electrical stimulation can improve outcomes in stubborn or chronic cases. For example, in a trial with people suffering chronic neck pain, those who received dry needling with E-stim had greater pain reduction and less post-treatment soreness than those who received dry needling alone.
By using electro-needling, we can sometimes achieve pain relief faster or make the relief last longer. I might suggest E-stim for you if we find that standard dry needling gives only temporary benefit, or if a muscle is particularly tight and not responding fully to manual methods. It’s like giving the muscle a series of gentle reminders to reset itself. Clients often ask how electro-needling feels compared to regular dry needling.
Surprisingly, many find it very tolerable – sometimes even easier, because the steady pulsing can feel oddly soothing after a few moments. I always start with a very low intensity and can adjust the strength and frequency of the pulses to a level you’re comfortable with. You remain in control: if the sensation ever feels too strong or unpleasant, let me know and I will dial it down or stop it. The goal is a strong but comfortable twitch, not pain. Most people describe it as a weird but not painful feeling – and they love the looseness in their muscle afterward.
Why Do We Use These Techniques?
I incorporate dry needling (and electro-needling when indicated) to address specific musculoskeletal issues that are contributing to your pain or movement dysfunction. Common reasons I might use dry needling include: reducing muscle spasm or tightness, releasing myofascial trigger points, and treating deep-seated muscle knots that are hard to fully relieve with hands-on pressure alone. For instance, if you have chronic tension in your upper trapezius (the muscle between your neck and shoulder) causing headaches or restricted neck movement, a dry needle can directly deactivate the trigger point in that muscle band. If you’re suffering from lower back pain with taut muscle bands or “knots” in your glutes or hips, needling those spots can help relax the area and reduce the ache. For athletes or anyone with sports injuries, dry needling can be great for speeding up recovery from strained muscles or resolving persistent tightness after intense training (hence its popularity in sports massage and physiotherapy circles). Scientific studies have shown dry needling to be beneficial across a wide range of conditions – from neck and shoulder pain to knee osteoarthritis and plantar fasciitis.
It’s been used successfully for tension headaches, tennis elbow, shin splints, piriformis syndrome, and many other myofascial pain syndromes. Essentially, any situation where a muscle’s taut band or trigger point is a key player in your pain, dry needling is on the table as a potential tool. I always perform a thorough assessment to determine if your condition has a myofascial trigger point component that needling could help. If your pain is coming from active trigger points, you’re likely a good candidate. Electro-needling, similarly, is chosen for particular scenarios. I might suggest using E-stim with the needles if you have a very chronic condition or nerve-related component to your pain that could benefit from extra stimulation. Because the electrical current can stimulate nerve fibers and enhance the release of pain-relieving chemicals, it’s sometimes used for neuropathic pain or stubborn pain that hasn’t responded to manual therapy alone. For example, in long-standing low back pain or a chronic tendon issue, a few minutes of electro-needling can provide a potent analgesic effect and even help “wake up” inhibited muscles. Research reviews indicate that combining dry needling with other therapies generally yields better outcomes than those therapies alone.
So, adding a modality like E-stim can further boost the overall treatment effect. My priority is always to choose the technique (or combination of techniques) that will best accelerate your healing. If I propose dry needling or E-stim, I will explain exactly why I think it’s appropriate for your case – whether it’s to settle down a persistent trigger point, break a pain cycle, or activate a lazy muscle as part of your rehab.
Integration into Your Treatment Plan
Think of dry needling and electro-needling as adjuncts to the hands-on remedial massage and movement therapy you’re already receiving. They are not a replacement for massage or exercise, but rather one more tool in our toolkit. During a typical session, I might begin with massage techniques to warm up and assess your soft tissues. If I find a particularly stubborn knot or a trigger point referring pain, I may suggest trying a needle to help release it more efficiently. The needling itself usually only occupies a short portion of the session – it might be just a few minutes of needling a couple of key spots. After the needles do their job, I often return to massage, stretching, or mobilization of the area. This combined approach helps to reinforce the positive changes. For example, if dry needling rebalanced a tight calf muscle, some guided stretching and movement afterward will help your body adapt to that new, looser state. Because I’m also trained in exercise therapy, I sometimes pair needling with targeted exercises. One common sequence is: dry needle the overactive or tight muscle to reset it, then immediately do some activation exercises for its weaker opposing muscle. This way we restore balance around a joint. (An example: needling a very tight hip flexor, followed by activation of the gluteal muscles to improve hip stability.) In fact, a clinical commentary noted that dry needling is often most effective when followed up with stretching and corrective exercise, to retrain the affected muscle in its pain-free state.
