Teton Therapy’s Zac Schaller, MOT, OTR/L, is a Masters-level Occupational Therapist in practice since 2021. Providing upper-extremity rehabilitation in Fremont County with an emphasis on shoulder recovery, he is now practicing full-time at Teton Therapy’s Lander clinic.
When Pittsburgh Steelers’ linebacker T. J. Watt experienced a collapsed lung following a dry needling session, it understandably caught public attention. Watt developed a pneumothorax, a partially collapsed lung, after treatment of the upper trunk region. He received prompt medical care, underwent a procedure, and has since recovered well. While serious, this type of adverse event is rare, especially when performed by properly trained clinicians following established safety protocols.
As an occupational therapist, I approach conversations about dry needling with transparency and education. Dry needling is not experimental or casually performed. It is a skilled intervention grounded in modern anatomy and neurophysiology and, when delivered appropriately, is safe and evidence-based.
What Is Dry Needling?
Dry needling uses a thin, sterile, solid monofilament needle inserted into specific muscular trigger points or areas of neuromuscular dysfunction. “Dry” indicates that no medication is injected. The goal is to reduce muscle tension, decrease pain, improve blood flow, and restore normal movement patterns.
A trigger point is a hyperirritable knot within a muscle that can produce local tenderness and sometimes referred pain. By stimulating these points, dry needling can interrupt abnormal muscle contraction, encourage relaxation, and initiate a localized healing response.
Physical and occupational therapists rarely use dry needling alone. It is typically one component of a comprehensive treatment plan that includes therapeutic exercise, manual therapy, mobility work, and education.
Dry needling is often confused with acupuncture because both use the same thin needles, but their foundations differ. Acupuncture, rooted in Chinese medicine, aims to balance energy flow, while dry needling is based on musculoskeletal evaluation, anatomical landmarks, and neuromuscular physiology. The intent is not to alter energy flow but to address specific trigger points contributing to pain and decreased function.
With Required Training and Certification, Risks are Rare
Dry needling is not typically part of entry-level therapy education. Therapists complete advanced post-professional certification courses that include anatomy, contraindications, sterile technique, and emergency procedures. The thoracic region, where the lungs are located, is treated with particular caution. Proper anatomical knowledge, conservative depth selection, and positioning significantly reduce the already low risk of pneumothorax.
Like injections or IV placement, dry needling carries potential risks. The most common side effects are mild and temporary, including muscle soreness, minor bruising, and fatigue lasting 24–48 hours. More serious complications, such as infection or pneumothorax, are extremely rare. Infections occur in far fewer than 0.1% of cases, while serious complications—including pneumothorax, nerve injuries, and infections—occur in less than 0.01%.
A Clinical Example
In my practice at Teton Therapy, dry needling has been a valuable tool for patients with persistent shoulder pain. One patient with chronic rotator cuff–related pain presented with limited overhead motion, referral pain into the lateral arm, and persistent tightness despite strengthening and manual therapy.
Examination revealed trigger points in the rotator cuff and upper trapezius. After screening and consent, dry needling was introduced using sterile, single-use needles and precise anatomical landmarks. A brief local twitch response was elicited. Following treatment, the muscles demonstrated reduced tightness and improved mobility.
The patient experienced mild soreness for about 24 hours, which resolved quickly. At the following visit, improvements included increased range of motion, decreased pain, and improved strengthening tolerance. Safety protocols were strictly followed throughout, and no adverse events occurred.
Putting It in Perspective
High-profile incidents like Watt’s can create concern, but isolated events must be viewed in context. Millions of dry needling treatments are performed safely each year. When serious complications occur, they are rare and typically associated with proximity to sensitive structures such as the lungs.
Dry needling is not appropriate for every patient, nor is it a stand-alone cure. But when integrated into a comprehensive rehabilitation program and performed by properly trained professionals, it remains a responsible option for reducing pain, restoring mobility, and helping patients return to the activities that matter most.
Teton Therapy Occupational Therapist Zac Schaller, MOT, OTR/L, is available for free consultations in our Lander, WY location. Teton Therapy offers Occupational Therapy in all of our clinics statewide.
Call or text to schedule your free Occupational Therapy consultation today!
In Lander, 307-332-2230
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