By: Andrea Javor
“Do you want a towel to bite down on?” my physical therapist asked, holding a steel needle that looked like half a strand of angel hair pasta inches above my hip flexor. I was desperate. I hadn’t slept for five nights straight. I trusted her, but I knew this was going to hurt. I locked into her kind eyes and nodded as tears of exhaustion welled.
I was trying dry needling, a therapy I didn’t know existed until days prior. My physical therapist had explained that she would feel for knots in my muscles and then repeatedly poke them with fine needles until it caused a “twitch release,” characterized as a rapid, involuntary contraction of the muscle fibers. She said it could be painful, but it was quick, and the relief should be immediate. No drugs would be injected, hence the term “dry.”
Why I turned to dry needling
Months earlier, I complained to my orthopedic surgeon that I wasn’t able to sleep through the night. We were reviewing the MRI results of my right knee scan. My knee had increasingly felt tight and restricted while walking and exercising, and despite being a heavy sleeper, I’d often wake in the middle of the night with sharp pain when laying on my stomach with my leg completely straight.
I didn’t know what caused my knee problems other than genetics, as my dad had recently had both knees replaced. I was 43, generally in good health, living an active lifestyle that included jogging on the treadmill, cycling and light weight lifting. I couldn’t attribute the pain to a distinct incident—I didn’t fall or feel acute discomfort during a specific workout—but I knew something was wrong.
The doctor told me I needed laparoscopic surgery to fix two issues: a PCL tear that was causing the pain while my leg was straight and, more critically, a root meniscus tear, which if left untreated would certainly cause even more pain and expedite the need for a full knee replacement.
“The surgery is easy, it’s the recovery that’s hard,” he warned me. “You won’t put weight on your right leg for six weeks.”
I had just started a new job leading a large marketing team that required in-office attendance three days a week. I wasn’t sure how to tell my HR manager I’d have to work from home so soon after I started, but I was also worried about my waning energy as I tried to function without quality sleep. So, I planned to prop my leg up on pillows and spend my workdays on virtual meetings until I could again stand in front of conference tables.
For the almost two months leading up to the surgery, I woke up with sharp, shooting, throbbing, aching pains nearly every night. My boyfriend would help me get comfortable by putting a pillow under my knee. But hours later, I would be up again—wincing, readjusting.
When I came home from surgery on a cold February morning, I thought that with my knee pain gone, I’d be able to sleep again. That didn’t happen.
Within a week, using crutches led to overcompensating on my non-surgical side, and sitting around all day on conference calls led to radiating muscle pain and tightness. My glutes, quads, hip flexor and lower back twitched in pain constantly, and I still wasn’t sleeping. I asked for more pain meds—assuming they would help me rest—but my doctor refused, citing the risk of opioid addiction.
I walked into my mid-week physical therapy appointment in tears. It had been three nights of errant 20-minute intervals of sleep as I writhed in the sheets. I was debilitated, trying to maintain focus while on work calls. That’s when my physical therapist brought up dry needling. She said we could try it at my next appointment. I was so desperate for shut-eye, I would have done it immediately.
Two days later, back at the physical therapy center, I braced myself for the first stabs of this licensed violence. She instructed me to indicate when I felt the knot loosen or if I needed her to take a break. I bit down on the towel and tried to bear it.
Over the course of 20 minutes, she slowly, with permission before inserting into a new area, moved around the left side of my body, seeking the knots and stabbing their release. In most cases I could take it for 25-30 seconds before yelling for her to stop. I felt each sharp, repeated stick of the needle reaching the edges of the knot.
But it was amazing—strange, radiant relief traveled in multiple directions from the areas she targeted. I slowly slid my left leg to the ground and grabbed my crutches to stand. In front of half a dozen patients and therapists, I burst an emphatic “thank you!” to my physical therapist. My previous pain was almost imperceptible.
That night, I pulled the covers over myself in bed and drifted to sleep without effort, for the first time in months.
What’s the difference between dry needling and acupuncture?
People with chronic pain, sports injuries and even bad posture are trying dry needling. It’s a rapidly growing market, globally valued at $3.12 billion in 2024. Providers are most commonly physical therapists, occupational therapists, acupuncturists or medical doctors.
Many confuse it with acupuncture, a practice that also relies on inserting thin needles into specific points of the body. “While both are within the same scope of practice, the reasons to use them are quite different,” Jan Dommerholt, a physical therapist who does dry needling, told me. Acupuncture takes a systemic approach to treat a broad range of issues, whereas dry needling is often meant to impact pain and movement functions by directly targeting those areas, he said.
Eventually I learned to walk again, while wearing a clunky black brace for stability. My physical therapy lasted for over six months while I rebalanced and strengthened both sides of my body. During that time, I did 5-6 sessions of dry needling. I finally felt like myself again.
While I found dry needling incredibly painful, everyone’s experience is different, and it also depends on what you’re targeting. I was trying to loosen big knots in my muscles, but I’ve also done the treatment to break apart scar tissue, and that was less painful. And like any treatment, it’s not for everyone, but I credit dry needling as a critical part of my recovery. Those few moments of sanctioned stabbing finally brought me what I needed most to function again: full nights of uninterrupted, restorative sleep.