Even if they’ve never had it performed, many people have an idea of what acupuncture is. If you are unfamiliar with the concept, acupuncture involves inserting thin needles into specific points on the body with the goal of relieving pain. It’s a form of alternative medicine that many people can’t imagine trying because they’re (understandably!) scared it might hurt.

But there is an alternative treatment for those who want a similar effect of acupuncture with less pain. The process is called dry needling, or dry needle therapy, and despite the fact that the name is 150 percent more terrifying than “acupuncture,” it’s actually less scary (and it’s quickly becoming a treatment of choice among acupuncturists and physical therapists).

What Even Is Dry Needling?

Dry needling is a practice involving the insertion of a microfilament instead of a traditional acupuncture needle. The microfilament needles are inserted to pinpoint muscular trigger points. Traditionally, these needles are believed to stimulate the flow of energy, called qi, throughout the body. Research has found that acupoints are, indeed, packed full of neurovascular structures, so inserting needles into these points can trigger a reaction.

“It’s meant to release tight muscle bands or hard knots within that muscle that may be causing pain over a large area,” says Josh Axe, DNM, CNS, founder of Ancient Nutrition. “The theory behind dry needling is that trigger points in the muscle and connective tissue can generate an increased sensitivity to pain and even lead to damage of the nociceptors or peripheral nerves. But by stimulating these specific points, you are actually releasing the tension and alleviating the discomfort.”

According to experts, dry needling follows the same concept used in acupuncture and traditional Chinese medicine to stimulate reactions in the body. Chinese medical practitioners believe when certain energy pathways are blocked, the result can be pain and illness in the body. In Western medicine, this concept has been studied in regards to blocking certain neuroreceptors.Western doctors believe that dry needling works by finding a spot of tension in the muscle from which pain then spreads. They hope that by stimulating the muscles that are spasming and causing muscular pain, they can force the muscle to relax. Once it does, the pain stemming from the spasm is abated.

Dry Needle Therapy—What It’s Good For

Dry needle therapy may help alleviate pain from any number of chronic conditions, such as arthritis, sports injuries including strains and sprains, and other musculoskeletal diseases that don’t necessarily respond to traditional pain meds. Dry needle therapy can be used as a form of therapy on its own, or it can be combined with other treatments. Most importantly, dry needle therapy may offer a viable treatment for conditions that continue to baffle many medical professionals, such as fibromyalgia and chronic complex pain syndrome.

While medications exist to treat some of these conditions, they often prove to be less than effective for the treatment of chronic pain. And in the midst of our current opioid epidemic, natural, alternative treatments for chronic pain can be helpful.

Few people doubt that chronic pain can be debilitating, but even fewer people understand just how disabling chronic widespread pain can be. And just like any medical treatment, dry needling will not necessarily work for everyone. But physical therapists, doctors, and other licensed medical practitioners have begun to discover a way to determine whether or not dry needling may work for a specific patient or not.

Practitioners of dry needling say that if the treatment is going to work for a particular patient, there will be a noticeable twitch in the inflamed area upon the insertion of the microfilament. When this twitch does occur, patients usually receive at least some pain relief from the dry needling treatment.

While experts aren’t entirely sure how dry needle therapy works to relieve pain, there’s a ton of anecdotal evidence that it’s effective for inflammatory pain, such as that stemming from arthritis and plantar fasciitis. Experts believe that dry needling works not only on the muscles, but also on the fascia, or connective tissue running between muscles.

While researchers continue to study the role fascia plays beyond that of connective tissue, it is thought that inflammation of the fascia may be the primary, or at least a contributing, factor in many pain conditions. In most medical contexts, this is referred to as myofascial pain syndrome.

Dry needling may even help with problems like anxiety and depression. “Acupuncture can help manage the symptoms associated with depression and anxiety, can improve mood, and create relaxation while reducing stress-like symptoms,” says Nekessa Remy, DC, chiropractor and licensed acupuncturist. “Acupuncture and dry needling can also help release endorphins, which can help with low energy.”

Does This Stuff Hurt?

Is the treatment as bad as the affliction? Does dry needle therapy cause pain or even exacerbate the pain it is meant to alleviate?

Any time a foreign object is inserted into the body, there’s a possibility it will hurt. However, comparatively speaking, the pain associated with dry needling pales in comparison to even acupuncture, which a lot of people swear is also relatively pain-free. While traditional acupuncture involves a 25 to 27 gauge needle, the microfilament used by dry needling is less than a 30 gauge. (When it comes to medical grade needles, the higher the number, the smaller the needle.) Because the microfilament used in dry needling is so tiny, there is very little pain with injection.

Are There Risks?

As with any medical treatment, certain risks exist. Whenever a foreign object enters the body, no matter how small, there’s a risk of infection. Patients can develop skin infections or even MRSA, although this is very rare. Patients may also develop sores or cysts at the injection site. Before undergoing dry needling, patients should discuss any skin conditions with their practitioners.

It’s also important to ensure that your dry needle therapy practitioner has received specific training in the technique. In the United States, acupuncturists must undergo a rigorous certification plan so they are properly versed in the risks. When a qualified practitioner performs it, dry needling is very safe.

Kate Harveston is a journalist from Pennsylvania. She frequently writes about health care and culture. You can follow her on Twitter at @KateHarveston or check out her author page here.