I wholeheartedly follow this principle – needling is rarely done in isolation. You’ll typically experience it as a seamless part of the session: I might say “I’m going to pop a needle in this spot to help it relax,” do the needling, then continue with other therapeutic work. By the end of the session, the aim is that your muscle is not only released but also soothed by massage and re-educated by movement. If you’re coming in for a general remedial massage and we discover a specific issue, I might ask your permission to include some dry needling as part of that session if I believe it will benefit you. We always tailor the treatment to your needs and comfort. Some sessions might use a lot of needling; others none at all – it depends entirely on what’s best for you on the day. Rest assured, I will never spring a needle on you without explanation. Communication is key: I’ll discuss the plan with you, and you’re free to decline any technique. My toolbox is diverse (massage, cupping, stretching, etc.), and needling is just one option within it.
Safety and Informed Consent
It’s completely natural to feel a little nervous about the idea of needles. Let me address the safety aspects clearly: dry needling, when performed by a trained professional, is very safe.
I have extensive training in anatomy, physiology, and safe needling practices – including identifying important structures to avoid. I use only single-use, sterile disposable needles. They come out of a sealed package, go into your skin, and then go immediately into a sharps container after one use. There is zero chance of cross-contamination between clients. The needles are extremely thin (much thinner than the needles used for injections or blood tests), so most insertions are virtually painless – you might not even feel it penetrate the skin.
Before I use this technique, I will always explain the procedure and ask for your explicit consent. You remain in control: if you’re uncomfortable at any point, we stop. Even if we initially agreed to try needling but you change your mind when the moment comes, that’s completely fine. Your comfort and trust are paramount. I also carefully screen for any contraindications. For example, if you are on blood-thinning medication, have a bleeding disorder, or are pregnant, certain points or techniques might be adjusted or avoided. I will ask you relevant health questions to ensure dry needling/E-stim is appropriate for you.
In terms of what you might experience during or after needling, the most common side effects are mild and short-lived. You may have a tiny spot of bleeding where the needle went in (usually just a droplet that stops quickly) or a small bruise that might develop afterward.
The area treated can feel a bit sore, like you had an intense workout, for a day or two. This post-needling soreness is normal – it’s actually a sign that the tissue is healing and adapting (similar to how you might feel after deep tissue massage or strong exercise).
I typically advise clients to stay hydrated, do some gentle movements, and maybe apply a warm pack later in the day to ease soreness if needed. Over-the-counter pain relief is usually unnecessary, as the soreness is mild and fades on its own. Serious adverse events are extremely rare. Because dry needling is an invasive procedure, one theoretical risk is puncturing something you shouldn’t – for example, if done incorrectly a needle could affect an internal organ or cause a pneumothorax (collapsed lung) when needling near the chest. Let me reassure you: in my practice I use safe needling techniques and avoid risk zones (like needling too deep in the upper back) to virtually eliminate these risks. Large-scale surveys in physical therapy have found the incidence of major complications to be well under 0.1% – on the order of 1 in 1,000 or 1 in 10,000 treatments.
To put it in perspective, that’s far lower than the risks associated with many common medical procedures or even taking certain medications. By using proper protocols – such as thorough anatomical knowledge, clean technique, and precaution in delicate areas – we make dry needling as safe as any other modality in manual therapy. I will also position you and insert the needles in a manner that ensures your comfort and safety (for example, using a pillow to support a limb if needed, and asking you to stay still during the insertion). Before we begin, I’ll inform you about the process and what you might feel, and I’ll get your consent in writing (if it’s your first time) as part of our clinic’s best practices. Nothing will ever be done without your agreement. I encourage questions – if anything is unclear or if you have concerns (“What if I move suddenly?” or “What if it hits a nerve?” etc.), please ask! I’ll happily talk you through how I handle those situations (for instance, I choose needle length and angle carefully to avoid nerves, and even if you did move, the needle is so fine it would just flex). Knowing the safety measures in place often helps clients feel more at ease.
Your Comfort and What to Expect
For those new to dry needling, the anticipation can be the hardest part. Let me paint a picture of what it’s like, so you’re not left to your imagination (which is usually far scarier than reality!). After explaining the technique and getting your consent, I’ll have you relax on the massage table in a comfortable position. I’ll clean the skin with an alcohol wipe at the chosen points. The needle itself is housed in a guide tube – I place the tube against your skin and tap the needle in quickly. You might feel a quick pinprick or nothing at all from this insertion. I then gently advance the needle to the target depth. I’m aiming for that trigger point, and when I hit it you may feel a dull ache or a twitch response in the muscle. That twitch is brief – a split-second – and then it’s gone. Some clients actually find it satisfying, like the muscle just gave up its tension.
I usually manipulate the needle slightly (a gentle pistoning or twisting) to elicit a therapeutic response, but I continually communicate with you. I’ll ask, “How are you doing?” and you can let me know what you feel. Many people say it’s not nearly as painful as they expected – it’s often described as weird, but not painful.
