Breaking New Ground: Dry Needling & Acupuncture for Vestibulodynia
- Dr. Autum Kirgan
- Jan 14
- 8 min read
Evidence-Based Relief for Chronic Pelvic Pain in Asheville
If you're experiencing burning, stinging pain at the vaginal opening that makes intimacy difficult or impossible, you're not alone, and more importantly, effective treatment options exist. Groundbreaking research published in 2025 demonstrates that dry needling can provide significant relief for provoked vestibulodynia (PVD), a chronic pain condition affecting up to 16% of women during their reproductive years.
At South Slope Acupuncture & Wellness in Asheville, we specialize in pelvic health acupuncture and dry needling, evidence-based treatments that address the root causes of vestibular pain through targeted myofascial release and nervous system modulation.
Understanding Provoked Vestibulodynia
Provoked vestibulodynia is the most common subtype of vulvodynia, characterized by severe pain upon pressure to the vulvar vestibule or during attempts at penetration, lasting more than three months.¹ This condition profoundly impacts quality of life, sexual function, and mental health, yet remains significantly underdiagnosed and undertreated.
Common symptoms include:
Burning, stinging, or rawness at the vaginal opening
Pain with sexual intercourse, tampon insertion, or gynecological exams
Pelvic floor muscle tension and tenderness
Pain that occurs with 90% or more of penetrative attempts
Associated anxiety, depression, and relationship distress
Research consistently shows that women with PVD have increased pelvic floor muscle tone² and myofascial trigger points in the pelvic floor, hip, lower back, and abdominal muscles.³⁻⁴ This myofascial dysfunction creates an ongoing cycle of pain and muscle tension that conventional treatments often fail to address.
The Science Behind Dry Needling & Acupuncture for Pelvic Pain
Unlike traditional acupuncture, which focuses on energy meridians, dry needling specifically targets myofascial trigger points, hyperirritable spots within taut bands of muscle that cause localized and referred pain. When applied to pelvic floor dysfunction, this technique addresses multiple pain mechanisms:
Mechanisms of Action
Peripheral Effects: Needle insertion into trigger points elicits local twitch responses, releasing muscle tension and increasing blood flow to hypoxic tissue. This mechanical disruption helps reset dysfunctional motor endplates and reduces muscle tone.⁵
Central Nervous System Modulation: Dry needling reduces central sensitization, the amplification of pain signals in the spinal cord and brain. Research demonstrates that five sessions of dry needling produce dose-dependent reductions in spinal substance P and measurable changes in brain activity patterns associated with chronic pain.⁶
Autonomic Nervous System Regulation: Treatment modulates both sympathetic and parasympathetic responses, helping to break the fear-pain-tension cycle common in vestibulodynia. This nervous system reset is crucial for women who experience heightened pain anticipation and muscle guarding.⁷
Pain Pathway Deactivation: By releasing pelvic floor and surrounding muscle trigger points, dry needling interrupts referred pain patterns that contribute to vestibular hypersensitivity.
Landmark Research: The 2025 Clinical Trial Results
A groundbreaking randomized controlled trial published in the Journal of Pain in 2025 provides the first rigorous evidence for dry needling as a treatment for provoked vestibulodynia.¹ Led by Dr. Mélanie Roch at the Université de Sherbrooke, this double-blind study examined 46 women diagnosed with PVD who received six weekly sessions of either real or sham dry needling.
Study Design & Treatment Protocol
The treatment protocol was strategically designed in two blocks. During sessions 1-3, practitioners targeted muscles in the hip, lower back, and abdominal wall, areas where myofascial trigger points commonly refer pain to the pelvic floor. Sessions 4-6 focused directly on pelvic floor muscles including the puborectalis, bulbospongiosus, transverse perineal, and coccygeus muscles.
Treatment targeted muscles only when they met at least two of three diagnostic criteria: presence of a taut band, hypersensitive spot (trigger point), or referred pain recognized by the participant. This evidence-based approach ensured precision in addressing the actual sources of pelvic pain.
Results: Significant Pain Reduction
The results were striking:
54% reduction in pain during intercourse in the real dry needling group (pain scores decreased from 6.8 to 3.1 on a 0-10 scale)
Statistically and clinically significant difference compared to sham treatment (mean difference of 2.4 points; p<.001)
56% of participants reported being "much improved" to "very much improved" after treatment
Significant improvement in sexual function as measured by the Female Sexual Function Index
99% adherence rate with 100% retention in the treatment group, demonstrating high patient acceptability
Importantly, the study found that dry needling was highly acceptable to patients across all dimensions measured, including burden, effectiveness, and ethical appropriateness, addressing concerns about treating such a sensitive anatomical area.
Safety Profile
The treatment demonstrated an excellent safety profile with only minor, transient side effects:
Muscle soreness (96%) – similar to post-exercise soreness, typically resolving within 24-48 hours
Mild bruising (48%) – minor and temporary
Transient autonomic responses (35%) – brief sweating, fatigue, or nausea during treatment, all resolving before leaving the clinic
No major adverse events or serious complications occurred, consistent with the established safety profile of dry needling in other musculoskeletal conditions.
