Dry needling efficacy disagreement

Science fight! A systematic review by Boyles et al concluded that poking sore spots with fine needles is probably helpful … strange as that may sound. (Yes, “dry needling” is actually a treatment for pain.) Venere and Ridgeway, on the other hand, think that the “strongly worded conclusion overstates the findings of the actual data,” and they make that case in a formal gripe to The Journal of Manual & Manipulative Therapy. They imply that Boyles et al. wrote a biased review in favour of needling, and they have responded with their own bias against it, while we munch popcorn and watch how science works. Again, strange as that may sound.

So we have experts who think the evidence is strongly positive, and experts who say “nonsense!” So how positive is it? Is it positive at all? Unknown. Boyles’ probably should stuck with a boring more-study-needed conclusion, because the evidence is conflicting at best and it just can’t be called yet. But it’s super rare for conflicting evidence lead to a happy ending, so place your bets!

2025 UPDATE

Ten years later, it’s not looking good for Team Boyles. Stieven et al in 2020 was a good quality trial of needling versus needling and PT, clearly negative. Gattie et al in 2021 was another good and entirely negative trial of dry needling for neck pain patients with long follow-up. Jeevan Pandya et al in 2024 showed that massage and exercise was more effective for neck pain than needling and exercises, both short and long term. And so on. The debate continues, but it looks worse for dry needling every year. There’s a substantial chapter about this in my trigger points book.