Thin filament needling of trigger points and muscle tissue. Performed only by certified dry needling providers. Pairs with movement so the release holds.
Performed by Tim Hu, PT, DPT, OCS, C-DN; Logan Merritt, PT, DPT, NCS, Cert. DN; and Mike Giles, PT, DPT, Cert. DN, all three formally certified in dry needling. $120 a session at Fusion Lindale and FIT Tyler.
Dry needling uses a thin monofilament needle to release tight muscle tissue and reset the neuromuscular pattern. It is performed only by clinicians with formal certification. It is not acupuncture.
Included inside a standard PT visit. Often pairs with manual therapy and a specific loading plan so the effect lasts past the session.
Four steps, and you will know after the first one whether needling is worth continuing. Nothing here happens before the screen says it should.
Upper trap and levator scapulae are the most common targets for neck pain. Suboccipitals come into it when a headache pattern is the main complaint.
Read the guide PillarQL and paraspinal release when those tissues are contributing to the pattern. Deep glutes get added when pain refers into the hip or down the leg.
Read the guide MoreWorks throughout the body for stubborn trigger points and chronic tension. Rotator cuff, forearm extensors, and glute med are the usual suspects.
See all conditionsThe muscles that get needled for back pain are usually quadratus lumborum, the lumbar paraspinals, and the deep glutes when the pain runs into the hip or down the leg. Those muscles guard after a disc flare or a heavy Saturday, and the guarding often outlasts whatever started it.
Needling drops that tone for a day or two. What you do inside that window decides whether it holds: hinge work, side planks and bird dogs, and walking, which is what the back pain plan is built around anyway. Needling with no loading behind it is a fix that expires by Thursday.
One honest limit. When leg pain comes from an irritated nerve root rather than a guarding muscle, needling the muscle changes the guarding and not the nerve. The exam sorts that out before a needle comes out, and the answer changes the plan, not just the technique. Dry needling for back pain goes deeper into which pattern is which.
Upper trapezius and levator scapulae are the two most needled muscles in the building. They are what locks up after a week of laptop days and a bad pillow, and they refer pain into the shoulder blade and up behind the ear, which is why people describe it as a knot that will not let go.
When headaches are the main complaint, the suboccipitals come into it too. Either way the needling buys range, and the range gets used the same visit: deep neck flexor work, mid back mobility, and the desk setup changes that stop it coming back. That is the neck pain plan, and needling is one tool inside it.
Some patients do best when needling and an adjustment happen in the same visit. Dry needling with adjustments covers when we combine the two and when we deliberately do not.
Dry needling in Lindale is done at Physio+ inside Fusion Athletic Club, 140 E Eagle Spirit Dr. Sessions are one on one with a certified DPT, not a high volume mill. You do not need a gym membership. Free parking at the main entrance.
Hours are Monday to Friday, 7a to 6p, closed weekends, and same week appointments are often open. The Lindale clinic page has directions, the towns most patients drive in from, and what the first visit looks like.
Dry needling in Tyler is at FIT, 2259 Broussard St. Same certified DPTs, same $120 session, same rule: we needle the muscle that is guarding the pattern we found in the exam, then we load it so it holds.
Same hours, Monday to Friday 7a to 6p, and free parking in the FIT lot. The Tyler clinic page has the map, the entrance to use, and the parking detail.
Most people should not buy four on day one. Two or three sessions alongside your loading programme tell you whether needling is doing anything for you. Needling is not billed the same as your $195 evaluation.
Most people do not need a package. Dry needling tends to declare itself quickly: if two or three sessions alongside your loading programme have not changed anything, a fourth usually will not either, and we will say so rather than keep booking. The four session package exists for the patients who clearly respond and know they want a course, not as the default recommendation.
Insurance is a separate question and the answer varies more than patients expect. Some carriers cover dry needling inside a physical therapy plan of care, some treat it as a separate billable code, and some exclude it entirely. We verify your specific benefits before the first session so the answer arrives before the bill does. Every cash rate is published on the insurance and cash pay page, and the complete dry needling guide covers what it feels like, how it differs from acupuncture, and the safety record.
One thing worth being direct about: dry needling is an opener, not a treatment. It drops tone in a muscle that has been guarding, which buys a window where the strength and movement work actually lands. Bought on its own, repeatedly, without the loading that follows it, it becomes an expensive way to feel better until Thursday. Every clinician here uses it that way on purpose.
Needle phobia is not a disqualifier, and it is worth saying out loud. Plenty of patients get where they are going with manual therapy, shockwave, and the loading that follows either one. Say so at the evaluation and the plan gets built without it, with no speech about it.
There are situations we screen before needling anyone: pregnancy, a bleeding disorder or blood thinning medication, an active infection or an open wound over the target muscle, lymphedema in that limb, an implant or port near the site, and simply being unwell that day. Some of those are a no, some only move the target or the timing, and your clinician tells you which one applies to you rather than leaving you to guess.
The screen is not a formality. It happens at the evaluation and again at each visit, because the answer can change between visits. And because needling is an opener rather than the plan, taking it off the table changes how a visit is spent, not where you end up.
Most patients feel a quick, deep cramp when the muscle twitches, then it releases. The needle itself is hair thin and most insertions are barely felt. The twitch lasts a second and is usually described as strange rather than painful.
Acute problems typically respond in 2 to 4 sessions. Chronic patterns run 4 to 8. We reassess at every visit and stop needling the moment it stops earning its place in your plan.
Often, for 24 to 48 hours. It feels like a hard workout in the treated muscle, not sharp pain. Water, movement, and heat settle it faster. Soreness beyond 48 hours is worth a call.
Coverage varies by plan when needling is part of a physical therapy plan of care. We verify your benefits before your first session so you know the exact cost walking in.
No. Different framework, different training, different goals. Dry needling targets specific trigger points and nerve tissue based on your movement exam. Our complete guide covers the differences in depth. See the complete dry needling guide.
No. Texas direct access law (HB 4099) allows up to 30 days of physical therapy care, including dry needling, without a physician referral. Book the initial evaluation directly.
Start with the initial evaluation. Needling happens inside a visit, when the exam says a specific muscle is guarding the pattern we found, which is the only way it earns its place. Once you are a patient here and needling is part of your plan, a needling focused follow up is straightforward to book at $120, or 4 for $400.
Dry needling is part of a real plan, not a magic fix. We decide together if it belongs in yours.