If at any point a sensation is too strong (for example, a sharp pain or a feeling that’s uncomfortable), I need you to tell me, and I will adjust or remove the needle. Remember, you’re not supposed to “tough it out” in silence; this is a collaborative process aimed at your well-being.
When using E-Stim, after inserting the needles I will clip tiny alligator clips onto them (you’ll feel a little pressure on the needle but no pain). Then I’ll turn on the stimulation device to the lowest setting and slowly increase it until you feel a mild pulsing in the area. I often look for a visible twitch in the muscle – it might tap along with the current. I’ll check in to make sure the sensation is strong but still OK for you.
We typically run the current for a few minutes, during which you can just breathe and relax. It’s quite brief – maybe 2-5 minutes of stimulation, often with pauses and checks. Some clients even find the rhythmic pulse relaxing in its own way. After removing the needles (which is usually completely painless – most people don’t even realise I’ve taken them out until I say “all done!”), I’ll apply a little pressure and a swab to each spot.
There’s typically no bleeding; at most a pinprick of blood that is easily wiped away. I’ll then continue with whatever next step is needed – perhaps massaging the area to flush it out, or guiding you through a stretch. Right after needling, the treated muscle often feels a bit fatigued or warmed, kind of like it had a workout.
You might also notice that you can move more freely. For example, clients with shoulder pain often sit up and realise their shoulder feels lighter or their neck rotation improved. I make sure you leave the session knowing what to expect later in the day. As mentioned, slight soreness is common and can peak within the first 24 hours. It’s usually very manageable – typically described as a mild muscle ache, not sharp pain. If you press on the spot, it might feel tender like a bruise. This soreness is temporary and should significantly dissipate within a day or two.
I’ll advise you on simple self-care: keep the area moving (gentle, normal activities are good; avoid strenuous exercise for the rest of that day), maybe apply warmth, and drink water. Most people find the soreness is gone by the time they would be due for their next appointment. There’s no special downtime required – you can go about your day, go back to work, etc. In fact, many clients report that aside from a little post-needling achiness, they feel better – looser and in less pain.
Importantly, I encourage you to communicate any post-session questions or concerns. If something feels not right or you’re unsure if what you experience is normal, just reach out.
Complications are rare, but I take any post-treatment feedback seriously. I’ll provide instructions on what to do if you experience anything unexpected (for example, signs of infection, which are exceedingly rare given sterile technique, but I’ll mention what to watch for just to be thorough).
Building Trust – You’re in Good Hands
Trying a new treatment can be daunting, especially one that involves needles. I want you to feel comfortable, informed, and in control at all times. Your trust is something I earn, not assume. To that end, I take the time to explain my findings and why I think a certain technique will help you. I back it up with both scientific evidence and clinical experience. Dry needling and electro-needling are not mystical cures; they are established, well-studied methods used by physiotherapists and myotherapists worldwide to effectively treat pain and muscle dysfunction. Research has shown that dry needling can provide short-term pain relief and improve function in musculoskeletal conditions, and when combined with other therapies it can enhance overall outcomes.
Knowing this should give you confidence that we’re not doing something “experimental” on you – these techniques are supported by clinical studies and professional practice guidelines. However, evidence is only one side of the coin. The other side is your personal comfort and preference. I never lose sight of the fact that you are a person, not just a collection of symptoms. Some people are eager to try needling once they understand it, while others remain anxious – both responses are completely valid. My role is to guide and recommend, never to pressure. If you decide you’re not ready for dry needling, I respect that fully, and we will use other tools to help you reach your goals. There is always more than one way to treat a problem. On the other hand, if you are curious but nervous, we can take a “test-drive” approach: maybe try one gentle needle and see how you go.
Often, once that first needle is done, clients realise “Oh, that wasn’t bad at all!” and their fear is relieved. It’s amazing how our mind can build something up to be scary, and then the reality is much easier. I’ve had many first-timers who were needle-phobic initially but became fans of the technique after experiencing the results. You might also wonder about my qualifications to perform these techniques. I’m happy to share that I have completed specialised training in dry needling as part of my professional development in myotherapy/remedial massage. I stay up-to-date with the latest research and safety protocols. In Australia, practitioners like me use dry needling under strict standards and within our scope of practice – it’s a respected skill set in the manual therapy field.
I also carry full professional indemnity insurance and adhere to all regulatory guidelines, so you can be assured of a high standard of care. Ultimately, my goal is to help you feel better in the safest, most effective way possible. Dry needling and electro-needling are simply options I can offer toward that goal.
