Dry Needling Berlin Prenzlauer Berg: Procedure, Effects, Risks

What is dry needling?

"Dry" because nothing is injected into the muscle. Unlike injections, no substance is introduced into the tissue. Instead, fine sterile acupuncture needles are placed precisely into myofascial trigger points – those pressure-sensitive spots in muscle tissue that people often describe as "tension knots" in everyday life.

Trigger points are microscopically small zones of tension within the muscle. What we feel as a hard "knot" when pressing is usually a cluster of these points, which can form painful taut bands and hardening in the tissue. They can cause local pain, radiate into other regions, produce muscle weakness or stiffness, and sometimes irritate tendons or nerves.

After a careful physical examination, the needle is guided into the affected muscle and stimulated mechanically. This promotes local circulation, can reduce inflammatory processes in the tissue and support the recovery of the muscle.

Dry needling and acupuncture – what is the difference?

Both methods use needles but pursue different goals. Acupuncture works with meridians and acupuncture points to influence the flow of energy throughout the body. Dry needling, on the other hand, targets specific muscular trigger points locally – to regulate tension, improve circulation and restore tissue supply.

Who is allowed to perform dry needling?

This varies by country. In Germany, it is an invasive technique and is legally permitted only for physicians and Heilpraktiker (licensed natural health practitioners) with the relevant additional training.

How a session works

I allow around 60 minutes for all treatments. The reason is straightforward: working with needles deserves a calm atmosphere – especially for those experiencing it for the first time. After a thorough anamnesis, we decide together how the session is structured.

In most cases I do not work exclusively with needles, but combine dry needling with manual techniques and active strengthening, mobilisation and stretching exercises. This makes it a comprehensive treatment approach that works well in practice.

How many sessions are needed? That depends on how acute or chronic the complaints are. Acute issues can sometimes be noticeably improved in 1–3 sessions, other cases take a little longer. As a general guideline, I recommend a gap of 5–7 days between treatments of the same muscle, to allow the tissue to recover.

What does dry needling feel like?

The initial insertion is usually barely noticeable – the needles are considerably finer than those used for blood draws or injections. As the needle is guided deeper into the muscle layers, most people describe a growing pressure sensation that intensifies as it approaches a trigger point.

When a trigger point is reached, a "local twitch response" occurs – a brief muscle twitch that I as the therapist can often see and you can clearly feel. The first few times this can seem strange, sometimes like a muscle cramp. With repeated sessions, the reactions tend to become milder and the sensation shifts for many into something like a "good pain".

Directly after a session, it is common to experience strong muscle soreness and a feeling of heaviness in the treated area. This usually subsides within 1–4 days.

What to keep in mind afterwards

• Drink water: Stay well hydrated throughout the day – this supports the clearance of metabolic by-products.
• Move: Exercise is generally recommended after dry needling. On the treatment day, it is best to avoid explosive sports (tennis, squash). Endurance activities, stretching and moderate strength training are usually fine and can even support recovery.
• Cool or warm: If the insertion site feels inflamed, local cooling with ice can help. Some people find a warm bath or sauna pleasant as a complement.
• Rest: Where possible, keep the rest of the day calm and relaxed.

Who should not receive dry needling

In certain cases, dry needling should not be performed or only with special precautions:

• Acute systemic infections or emergencies (require medical care)
• Patients taking blood thinners (e.g. acetylsalicylic acid, clopidogrel, heparins)
• Sensory disorders (e.g. following a herniated disc, surgery or diabetes)
• Lymphoedema or post-lymph node removal
• Elevated infection risk (immunosuppression, diabetes)
• Skin changes, infections or allergies at the treatment site
• Tumours, haematomas, osteosyntheses or joint replacements
• Implants near the treatment area
• Pregnant women, children and psychiatric patients

Possible side effects and complications

Dry needling is a safe method when performed correctly with sterile single-use needles. The risk of serious complications is low – but I want to be fully transparent:

• Intense muscle soreness at the treated site (common, lasting approximately 1–4 days)
• Fatigue and deep relaxation directly after the session – driving ability may be temporarily affected
• Temporary autonomic reactions such as sweating, dizziness, cardiac rhythm changes, blood pressure drop, drowsiness, nausea or stomach discomfort
• Skin reactions (redness) at the insertion site
• Small bruise or bleeding from minor blood vessel contact (disappears within a few days)
• Rarely: activation of latent, pre-existing conditions
• Rarely: emotional reactions such as anxiety, euphoria or lethargy
• Rarely: mild sensory disturbances from contact with smaller nerves
• Very rarely: needle breakage (please try to remain still during treatment)
• Extremely rarely: injury to internal organs due to insufficient anatomical knowledge (e.g. pneumothorax)

Frequently asked questions

Is dry needling painful?

The insertion itself is barely noticeable. When a trigger point is reached, a brief muscle twitch occurs that can feel unusual the first time. Most people find it well tolerable after a short adjustment. I work in a graduated way and follow your feedback.

How many sessions are needed?

That depends on how acute or chronic the complaints are. Acute issues can sometimes be noticeably improved in 1–3 sessions, chronic ones take a little longer. I recommend a gap of 5–7 days between treatments of the same muscle.

Can I exercise after the session?

Generally yes. Endurance activities, stretching and moderate strength training are usually fine. Avoid explosive sports such as tennis or squash on the treatment day.

Do I need a prescription or referral?

No. At a Heilpraktiker practice, no medical referral is required. If medical assessment would be useful, I will mention it openly.

What is the difference from acupuncture?

Both methods use needles but pursue different goals. Acupuncture works with meridians, while dry needling targets specific muscular trigger points locally – to release tension and improve circulation.

Do health insurers cover the costs?

This is generally a private service. More details on Billing