Injury type: Chronic

Category: Complementary and Alternative Therapies

Rating: No research

What is it?

Intra-muscular injection, or dry needling involve the insertion of fine acupuncture needles into myofascial trigger points, with the aim of deactivating trigger points. Trigger points are thought to be hyperirritable spots in skeletal muscle that are associated with ‘knots’ in tight bands of muscle fibers. The palpable nodules are said to be small contraction knots and a common cause of pain. Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response. Dry needling uses western based anatomy and physiology to select the myofascial trigger points found in muscles throughout the body. Many of these points correspond with those used in Traditional Chinese Medicine during acupuncture. Commonly following whiplash, the muscles at the back of the neck become shortened, tight and painful, and these muscles may form the target of intra-muscular injection.

How does it work?

Trigger points are painful on compression and can give rise to characteristic referred pain/tenderness, motor dysfunction and “autonomic” responses; these can include temperature and skin changes over the site. Dry needling of the ‘shortened’ muscle band may cause an immediate relaxation in the muscle. A sense of release and increased range of motion may also be experienced by the patient.

Is it effective?

A narrative review1 identified a single study examining the effect of dry needling for chronic whiplash. In this study, subjects from the dry needling and exercise group reported statistically significant reductions in pain-related disability, pain catastrophising and post-traumatic stress symptoms at intermediate to long term follow-ups (i.e. 6-12 months), along with small increases in pressure pain thresholds on the neck at short term follow-up, as opposed to the sham dry needling and exercise group. However, these effects were minor and not deemed clinically significant. Furthermore, the independent effect of dry needling was not evaluated in this study.

Are there any disadvantages?

There should be few side effects when practiced by a qualified health practitioner. However, you may experience some discomfort associated with the insertion of the needle, and/or movement of the needle within the muscle. If it is painful you should inform the practitioner.

Where do you get it?

Acupuncturists, Physiotherapists and other health professionals who have all undertaken courses in dry needling can provide intra-muscular injection. They can be found in the Yellow Pages.


The effects of dry needling have not been fully evaluated and hence cannot be recommended for whiplash. Further research is needed.