Can Dry Needling Cause a Collapsed Lung? What T.J. Watt's Case Shows
Updated: Oct 6
Yes, dry needling can cause a collapsed lung, but it is very rare. Serious complications have been reported in about 0% to 0.43% of treatments. That number includes all serious complications, not pneumothorax specifically. T.J. Watt’s case shows that this complication can happen, even though the overall risk remains low.
Key Takeaways
A collapsed lung from dry needling is possible, but it appears to be very rare, especially compared with minor reactions like soreness or bruising.
The risk depends heavily on where the needle is placed, with more caution needed around the chest, upper back, neck, shoulder blade and ribs.
At Phenom Sports & Rehabilitation, dry needling is one tool within a larger rehab plan, not a standalone treatment.
Table of Contents
How Rare Is a Collapsed Lung From Dry Needling?
Very rare. Across 59 studies, major complications were reported in roughly 0% to 0.43% of treatments.
Put that into normal language. Even at the very top of that range, we are talking about 4 major complications for every 1,000 treatments.
And this is the most important part. That is not the collapsed-lung rate. It includes all serious complications combined. Pneumothorax is only one of them.
Another study followed 420 physical therapists through 20,494 dry needling treatments.
That is a lot of needles.
Only 20 problems were reported. That is fewer than 1 in 1,000 treatments.
And no collapsed lungs were reported in that study.
What happened much more often were the small, expected reactions.
About 16% of treatments caused a little bleeding, 7.7% caused some bruising and 5.9% caused temporary discomfort during needling.
Overall, minor reactions were reported in about 1 in 3 treatments, but that usually meant something simple like a small spot of blood, a bruise or short-term soreness.
That is why context matters.
If all you saw was T.J. Watt, an NFL player for the Pittsburgh Steelers, ending up in the hospital after dry needling, it would be easy to think a collapsed lung is a common risk.
Minor reactions are common. Serious complications are uncommon. A collapsed lung can happen, but it is very rare.
How Dry Needling Can Cause a Collapsed Lung
A collapsed lung from dry needling happens when a needle penetrates the pleura, the thin membrane surrounding the lung.
Once the pleura is punctured, air can enter the pleural space, the small space between the lung and the inside of the chest wall.
Doctors call this a pneumothorax.
In simple terms, air gets around the outside of the lung where it should not be. That can cause part of the lung to pull away from the chest wall and collapse.
The risk is mainly tied to where the treatment is being done.
It matters most in areas such as the chest, upper back, shoulder, and lower neck, where the pleura can sit relatively close beneath the muscles.
That is very different from needling areas farther away from the lungs, such as the calf or thigh.
Where the Pneumothorax Risk Is Higher
Pneumothorax is mainly a concern when dry needling is performed in areas where the lungs sit relatively close underneath the muscles being treated.
Area | Why more caution is needed |
|---|---|
Chest | The chest wall sits directly over the pleural cavity. |
Upper back and shoulder blade | The ribs and pleura sit underneath the muscles in this region. |
Upper trapezius and lower neck | Parts of the upper lung extend into this area, so depth and direction matter. |
Intercostal region | These are the spaces between the ribs, where the pleura may be relatively close. |
This does not mean dry needling in these areas is generally dangerous.
It means these regions deserve more anatomical precision than needling somewhere like the calf or thigh.
The closer the treatment is to the chest, the more important anatomy, needle depth and direction become.
What Symptoms to Watch for After Dry Needling
A little soreness after dry needling can be normal. New chest pain or trouble breathing is different.
That is the distinction I want you to remember.
If dry needling was done near the chest, upper back, shoulder, or lower neck, watch for symptoms like:
new chest pain
sharp pain that gets worse with a deep breath
shortness of breath
chest tightness
difficulty taking a full breath
Pain that gets worse when you breathe deeply is sometimes called pleuritic pain. It can happen when the tissues around the lung become irritated.
Some local tenderness or aching after dry needling is expected.
The treated muscle may feel tender, achy or a little beat up for a day or two. That by itself is not something I would want a patient to panic about.
