Adverseeventsfollowingtriggerpointdryneedling:aprospectivesurveyofcharteredphysiotherapists

Trigger point dry needling (TrP-DN) is commonly used by physiotherapists to treat myofascial pain, but little research existed on its safety profile. This study addressed the critical need to understand adverse events associated with dry needling practice, as previous safety data came primarily from acupuncture studies, which differ significantly in technique and depth of needle insertion. Understanding safety is essential for informed consent and clinical decision-making.

Researchers conducted a 10-month prospective survey of 39 physiotherapists in Ireland who had completed standardized trigger point dry needling training through the David G Simons Academy. Participating physiotherapists recorded all adverse events using two forms: one for mild events (short-term, non-serious) and another for significant events (serious, requiring treatment). The study aimed to collect data on over 10,000 treatments to identify even rare adverse events. Physiotherapists recorded detailed information about each treatment session and any unwanted effects, no matter how minor.

Over 7,629 dry needling treatments, 1,463 mild adverse events occurred, representing 19.18% of all treatments. No significant adverse events were reported, giving an estimated upper risk rate of ≤0.04% for serious complications. The most common adverse events were bleeding (7.55% of treatments), bruising (4.65%), pain during treatment (3.01%), and pain after treatment (2.19%). Uncommon events included symptom aggravation (0.88%), drowsiness (0.26%), feeling faint (0.22%), headache (0.14%), and nausea (0.13%).

Rare events included fatigue, altered emotions, shaking, itching, claustrophobia, and numbness, each occurring in less than 0.04% of treatments.

This study provides the first comprehensive safety data for trigger point dry needling, showing that while mild adverse events are very common (nearly 1 in 5 treatments), serious complications are extremely rare. The findings suggest dry needling has a favorable safety profile compared to many over-the-counter pain medications. For patients, this means they can expect minor side effects like brief bleeding or bruising in about 1 in 5 treatments, but serious complications are highly unlikely. For clinicians, these data provide evidence-based information for informed consent discussions and support the safety of dry needling when performed by properly trained practitioners.