Recently, Pittsburgh Steelers linebacker T.J. Watt suffered a partially collapsed lung (pneumothorax) following a dry needling session, news that sparked understandable concern among both patients and clinicians. While any serious injury deserves attention, it’s equally important to understand what this event does — and doesn’t — mean about dry needling as a therapeutic tool.
At Bethesda Physiocare, we use dry needling safely and effectively every day to help patients reduce pain, improve movement, and get back to the activities they love. Here’s what you should know.
What Is Dry Needling — and What Happened with T.J. Watt?
Dry needling is a clinical technique performed by trained practitioners, where fine, solid needles are inserted into muscles to address myofascial trigger points and dysfunction. It’s not an injection; the needle itself stimulates tissue and neuromuscular responses that can reduce pain and improve mobility. (Wikipedia)
In Watt’s case, the reported pneumothorax occurred after needling near the thorax — a known but extremely rare risk when needles are placed near the chest cavity.
Dry Needling Safety — What the Research Shows
When patients hear about a collapsed lung, it’s natural to worry. But peer-reviewed studies show that serious complications like pneumothorax are very, very uncommon when dry needling is performed by trained clinicians.
Minor Adverse Events Are Common — But Typically Benign
One large survey of physical therapists found that:
- Minor side effects (bleeding, bruising, temporary pain) occurred in about 36.7% of treatments.
- These are usually mild, localized, and resolve quickly. (PubMed)
Major Adverse Events Are Rare
Serious complications (like pneumothorax, nerve injury, or infection) are very uncommon:
- A 2020 study tracking over 20,000 dry needling treatments found fewer than 0.1% major adverse events — roughly 1 major event per 1,024 treatments. (PubMed)
- Another systematic review of published cases reported the incidence of pneumothorax related to dry needling to be less than 0.01% in those data analyses. (PMC)
These numbers include all serious events, not just pneumothorax — and pneumothorax is consistently one of the rarest.
Specific Pneumothorax Data
- Peer-reviewed literature documents only very small numbers of pneumothorax cases associated with dry needling in the medical literature. Case reports and case series exist precisely because they are unusual. (PMC)
- Even acupuncture — a related but different practice — has documented pneumothorax at a rate below 0.01 per 10,000 interventions in some estimates, reinforcing how rare it is in needling overall. (APTA Orthopedics)
In other words: while pneumothoraces can occur when needles are placed over lung fields, the statistical likelihood is extremely low in clinical practice.
Why This Shouldn’t Scare You Away from Dry Needling
- Dry needling is an evidence-based tool when appropriately applied.
Millions of treatments are performed worldwide each year, with overwhelmingly positive outcomes when guided by clinical judgment. - Most side effects are minor and self-limited.
Transient soreness, mild bleeding, and small bruises are far more common than serious complications like pneumothorax. (PubMed) - Serious complications are rare — especially with proper technique.
The low incidence of pneumothorax and other major events reflects the rarity of these events even when treatments are widespread — especially when clinicians are trained and cautious. (PMC) - Safety is tied to anatomy and training.
Research consistently highlights that deep knowledge of anatomy, patient selection, and needling skill matters in minimizing risk. (PMC)
How We Protect Your Safety at Bethesda Physiocare
At Bethesda Physiocare:
- Your complete history and physical exam guide every decision.
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- We assess whether dry needling is appropriate for your specific condition.
- Clinicians trained through reputable programs — including Myopain Seminars, known for its rigorous emphasis on anatomy, technique, and safety — perform needling.
- We communicate clearly about potential risks, benefits, and what to expect before treatment.
- Dry needling is one component of a broader, individualized care plan that may include manual therapy, exercise prescription, and other modalities.
Why Training — Like That from Myopain Seminars — Matters
Not all dry needling education is the same. Programs like Myopain Seminars emphasize:
- Detailed anatomy and palpation skills
- Clinical reasoning and decision-making
- Safety principles for higher-risk regions
- Evidence-based protocols
Their structured training helps clinicians make smart decisions in real time, reducing risk while maximizing patient benefit. These are the types of standards we uphold at Bethesda Physiocare.
You can view their discussion on this topic on their blog, which provides excellent context for clinicians and patients alike. (Myopain Blog)
Final Takeaway
T.J. Watt’s pneumothorax was a rare and unfortunate event, but it does not change the safety profile of dry needling when performed appropriately.
Dry needling remains a safe and effective tool in the hands of trained and cautious professionals — and at Bethesda Physiocare, your safety, comfort, and outcomes always come first.
If you’d like to know more about dry needling, how it works, or whether it’s right for you, contact us today — we’re happy to answer your questions.