Dry needling is a very effective treatment option in the management of the myofascial pain syndrome, MPS. We recommend to avoid using dry needling as a stand alone approach but as an addition to manual techniques particularly to manual trigger point therapy. Dry needling is not acupuncture. However the needles utilised for dry needling are acupuncture needles. The goal of dry needling is to puncture the trigger point and the taut band that are responsible for the patient's current dysfunctions or pain. Studies have shown that the elicitation of the local twitch response has an effect on the local chemical millieu of the trigger point and that it is not necessary to inject substances into the trigger point. Therefore the term "dry needling" has been established. Dry needling can be successfully used with MPS patients where it has been deemed to be a suitable treatment. It is particularly effective with athletes.