 Background Dry Needling DN is a skilled intervention that uses acupuncture filiform needles that are inserted into myofascial trigger points or other tissues underneath the skin Dunning. Trigger points are spots in taut muscle fibers that can produce local and radiating pain when irritated, for example when pressed upon. Several theories on the etiology of trigger points exist, such as a local energy crisis and increased acetylcholine release due to mechanical muscle overuse Bron. The existence of trigger points is widely accepted Hong, although there are also some vocal opponents Quintner 2015, Quintner 1994. 