A thin needle goes into the muscle. The muscle releases. The pain that wouldn't quit finally has a reason to.
I'm Dr. Birikov. I've been performing dry needling in Baltimore for 10 years, and I hold the certification Maryland requires to do it legally and safely. Every session is one-on-one — no aides, no assistants, no shared treatment floor. If you've tried other approaches and the pain keeps coming back, there's usually a structural reason. Dry needling is often part of fixing it.
Dry Needling in Baltimore — What It Is and How It Works
Dry needling is the insertion of a thin filament needle directly into a trigger point — a tight, irritable knot inside a muscle that won't release on its own. The needle creates a localized twitch response: the muscle fires involuntarily, then relaxes. That release reduces pain, restores range of motion, and allows the surrounding tissue to move the way it's supposed to.
The word "dry" means there's no medication in the needle. Nothing is injected. The effect comes entirely from the mechanical disruption of the trigger point itself. It works on muscles that have been locked up for weeks, months, or years — the kind that don't respond to stretching, foam rolling, or hands-on massage alone.
I use dry needling as one tool inside a broader treatment plan, not as a standalone fix. After 10 years and over 300 five-star Google reviews, the approach is straightforward: find the root cause, treat it directly, and build a plan that holds.
Dry Needling vs. Acupuncture — The Key Difference
They use the same type of needle. That's where the similarity ends. Acupuncture is a practice rooted in traditional Chinese medicine — it works along energy meridians and is performed by licensed acupuncturists trained in that system. Dry needling is a physical therapy technique grounded in Western anatomy and neuromuscular science. The target is a specific trigger point inside a specific muscle, identified through clinical assessment.
The training is different. The mechanism is different. The clinical goal is different. Dry needling is not acupuncture rebranded — it's a distinct intervention aimed at releasing dysfunctional muscle tissue and reducing referred pain patterns. In Maryland, physical therapists who perform dry needling must hold a specific certification. I do.
What Conditions Respond to Dry Needling
Does Dry Needling Hurt? What to Expect
During the session
The needle itself is very thin — thinner than a hypodermic needle. Insertion usually produces little to no sensation. When the needle reaches the trigger point, you'll feel a brief, involuntary muscle twitch. Some people describe it as a deep ache or a cramping sensation that lasts a few seconds. It's not comfortable, but it's brief, and it's the signal that the technique is working.
After the session
Post-treatment soreness is real and worth knowing about before you book. The treated muscle often feels like it went through a hard workout — sore, heavy, sometimes tender to the touch. That typically lasts 24 to 48 hours. Most patients can work and move through it. I'll tell you exactly what to expect based on which muscles we treated and how reactive they were.
Is it safe?
Yes, when performed by a certified practitioner. I'm dry needling certified in Maryland and have been performing this technique for 10 years. I use single-use, sterile needles. The risks — minor bruising, temporary soreness, rare lightheadedness — are real but low. I go over them with you before we start.
If you're afraid of needles
That's a fair concern and it comes up often. Dry needling needles are nothing like the needles used for blood draws or injections — there's no syringe, no medication, and the gauge is much finer. Most patients who come in anxious are surprised by how manageable it is. That said, it's not for everyone, and I won't push it if another approach makes more sense for you.
Cost, Insurance, and What to Know Before You Book
Physica Medica is a cash-pay practice. I don't bill insurance. That's a deliberate choice: insurance reimbursement structures dictate session length, treatment frequency, and which interventions are covered — and those constraints get in the way of actual results. When you pay directly, I answer to you, not to a billing department.
- Dry needling is not covered by most insurance plans, even when billed through an in-network provider. You'd likely be paying out of pocket either way.
- Some patients use HSA or FSA accounts, which typically cover dry needling as a qualified medical expense. Worth checking before you call.
- Exact pricing is discussed on your first call. I'm not going to bury a number here and have it mean nothing without context — what you're treated for, how many sessions make sense, what's included. That conversation takes two minutes.
If cost is the deciding factor, I'd rather you know that upfront than book a session and feel blindsided. The investment is real. So are the results.
Why Patients Choose Physica Medica for Dry Needling
Most dry needling in a standard PT clinic gets delegated. A certified aide or junior clinician performs the technique while the supervising therapist manages three other patients. You may not even see the same person twice. That's not how this works.
Questions I Hear Before the First Session
| Physica Medica | Traditional PT Clinic | |
|---|---|---|
| Who treats you | Dr. Birikov, every session | Whoever is available that day |
| Hands-on time | The full session | ~10–15 minutes, often with an aide |
| The floor | Private treatment space | Shared gym floor, 3–4 patients at once |
| Your plan | Built and adjusted for your body | Standardized protocol sheet |
| Continuity | Same doctor tracks your progress | New therapist re-reads your chart |
Will insurance pay for dry needling?
Most insurance plans don't cover dry needling, or cover it only under narrow conditions. Even at in-network clinics, patients often pay out of pocket for it. At Physica Medica, the practice is cash-pay across the board — no insurance billing of any kind. HSA and FSA funds are generally accepted. Full details are on the payment page.
See payment and insurance details →
What one-on-one care feels like
A selection from 300+ verified five-star reviews on Google.
[Real patient testimonial will be placed here — verified Google review snippet.]
[Real patient testimonial will be placed here — verified Google review snippet.]
[Real patient testimonial will be placed here — verified Google review snippet.]
Rated 5.0 stars across 300+ reviews on Google.
Is there a downside to dry needling?
Post-treatment soreness is the most common one. The treated muscle can feel sore for 24 to 48 hours — similar to delayed onset muscle soreness after a hard workout. Minor bruising at the needle site is possible. Rarely, patients feel lightheaded during or after the session. These are real side effects, not rare anomalies. I tell every patient about them before we start.
Dry needling is not appropriate for everyone. Certain medications, bleeding disorders, and other factors affect whether it's the right call. That's part of why the initial assessment matters — I'm not going to needle a muscle without understanding the full picture first.
If you have specific concerns, call or text before booking. 443-228-8029.