We have had a lot of success with dry needling both to improve pain and to capture significant improvement in range of motion. Both of these improvements create a really nice window to improve our ability to load the body.
Here is how we typically use it:
When someone has pain consistent with trigger point pain referral patterns or something call "Nociceptive Behavior"
Muscles are somatic tissue and can refer pain. Is it the direct cause of someone's pain? Probably not. Pain is far too complex to blame a specific structure but we are going after "patterns" of pain that can lead to decisions in the short term then can move us in a positive direction for the long-term
Sensitivity is high (sharp pain) but irritability is low (the pain goes away quickly)
Basically, is the pain mechanical in nature more than inflammatory
mechanical > inflammatory pain
Palpation reproduces your "familiar pain"
If we are going to needle an area we need to be able to reproduce your "familiar pain" and not just an area that we deem as "tight", "stiff" or "wow this isn't moving at all!"
Lastly, and possibly most importantly, have we done our best to find exercises and movements that you can do without having to use dry needling.
Needling is NEVER our first consideration to intervene with someone's pain experience. We don't needle the same area (and rarely different areas) more than we feel is necessary over your course of care.
Being able to help change someone’s pain experience is a powerful thing.