Post needling soreness is a common side effect of dry needling, particularly if multiple twitches are obtained. "Six" twitches seems to be the number of twitches necessary to obtain better clinical results (1).  Mitigation of this "post needling soreness" has been explored. One study (2) looked at "spray and stretch" as a way to reduce post needling soreness, but the effects were found to be short term, less than 6 hours, and did not affect pressure pain thresholds. Another study (3) looked at acupuncture itself as a way of treating delayed onset muscle soreness following exercise, but it only reduced perceived pain and did not seem to have an effect on mechanical thresholds or muscle function. Overall, there just isn't a lot out there about treating post needling soreness in the literature.

Both ischemic compression and dry needling have been successfully utilized to manage trigger points and trigger point pain, with both reducing pain and increasing range of motion (4). The use of ischemic compression for post needling soreness has recently been published in the literature (5), and has been shown to decrease both soreness intensity and duration. This carried over to at least 48 hours post treatment. 

The physiological mechanisms that could explain how this works may include large diameter afferent stimulation through muscle and skin mechanoreceptors causing presynaptic inhibition at the spinal cord or perhaps through descending cortical inhibition pathways. The likely answer is that it is probably a combination of both. 

Since this is such a simple procedure, why not added to your post-treatment regimen of care?

1. Fernández-Carnero J¹, Gilarranz-de-Frutos L, León-Hernández JV, Pecos-Martin D, Alguacil-Diego I, Gallego-Izquierdo T, Martín-Pintado-Zugasti A.: Effectiveness of Different Deep Dry Needling Dosages in the Treatment of Patients With Cervical Myofascial Pain: A Pilot RCT. Am J Phys Med Rehabil. 2017 Oct;96(10):726-733. doi: 10.1097/PHM.0000000000000733.

2. Martín-Pintado-Zugasti, A., Rodríguez-Fernández, A.L., García-Muro, F. et al.: Effects of spray and stretch on postneedling soreness and sensitivity after dry needling of a latent myofascial trigger point. Arch Phys Med Rehabil. 2014; 95: 1925–1932  link to free full text: http://www.archives-pmr.org/article/S0003-9993(14)00416-X/pdf

3. Hübscher M¹, Vogt L, Bernhörster M, Rosenhagen A, Banzer W.: Effects of acupuncture on symptoms and muscle function in delayed-onset muscle soreness J Altern Complement Med. 2008 Oct;14(8):1011-6. doi: 10.1089/acm.2008.0173.

4. Barbara Cagnie; Birgit Castelein; Flore Pollie; Lieselotte Steelant; Hanne Verhoeyen; Ann Cools: Evidence for the Use of Ischemic Compression and Dry Needling in the Management of Trigger Points of the Upper Trapezius in Patients with Neck Pain: A Systematic Review American Journal of Physical Medicine & Rehabilitation. 94(7):573–583, JUL 2015

5. Martín-Pintado-Zugasti, Aitor et al. : Ischemic Compression After Dry Needling of a Latent Myofascial Trigger Point Reduces Postneedling Soreness Intensity and Duration      PM&R , Volume 7 , Issue 10 , 1026 - 1034    link to free full text: http://www.pmrjournal.org/article/S1934-1482(15)00173-2/fulltext