Dry needling practice, perceptions, and safety challenges among physiotherapists working in Saudi Arabia: A cross-sectional survey

Objective: Dry needling (DN) is a common, low-cost technique that uses a monofilament needle to target muscles, fascia, and connective tissues to reduce pain and movement. Despite the increase in DN applications by physiotherapists (PTs), the use and experience associated with this technique remain under-researched. This study describes the current practice patterns, perceptions, and self-reported experiences (including adverse events) of DN among Saudi PTs, rather than evaluating its clinical effectiveness. Methods: An online cross-sectional survey was conducted among licensed PTs in Saudi Arabia. The survey comprised 23 questions, organized into three sections: (i) demographic data; (ii) patterns and beliefs regarding DN practice; and (iii) experiences with AEs associated with DN. Overall, 228 participants were surveyed; after excluding 44, 184 participants were included in the final analysis. Descriptive statistics were used to summarize the data. Descriptive statistics were used to summarize the data. Statistical significance was set at p<0.05. Results: Most participants (75.5%) reported integrating DN into clinical practice within the previous 12 months, primarily for pain relief (87.9%) and muscle tension reduction (86.4%). Minor AEs, such as transient patient discomfort (28.2%), bruising (22.7%), and minor bleeding (20.0%), were commonly reported. Self-reported major AEs were rare, with pneumothorax (1.8%) and syncope (0.9%) being the most severe. Conclusions: DN is widely practiced among PTs in Saudi Arabia, with positive perceptions of patient outcomes and a low incidence of self-reported severe AEs. These findings highlight the importance of standardized training and safety-focused guidance to support responsible DN practices within healthcare systems.