Dry Needling and Soft-Tissue Treatment for Neck and Shoulder Pain

By Laura Schmonsees, DPT

Neck and shoulder pain are among the most common musculoskeletal complaints. Symptoms can involve a combination of joint stiffness, muscular sensitivity, myofascial trigger points, and changes in movement patterns. Pain may become especially noticeable with repetitive activities, prolonged positions, or the physical demands of work, sports, and everyday life.

Physical therapy offers a variety of tools to address these problems, including exercise, movement retraining, manual therapy, and dry needling. The goal is not simply to decrease pain, but to help patients move more comfortably, build strength and mobility, and return to the activities they enjoy.

How Can Dry Needling Fit Into Your Treatment Plan?

Dry needling uses a thin, solid filament needle inserted into muscular and connective tissues. Physical therapists commonly use dry needling to address areas of muscular tenderness, tissue sensitivity, and myofascial trigger points as part of a broader treatment program.

Research on dry needling for neck pain has continued to grow, with multiple reviews finding that it can help reduce pain and improve function, particularly in the short term. Research also suggests that dry needling may improve pressure-pain sensitivity and disability in people with mechanical or chronic neck pain.

Similar findings have been reported for musculoskeletal shoulder pain. Dry needling can help decrease pain and improve function, particularly when muscular pain and sensitivity are making it difficult to move comfortably or participate fully in rehabilitation.

Reducing pain and muscular sensitivity can create a window in which movement feels easier. This can make it easier to participate in mobility exercises, strengthening, movement retraining, and other parts of a rehabilitation program.

What About Muscle Scraping and Other Manual Techniques?

Dry needling is one of several hands-on tools that a manual therapy-based physical therapist may use as part of a broader rehabilitation program. Depending on the individual patient, treatment may also include joint mobilization, soft-tissue techniques, myofascial release, cupping, or instrument-assisted soft-tissue mobilization (IASTM), commonly known as muscle scraping.

IASTM is a form of myofascial release that can be used to address areas of tenderness, neuromuscular pain, and movement limitations. IASTM has mixed but growing evidence for reducing pain and improving some function or range-of-motion outcomes in musculoskeletal disorders, with some studies reporting greater short-term benefit when it is added to conventional rehabilitation.

Dry needling and other manual techniques can help some patients tolerate exercise and movement training more comfortably. By helping decrease pain and improve comfort with movement, hands-on treatment can help patients participate more effectively in the active portions of rehabilitation.

A Comprehensive Approach to Recovery

Exercise and strengthening help restore mobility, strength, and physical capacity. Hands-on treatments such as dry needling, IASTM, myofascial release, and other manual techniques can help decrease pain and muscular sensitivity leading to improved movement and tolerance for strengthening.

Dry needling is an important tool in the physical therapist’s toolbox—but it is one part of a comprehensive treatment plan designed around the individual patient and their goals.

The ultimate goal is simple: To help you move better, feel better, and get back to doing the things you love.

References

1. Navarro-Santana MJ, et al. Effectiveness of dry needling for myofascial trigger points associated with neck pain symptoms: an updated systematic review and meta-analysis. J Clin Med. 2020;9(10):3300.
2. Hernández-Secorún M, et al. Effectiveness of dry needling in improving pain and function in comparison with other techniques in patients with chronic neck pain: a systematic review and meta-analysis. Pain Res Manag. 2023;2023:1523834.
3. Aleid AM, et al. Dry needling for mechanical neck pain: a systematic review and meta-analysis of randomized controlled trials. Surg Neurol Int. 2025;16:44.
4. Navarro-Santana MJ, et al. Effects of trigger point dry needling for nontraumatic shoulder pain of musculoskeletal origin: a systematic review and meta-analysis. Phys Ther. 2021;101(2):pzaa216.
5. Ahmadpour Emshi Z, et al. Comparison of the effects of instrument assisted soft tissue mobilization and dry needling on active myofascial trigger points of upper trapezius muscle. Med J Islam Repub Iran. 2021;35:59.
6. Lin HW, et al. Efficacy of instrument-assisted soft tissue mobilization on patients with neck pain: a systematic review and meta-analysis of randomized trials. Disabil Rehabil. 2026;48(8):2288-2303.
7. Tang, Sien, Li Sheng, Xiating Wei, M. Liang, Jinming Xia, and Jue-Ru Chen. “The effectiveness of instrument-assisted soft tissue mobilization on pain and function in patients with musculoskeletal disorders: a systematic review and meta-analysis.” BMC Musculoskeletal Disorders 26 (2025).
8. Liu, Yang, Yueyong Yu, Pan-Feng Liu, Jie-Xing Yan, and Ziyong Cheng. “Instrument-assisted soft tissue mobilization for musculoskeletal disorders: a systematic review and meta-analysis of its effects on pain, function, and range of motion.” European Journal of Medical Research 31 (2026).