Can Dry Needling Help Sciatica and Nerve Pain? A Physical Therapist Explains
- Dinell Jacobson
- Aug 1
- 4 min read
What Is Sciatica—and Why Is It So Hard to Treat?
If you’ve ever experienced a shooting pain down the back of your leg, numbness in your foot, or a dull ache in your lower back that just won’t quit, you may be dealing with sciatica.
Sciatica refers to pain caused by irritation or compression of the sciatic nerve, which runs from your lower spine down through your hips, buttocks, and legs. The sciatic nerve can get compressed or stretched in any one of these areas, causing your body to produce pain as a way to get your attention that something is wrong.
But here’s the frustrating part: even when imaging shows a bulging disc or spinal stenosis, the pain often doesn’t match the picture—and treatments like pain meds, injections, or surgery don’t always help. Because of the long journey your sciatic nerve makes from your low back to your foot, many different things can go wrong along the way. Sciatica is not always the result of a disc herniation.
That’s where dry needling, a specialized physical therapy technique, comes in.
What Is Dry Needling?
Dry needling is a therapy where a trained physical therapist inserts tiny acupuncture needles into specific muscles, trigger points, or areas near irritated nerves. Unlike acupuncture, which is based on traditional Chinese medicine, dry needling is based on modern Western anatomy and neuroscience.
The goal?
Release tight muscles
Calm overactive nerves
Restore healthy blood flow and reduce inflammation
It’s called “dry” because the needle doesn’t inject any substances—it simply stimulates the tissue to trigger a healing response.
Dry Needling vs. Acupuncture: What’s the Difference?
It’s a common question—and a good one.
Dry Needling | Acupuncture | |
Philosophy | Based on anatomy, neurophysiology | Based on Traditional Chinese Medicine |
Practitioners | Physical therapists, chiropractors | Licensed acupuncturists |
Goal | Trigger point release, nerve regulation | Qi balancing, energy flow |
Conditions Treated | Muscle/nerve pain, tightness, mobility issues | Pain, stress, fertility, digestion, etc. |
We often refer out for acupuncture when it fits—but for mechanical nerve pain, dry needling is often faster-acting and more specific.
How Dry Needling Helps Sciatica
Sciatica can come from many sources: disc herniation, piriformis syndrome, spinal stenosis, postural imbalances—even inflammation around the nerve itself. Dry needling helps by targeting these sources from multiple angles:
Releasing Trigger Points That Compress Nerves
Many sciatica sufferers have tight muscles in the glutes, piriformis, and low back that clamp down on the sciatic nerve. Dry needling can “reset” these muscles, allowing them to relax and reduce nerve pressure.
Reducing Neurogenic Inflammation
Irritated nerves create a local inflammatory response. Dry needling stimulates circulation and releases natural anti-inflammatory compounds in the area, calming the nerve and reducing hypersensitivity.
Reprogramming Pain Signals in the Brain
Chronic pain often creates a cycle where your nervous system becomes more sensitive over time. Dry needling disrupts this loop by sending new, non-painful input to the central nervous system—helping it “downregulate” the pain signal.
Improving Mobility and Muscle Balance
By releasing spasms and reducing guarding, dry needling allows better movement patterns. This reduces further irritation of the nerve and gives physical therapy exercises a greater chance of success.
What Does the Research Say?
A growing body of evidence supports dry needling as an effective tool for nerve pain, especially when combined with other therapies like manual therapy and corrective exercise.
A 2021 meta-analysis published in Pain Medicine concluded that dry needling showed statistically significant improvements in pain and function for people with sciatica compared to control groups.
A separate study in the Journal of Orthopaedic & Sports Physical Therapy found that patients with lumbar radiculopathy (nerve root pain) had improved range of motion and decreased pain scores after just 2–3 sessions of targeted dry needling.
What a Session Looks Like at True Health Centers
At True Health Centers in Westminster, CO, dry needling is performed by our experienced physical therapist who specializes in complex pain cases and neuromuscular re-education.
Here’s what you can expect during a session:
Assessment: We start by identifying the specific muscles and nerve patterns involved in your pain.
Targeted Needling: Ultra-fine needles are inserted into trigger points or along irritated nerve pathways.
Manual Therapy: We often combine dry needling with hands-on techniques like myofascial release or joint mobilization.
Corrective Exercise: You’ll receive a custom rehab plan to strengthen weak areas and retrain your posture.
Progress Tracking: We monitor your response carefully—most patients feel a significant change within 2–4 sessions.
Who Is a Good Candidate?
Dry needling may be right for you if you:
Have sciatic pain, numbness, or tingling down the leg
Feel like your glutes or back are always “tight” or cramping
Have tried other therapies with limited relief
Are looking to avoid medications or injections
Want a more targeted solution to your nerve pain
Who Should Avoid Dry Needling?
Dry needling is generally safe when performed by a trained professional, but we avoid it in:
People with a needle phobia
Active skin infections at the site
Bleeding disorders or uncontrolled anticoagulant use
Pregnancy (specific precautions apply)
Very young children
Patient Story: Sciatica That Finally Got Better
One of our patients, an 80-year-old female, came in with left-sided sciatica that had lingered for over 9 months. The pain was so debilitating that she frequenly spent a week of more in an assisted living nursing home. She used to find a lot of relief with chiropractic care but due to her severe osteoporosis, chiropractic and some physical therapy was not safe for her. She'd tried massage, stretches, and muscle relaxers—but the pain always returned.
After evaluating her movement patterns, we identified deep gluteal trigger points that were irritating her sciatic nerve. Within three dry needling sessions her pain reduced by 70%. After six sessions, she was pain-free for the first time in nearly a year—and back to living in her home permanently.
How to Get Started at True Health Centers
If you're struggling with sciatic or nerve pain and want a non-surgical, drug-free solution, dry needling may be a key piece of the puzzle. You can book your appointment online or by calling (970) 716-0557.