Dry needling for knee pain explained to a non-medical professional can be confusing. It doesn’t usually cause a lot of pain when used by a trained provider. In comparison to an injection from a hypodermic needle, dry needling is much less uncomfortable. One of the reasons dry needling isn’t usually painful is because the “dry” needles aren’t hollow on the inside, so they cause less tissue damage. If you’re considering dry needling as a treatment for knee pain, let’s explore some details.

In this post, I’ll discuss aspects of dry needling and it’s application in treating knee pain. I’ll answer questions such as:

  • A typical dry needling treatment for knee pain – What does it feel like?
  • How many needles do you dry needle when treating a knee pain complaint?
  • How many dry needling treatments will you need for knee pain?

A typical dry needling treatment for knee pain – What does it feel like?

The good news about dry needling for knee pain is that it isn’t exquisitely painful in the hands of a trained provider. I’m not going to lie, dry needling is NOT COMPLETELY pain-free. Know that pain from dry needling isn’t going to last a significant amount of time. Expect some pain, usually what feels like a post-workout muscle soreness, to last anywhere from 12 to 48 hours after treatment. Everyone has a different pain threshold and perception, and it often depends on how significant your knee pain is in the first place.

When you’re having dry needling, your provider will target specific areas in the muscle called trigger points. Trigger points are pain producing taut bands of muscle fibers, and they’re the main finding in what’s called “myofascial pain syndrome.”

For more on myofascial pain syndrome check out this content where I discuss the topic –> dry needling and knee pain.

After your provider stimulates a trigger point near the knee with a needle, the muscle will produce a muscle twitch response. This causes that muscle to involuntary twitch or spasm. What a strange feeling it can be when your muscle is twitching on its own, but the good news is that after the trigger point is dry needled the twitching will stop and your muscle will relax. This is part of the therapeutic effect of dry needling for knee pain and can sometimes be uncomfortable. The twitch response can also feel relieving though!

Interested in acupuncture for knee osteoarthritis? See this content I wrote where I discuss the effectiveness of acupuncture for knee osteoarthritis –> Acupuncture for knee osteoarthritis

How many muscles do you dry needle when treating a knee complaint?

The honest answer to this questions is that it depends. It depends on what’s causing your knee pain, what the muscles and tissues around the knee feel like with palpation, and how they are functioning. When I treat knee pain with dry needling I usually start conservatively at first to see how the patient tolerates treatment. Generally, I’ll usually needle between 4-8 muscles but it depends on where I believe what the pain-producing areas of your knee pain are. Here are some of the muscles that I frequently address when I use dry needling for knee pain:

  • Muscles of the lower leg I may dry needle for knee pain: Gastrocnemius, soleus, and tibialis anterior.
  • Muscles of the front of the thigh I may dry needle for knee pain: Vastus lateralis, vastus medialis, and rectus femoris.
  • Muscles of the back of thigh I may dry need for knee pain: Biceps femoris, semitendinosus, semimembranosus, and gluteal muscles.
  • Muscles of the inside and outside of the thigh I may dry needle for knee pain: TFL and adductor magnus.
  • Muscles of the back of the hip I may dry needle for knee pain: Gluteus maximus, gluteus medius, and gluteus minimus.

Know that I’m usually not going to dry needle trigger points in all these muscles, especially not every visit. Treatment is directed by what you tell me about your injury and where I find trigger points that are contributing to your knee pain.

How many dry needling treatments will you need for knee pain?

Dry needling for knee pain sometimes relieves pain very quickly, and I only end up treating those patients a few times. As a general rule, I suggest 4-6 treatments as a trial of care when we first begin. Some knee pain will get completely better during this trial or dry needling, some will improve but not 100%, and few patients won’t respond as well as expected. 4-6 visits of dry needling give us enough information to see if it’s going to be an effective treatment. If it is relieving knee pain and I feel like a few more treatments will get you to your goal I’ll recommend that.

What I don’t do is ask you to commit to a long treatment plan without knowing if dry needling for knee pain is going to work for you. If it’s not effective it’s wasting your time and money. Keep in mind, I’m also going to give you a home rehab program, use other supportive therapies, and re-examine your frequently to make sure you’re getting relief from knee pain.

If you’re looking for more information on dry needling, check out this article from the world’s best hospital – Mayo Clinic, to see what they say about dry needling.


Dr. Jason Williams DC is a chiropractic physician practicing at AccessHealth Chiropractic in Cary, NC. He treats neuromusculoskeletal pain and injuries using chiropractic manipulation, dry needling, acupuncture, rehab exercise strategies, and other supportive therapies. Primary areas of focus include back pain, neck pain, muscular pain, extremity pain, and orthopedic injuries. Dr. Williams is experienced in treating athletes, especially those in the CrossFit, Brazilian Jiu-Jitsu, Muay Thai, and MMA community.

If you’re interested in whether he or another AccessHealth provider can help you, navigate to our contact page or follow this link to request an appointment.