Risks of Dry Needling
Common temporary side effects are momentary pain with the initial skin puncture (possible to not feel the puncture, but also possible to find a nerve ending in the skin), very temporary provocation of symptoms (30 to 60 seconds, then improving overall with light movement), bruising (interaction with a smaller blood vessel), and soreness that will last up to a day (typically minutes to hours).
Potential risks that are less common include temporary lightheadedness/dizziness, fainting, and temporary tingling / referral of pain.
Potential risks that are rare (less than 1 in 1,000 encounters) include infection, nerve injury, and pneumothorax.
What is the worst risk that you expect to be experienced? I have observed two or three times a year what I term ‘grazing the bear’ – an interaction where the needle interacts with the edge of the desired portion of muscle. This results in the muscle responding with acute symptoms (heaviness, cramping/spasm, pain with perception of needle still being in place after being removed) and would require re-application of treatment just next to the area of interaction to achieve the intended response. I use the term based on the imagery of somebody attempting to shoot a bear but only has a direct enough hit to make the bear very angry. Trying to leave it alone at that point is not really an option. I have not had a patient decline re-application of treatment so I am not aware of how long it would take for the aggravation to settle down.