Additional Evidence: Acupuncture for Vulvodynia
While the Roch study represents the first controlled trial of dry needling for PVD specifically, multiple studies support the use of acupuncture for vulvodynia more broadly:
Schlaeger et al. (2015) Pilot Study
The first randomized controlled pilot study examining acupuncture for vulvodynia found that 36 women receiving 10 acupuncture sessions over five weeks experienced significant reductions in vulvar pain and painful intercourse, with improvements in overall sexual function.⁸ This study established feasibility and provided preliminary evidence that needle-based therapies could effectively address vulvar pain.
Schlaeger et al. (2025) Long-term Effects Study
A larger double-blind randomized controlled trial with 89 women found that 58% of those receiving penetrating acupuncture were treatment responders with clinically meaningful pain reduction.⁹ Critically, among responders, the therapeutic effects of penetrating acupuncture lasted significantly longer than placebo effects during the 12-week follow-up period, suggesting durable pain relief.
Curran et al. (2010) ACTIV Study
This pilot study of traditional Chinese medicine acupuncture for eight women with PVD demonstrated feasibility and preliminary effectiveness, with participants reporting reduced vulvar pain and improved sexual function.¹⁰ The individualized treatment approach honored each woman's unique presentation while achieving positive outcomes.
Chronic Pelvic Pain Research
Beyond vulvodynia-specific research, a 2024 randomized controlled trial demonstrated that five sessions of dry needling for chronic pelvic pain in women significantly reduced central sensitization, decreased pain catastrophizing, and improved quality of life measures.⁶ This research confirms that dry needling addresses not just local tissue dysfunction but also the central nervous system amplification of pain that perpetuates pelvic pain conditions.
Our Treatment Approach at South Slope Acupuncture
As a Doctor of Acupuncture & Chinese Medicine with specialized certification in both Pelvic Floor Acupuncture & Dry Needling (ASE Seminars) and Dry Needling for Pelvic Pain (Myopain Seminars), I bring advanced training in sports medicine acupuncture and women's health to address vestibulodynia comprehensively.
Comprehensive Assessment
Treatment begins with a thorough evaluation including:
Detailed pain history and symptom patterns
Pelvic floor muscle assessment for trigger points and hypertonicity
Evaluation of hip, lower back, and abdominal musculature
Assessment of pain referral patterns
Discussion of treatment goals and expectations
Individualized Treatment Protocol
Following the evidence-based approach demonstrated in research, treatment progresses systematically:
Phase 1 (Weeks 1-3): Initial sessions address myofascial trigger points in the hip, lower back, quadratus lumborum, gluteal muscles, and abdominal wall. This peripheral-to-central approach reduces referred pain to the pelvic floor while building patient comfort with the technique.
Phase 2 (Weeks 4-6+): Direct pelvic floor treatment targets specific muscles including the puborectalis, bulbospongiosus, transverse perineal, and other pelvic floor muscles as indicated. Treatment is performed externally through the perineum with the highest standards of comfort and dignity.
Integrated Care Approach
Dry needling and acupuncture are most effective as part of a comprehensive treatment plan:
Additional modalities: Red Light Therapy for tissue healing and inflammation reduction, PEMF (Pulsed Electromagnetic Field) therapy for pain modulation
Pelvic floor physical therapy: Coordination with specialized pelvic floor PTs for breathing techniques, muscle relaxation strategies, and graduated desensitization
Pain neuroscience education: Understanding pain mechanisms to reduce fear-avoidance and catastrophizing
Lifestyle modifications: Stress management, sleep optimization, and anti-inflammatory nutrition
What to Expect During Treatment
Treatment Sessions: Sessions typically last 45 minutes, depending on the number of muscles treated and individual response. You'll remain draped throughout treatment with only the specific treatment area exposed.
Sensations: Needle insertion feels like a quick pinch. When the needle reaches a trigger point, you may experience a local twitch response, a brief, involuntary muscle contraction, followed by a deep ache or reproduction of familiar pain. This recognition response confirms we're addressing the right tissue. Some patients experience referred sensations to other areas, indicating successful trigger point deactivation.
Post-Treatment: Muscle soreness similar to post-workout ache is common for 24-48 hours. Many patients report feeling more relaxed immediately after treatment. Progressive improvements in pain and function typically emerge over the treatment series.
Expected Timeline: Based on research protocols, a minimum of 6 weekly sessions is recommended for initial treatment. Some patients achieve significant relief within this timeframe, while others benefit from additional sessions or periodic maintenance treatment.
Who Is a Candidate for This Treatment?