Many clients who give it a try are pleasantly surprised at how much relief it provides for stubborn aches. Some even say things like, “That needle did more in 2 minutes than massage did in 30!” – not that it’s a competition, but it shows that for certain issues, needling really can produce a fast, positive change. For others, the change might be more gradual or subtle, and that’s okay too. We will monitor your progress together. If it helps, great – we’ll continue as needed. If it doesn’t seem to make a difference for you, we won’t persist unnecessarily. It’s all about finding what works best for your body.
If you’re new to these techniques, I want you to feel reassured. I will guide you through the process gently, and you can ask me questions at any time. There are no silly questions – whether you’re curious about how it works, or you want to know about the needles, or even if you wonder “what happens if I sneeze while needles are in?” (answer: nothing terrible, I promise!). Education is a big part of my treatment approach; I believe when you understand why we’re doing something, it becomes far less intimidating and even empowering. My hope is that after your session, you’ll not only feel physically better but also have a better understanding of your body and confidence in the care you’re receiving.
In Summary
Dry needling and electro-needling are effective, evidence-based techniques for relieving muscle pain and tension. They work by targeting trigger points in your muscles with fine needles, with E-stim providing an extra therapeutic nudge through gentle electrical pulses. These methods can accelerate pain relief, improve your range of motion, and help reactive muscles “reset” toward normal function. Importantly, they are used as part of a holistic treatment plan – one piece of the puzzle alongside massage therapy, stretching, and exercise. When performed by a qualified practitioner, dry needling and E-stim are very safe. I will always prioritize your safety and comfort, using sterile procedures and obtaining your consent before we begin. Minor side effects like temporary muscle soreness or small bruises are possible, but serious complications are exceedingly rare.
I take all precautions to ensure you have a positive and beneficial experience. If you’ve been enduring stubborn muscle knots or pain that hasn’t resolved with standard massage, dry needling might be the missing link to provide relief. Many clients who were initially apprehensive have become enthusiastic about the results – feeling looser, lighter, and less pain after a session that includes needling.
My role is to make the process as comfortable and transparent as possible, so you can feel at ease trying this approach. Remember, you’re always in control of your treatment. I’m here to answer questions and adjust to your comfort level. Together, we’ll decide if dry needling and electro-needling are right for you. Should you have any queries or lingering concerns, please don’t hesitate to reach out or bring them up during your appointment. I’m more than happy to discuss these techniques in more detail or explore alternative options. Your peace of mind is just as important as your physical improvement. In the end, my goal is simple: to help you move better and feel better.
Dry needling and electro-needling are just some of the ways we can achieve that. If they’re the right tools for the job, we will use them with skill and care. If not, we’ll find another way. You can trust that every treatment I offer is grounded in knowledge, professionalism, and a genuine commitment to your well-being. If you have questions about dry needling or electro-needling, please feel free to ask me anytime – whether in person, by phone, or email. I’m here to help demystify the process and ensure you feel comfortable and confident in your care.
References
Boyce, D., Wempe, H., Campbell, C., Fuehne, S., Zylstra, E., Smith, G., … Jones, R. (2020). Adverse events associated with therapeutic dry needling: A prospective survey of 20,000 sessions. International Journal of Sports Physical Therapy, 15(1), 103–113.
Chys, M., De Meulemeester, K., De Greef, I., Murillo Ezcurra, C., Kindt, W., Kouzouz, Y., … Cagnie, B. (2023). Clinical effectiveness of dry needling in patients with musculoskeletal pain: An umbrella review. Journal of Clinical Medicine, 12(3), Article 1205. https://doi.org/10.3390/jcm12031205:contentReference[oaicite:30]{index=30}:contentReference[oaicite:31]{index=31}
León-Hernández, J. V., Martín-Pintado-Zugasti, A., Frutos, L. G., Alguacil-Diego, I. M., de la Llave-Rincón, A. I., & Fernández-Carnero, J. (2016). Immediate and short-term effects of the combination of dry needling and percutaneous TENS on post-needling soreness in patients with chronic myofascial neck pain. Brazilian Journal of Physical Therapy, 20(5), 422–431. https://doi.org/10.1590/bjpt-rbf.2014.0176:contentReference[oaicite:32]{index=32}
Perreault, T., Ball, A., Dommerholt, J., Theiss, R., Fernández-de-Las-Peñas, C., & Butts, R. (2022). Intramuscular electrical stimulation to trigger points: Insights into mechanisms and clinical applications—A scoping review. Journal of Clinical Medicine, 11(20), 6039. https://doi.org/10.3390/jcm11206039:contentReference[oaicite:33]{index=33}:contentReference[oaicite:34]{index=34}
Unverzagt, C. A., Berglund, K. M., & Thomas, J. J. (2015). Dry needling for myofascial trigger point pain: A clinical commentary. International Journal of Sports Physical Therapy, 10(3), 402–418.
