• Superficial vs. Deep Needling for Neck and Back Pain

  • There are a variety of needling techniques involved in Dry Needling. One aspect to consider is the depth of needle placement. The following 2 studies each compared pain relief by superficial needle placement vs. deep muscle tissue needle placement.

    In a controlled and double-blinded study of 50 adult patients with upper trapezius myofascial pain for > 3 months, half of the patients were randomly assigned to a superficial needle group and half assigned to a deep needle placement group.[1]  All patients received dry needling at the same mid-point of each patient’s upper trapezius, for 3 sessions.  The deep needle method allowed a consistent “local muscle twitch” response. Standardized measures were taken of the area of reduced tissue tenderness, and pain ratings were taken after the treatment, and again 7 days and 15 days after last treatment.   

    The result was that the size of the tissue area with pain relief was greater for the deep needle placement group when compared to the superficial needle placement group.  Also, comparison found the deep needle group had a greater reduction of pain intensity than the superficial needle group at 7 days and 15 days after treatment.

    In another controlled and blinded study, 42 patients with lumbar myofascial pain received either superficial needle placement or deep muscle tissue needle placement.[2] Both groups had short-term pain relief.  The pain reduction was greater in the group treated with deep needle placement.  At 3 month follow-up, a statistical difference existed between the two groups, with a better pain reduction result in the deep needle placement group.  The final clinical conclusion by the research team:  the deep needle stimulation resulted in “a better analgesic effect when compared with superficial stimulation”. 


    These and other studies indicate that for neck and low back myofascial pain, deep needling methods provide greater pain reduction and more long- lasting pain relief.  

    Legacy Therapy provides “Deep Dry Needling” techniques, and Electrical Dry Needling techniques — using the Functional Dry Needling® method.  


    1. Ezzati et al.  Effects of Superficial and Deep Dry Needling on Pain and Muscle Thickness in Subject with Upper Trapezius Muscle Myofascial Pain Syndrome. J Pain Relief 2018, 7:3
    2. Ceccherelli F, Rigoni MT, Gagliardi G, Ruzzante L. Comparison of superficial and deep acupuncture in the treatment of lumbar myofascial pain: A double-blind randomized controlled study. Clin J Pain 18: 149-153.