You may benefit from pelvic floor dry needling and acupuncture if you experience:
Pain with sexual intercourse, gynecological exams, or tampon insertion
Burning or stinging at the vaginal opening
Pelvic floor muscle tension or tightness
Chronic pelvic pain with myofascial components
History of limited response to other conservative treatments
Desire for evidence-based, non-pharmaceutical intervention
Treatment is appropriate for most patients with vestibulodynia. Contraindications include active infection in the treatment area, bleeding disorders, anticoagulation therapy, immunosuppression, or needle phobia. During your initial consultation, we'll review your complete medical history to ensure dry needling is safe and appropriate for you.
Why Choose South Slope Acupuncture for Pelvic Health
Our Asheville practice specializes in evidence-based orthopedic and pelvic health acupuncture with:
Advanced dual certification in Pelvic Floor Acupuncture & Dry Needling (ASE Seminars) and Dry Needling for Pelvic Pain (Myopain Seminars)
Specialized expertise in women's health, fertility support, and pelvic floor dysfunction
Sports medicine acupuncture background (C.SMA) ensuring precision in myofascial assessment and treatment
Evidence-based protocols informed by the latest research
Comprehensive approach integrating multiple treatment modalities for optimal outcomes
Compassionate, dignified care in a supportive environment
Ready to Reclaim Your Comfort and Confidence?
The groundbreaking 2025 research confirms what many patients have experienced: dry needling and acupuncture offer genuine relief for vestibulodynia by addressing the myofascial dysfunction and central sensitization that perpetuate this challenging condition. With proper treatment, significant improvement is possible.
If you're experiencing vestibular pain, painful intercourse, or chronic pelvic discomfort in the Asheville area, I invite you to schedule a consultation at South Slope Acupuncture & Wellness. Together, we'll develop an evidence-based treatment plan tailored to your unique needs and goals.
About the Author
Dr. Autum Kirgan, DAOM, L.Ac, C.SMA is the Clinic Director of South Slope Acupuncture & Wellness in Asheville, North Carolina. She specializes in orthopedic and sports medicine acupuncture, women's health, fertility support, and pelvic health acupuncture and dry needling. With dual certification in Pelvic Floor Acupuncture & Dry Needling (ASE Seminars) and Dry Needling for Pelvic Pain (Myopain Seminars), Dr. Kirgan brings evidence-based expertise to addressing complex pelvic pain conditions. Her practice integrates traditional acupuncture wisdom with contemporary pain science and myofascial techniques to provide comprehensive, compassionate care.
References
1. Roch M, Gaudreault N, Paré J, et al. A randomized controlled trial investigating feasibility, acceptability and effects of dry needling for provoked vestibulodynia. J Pain. 2025;38:105596. doi:10.1016/j.jpain.2025.105596
2. Morin M, Binik YM, Bourbonnais D, Khalifé S, Ouellet S, Bergeron S. Heightened pelvic floor muscle tone and altered contractility in women with provoked vestibulodynia. J Sex Med. 2017;14(4):592-600. doi:10.1016/j.jsxm.2017.02.012
3. Pastore EA, Katzman WB. Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain. J Obstet Gynecol Neonatal Nurs. 2012;41(5):680-691. doi:10.1111/j.1552-6909.2012.01404.x
4. Sanses TV, Chelimsky G, McCabe NP, et al. The pelvis and beyond: musculoskeletal tender points in women with chronic pelvic pain. Clin J Pain. 2016;32(8):659-665. doi:10.1097/ajp.0000000000000307
5. Fernández-de-Las-Peñas C, Dommerholt J. International consensus on diagnostic criteria and clinical considerations of myofascial trigger points: a Delphi study. Pain Med. 2018;19:142-150. doi:10.1093/pm/pnx207
6. Ghanbari A, Rahimijane A, Hadian MR, et al. Effect of dry needling on pain and central sensitization in women with chronic pelvic pain: a randomized parallel-group controlled clinical trial. Heliyon. 2024;10(11):e31699. doi:10.1016/j.heliyon.2024.e31699
7. Cagnie B, Dewitte V, Barbe T, Timmermans F, Delrue N, Meeus M. Physiologic effects of dry needling. Curr Pain Headache Rep. 2013;17(8):348. doi:10.1007/s11916-013-0348-5
8. Schlaeger JM, Xu N, Mejta CL, Park CG, Wilkie DJ. Acupuncture for the treatment of vulvodynia: a randomized wait-list controlled pilot study. J Sex Med. 2015;12(4):1019-1027. doi:10.1111/jsm.12830
9. Schlaeger JM, Shinohara M, Steffen AD, et al. Long-lasting effect of penetrating acupuncture among responders: double-blind RCT of acupuncture for vulvodynia. J Pain. 2025. doi:10.1016/j.jpain.2025.105811
10. Curran S, Brotto LA, Fisher H, Knudson G, Cohen T. The ACTIV study: Acupuncture treatment in provoked vestibulodynia. J Sex Med. 2010;7:981-995. doi:10.1111/j.1743-6109.2009.01582.x
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