The local mechanisms for analgesic effects reported after dry needling remain a point of study and discussion and little clarity currently exists in this regard.

Central opioid release may be one mechanism that can be capitised on. In brief, in response to noxious stimuli the body will release endogenous opiods , which inturn results in hypoalgesia at the spinal cord level. However, the stimulus has to be noxious enough to reach the system’s threshold. Therefore, exhausting twitch responses in as many TP hot spots of a particular muscle, makes sense not only with respect to local relaxation, but also for opioid release, because the likelyhood of spinal cord mediated analgesia is raised significantly.

The down side is that post needle soreness appears to be proportional to the amount of needling given. The clinician therefore has to therefore strike a balance in this regard.