Understanding Dry Needling: Exploring the Three Key Levels of Stimulation for Effective Pain Management

Millions struggle daily with chronic pain, seeking relief in various therapies with mixed results. Dry needling, a popular yet often misunderstood technique, stands out for its unique approach to pain management. However, the lack of clarity about its effectiveness can leave patients and practitioners alike feeling frustrated and skeptical. In our latest blog post, we delve into the intricacies of dry needling, breaking down its three core levels of stimulation – tissue, spinal cord, and brain. By understanding these mechanisms, we aim to demystify dry needling and reveal how this targeted approach can be a game-changer in your journey towards pain relief and improved physical function.

  1. Tissue Level Stimulation:
    • Insertion of the needle increases circulation in the tissue.
    • This is due to microtrauma caused by the needle, leading to a local inflammatory effect.
    • Increased circulation changes the biochemical makeup of the trigger point or taut band, resulting in reduced nociception (pain sensation).
    • Mechanical stimulation of mechanoreceptors occurs, sending sensory information to the spinal cord.
  2. Spinal Cord Level Stimulation:
    • Sensory information from the needle is interpreted at the spinal cord.
    • This results in a motor effect, either reducing or increasing muscle tone, depending on the type of stimulation.
    • The gate control theory is applied, where stimulation can inhibit pain signals at the spinal cord level.
    • This process involves gating the input from nociceptors (pain receptors), reducing the potential for pain.
  3. Brain Level Stimulation:
    • Stimulation passes up the spinal cord to the somatosensory cortex in the brain.
    • The brain perceives the activity at the needle insertion site and sends descending inhibitory control back down the spinal cord.
    • This results in the release of endogenous opioids, dampening the nociceptive effect.
    • It involves changes in sensation due to chemical stimulation at the tissue level and motor control adjustments, along with gating of pain at the spinal cord.

Dr. Hanson, with his extensive experience in dry needling, possesses a keen understanding of the delicate balance required in stimulation levels. He recognizes that each patient presents a unique set of challenges and sensitivities. His approach is tailored not just to the condition but also to the individual’s pain threshold and response to treatment. Dr. Hanson carefully considers the desired therapeutic effect, whether it’s targeting tissue-level pain relief, spinal cord-level muscle tone adjustments, or brain-level pain management. This patient-centric approach ensures that each treatment is not only effective but also aligned with the patient’s comfort and overall wellness goals, embodying the art and science of pain management through dry needling.


In conclusion, the journey to managing chronic pain can be fraught with uncertainty and discomfort. Dry needling, with its complex interplay of tissue, spinal cord, and brain stimulation, often raises more questions than answers. However, by dissecting these three levels of needling stimulation, we gain not only a deeper understanding but also a more effective approach to pain management. This understanding empowers both practitioners and patients to make informed decisions, balancing stimulation levels for maximum therapeutic effect. Whether you’re dealing with persistent muscle pain or seeking more subtle forms of relief, recognizing the nuances of dry needling could be your key to unlocking a more pain-free and active lifestyle.

Dr. Josh Hanson, DACM

Dr. Josh Hanson, DACM

Dr. Josh Hanson specializes in treating chronic pain and providing fertility support. He has performed 40,000+ procedures over the last 10+ years. Dr. Hanson has a clinic in Tampa, FL where patients travel from all over Florida to receive cutting edge care.

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