Dry needling, trigger point needling or intramuscular stimulation refers to use of acupuncture needles in a western approach to pain management. The needles are inserted directly into muscular trigger points, described as abnormally taut little bands of muscle within a larger muscle mass that are tight in response to local or distant physical insult or stress. We can feel these as ‘knots’ in a muscle, locally tender and also often referring pain or discomfort to areas distant to the tenderness. They can directly cause pain, indirectly complicate pain syndromes and even mimic other pain problems. As trigger points have been well mapped out in the texts, educated health professionals can readily find them when they are active, and use dry needling (meaning no injection of any substance) as part of treatment, to switch off or down regulate the trigger point activity. The sensation to the patient is typically one of an involuntary twitch, or an ache that diminishes as the point settles, with subsequent improvement (whether immediate or within a couple of days) in pain and range of motion of an affected area. Dry needling is typically used in conjunction with other treatment modalities, including mobilization techniques, manual therapy and tailored exercise prescription, all aimed at addressing the root of the injury or problem.