What gets my attention as a physical therapist is when the symptoms stop feeling like normal muscle soreness.
The other thing to know is that symptoms do not always start right away.
Published cases show that they can begin during treatment, a few hours later, the next day, or occasionally several days afterward.
If you develop new chest pain or trouble breathing after dry needling near the chest or upper back, get medically evaluated.
At Phenom Sports & Rehabilitation, we want you to understand what is normal after treatment, what you may feel afterward and what would be unusual. If something worries you, ask us.
We would much rather explain it, answer your questions and put your mind at ease than have you sitting at home wondering whether a sensation is normal.
What Actually Happened to NFL Star T.J. Watt
Now that we have covered the anatomy, the risk areas and the numbers, T.J. Watt’s case is easier to understand in context.
In December 2025, Pittsburgh Steelers star T.J. Watt underwent dry needling at the team’s facility.
Not long afterward, something felt wrong.
Watt went to the hospital, where doctors found that part of his lung had collapsed. He needed surgery to stabilize and repair it, and the injury kept him out for three games.
That sounds dramatic because it was.
But his recovery was also encouraging.
Within weeks, Watt was back at practice. On January 4, 2026, he returned to play against the Baltimore Ravens and even made an interception, catching a pass thrown by the opposing quarterback.
A collapsed lung can sound like an injury that automatically means months away from sport. Watt’s recovery shows that this is not always the case.
He had a serious complication, received treatment, recovered and returned to one of the most physically demanding sports in the world.
There is one important thing we still don’t know.
Public reports have not revealed:
where the needle was placed
which muscle was being treated
how deep the needle went
what angle was used
exactly how the pleura was injured
We also cannot assume that Watt was being treated in one of the higher-risk areas discussed earlier. That information has not been made public.
And that distinction matters.
It is tempting to look at a case like this and conclude that someone simply pushed the needle too deep.
Maybe. Maybe not.
We do not have enough information to know exactly what happened, and I do not think guessing adds anything useful.
What Watt’s case does show is much simpler: a pneumothorax from dry needling is possible, but one high-profile case does not tell us how often it happens.
His injury required surgery, but that does not mean every pneumothorax follows the same path. Published cases include patients who recovered with observation, needle aspiration or chest drainage.
Watt’s case is a good reminder that where we needle, how we do it and who we are treating all matter.
An NFL star ending up in the hospital is going to make headlines. The thousands of treatments that happen without a serious problem, or quietly help someone get back to moving and training, usually won’t.
The lesson is simple. Take the risk seriously, but keep it in perspective.
How Dry Needling Fits Into Your Rehab Plan
Dry needling works best as one tool within a larger rehab plan, not as the entire treatment.
At Phenom Sports & Rehabilitation, we do not use dry needling simply because a muscle feels tight.
We first want to understand what is causing the problem, what you are trying to get back to doing and whether dry needling actually adds something useful to your recovery.
In sports rehab, dry needling is not unusual. Even after what happened to T.J. Watt, several NFL players said they planned to keep using it as part of their recovery routines.
For some athletes, it is simply one tool we may use to calm down an irritated or guarded area before moving into active rehabilitation, kinesiology, strength work or movement training.
Depending on the problem, dry needling may also be part of a treatment plan for conditions such as lower back pain or plantar fasciitis, always alongside the rehab work needed to address the bigger picture.
For someone dealing with stiffness or muscle tension, it may be combined with physical therapy, massage therapy, mobility work, and progressive strengthening.
For certain tendon or musculoskeletal problems, treatments such as focused shockwave therapy or EMTT may also make sense.
The important part is that the treatment should fit the problem.
The needle is not the rehab plan.
And when we are needling around areas such as the upper back, ribs, chest, or neck, that clinical reasoning matters even more. We want a clear reason for using the technique, a good understanding of the anatomy underneath it and a plan for what comes next.
T.J. Watt’s case does not mean you should be afraid of dry needling. But it does show why the treatment should be taken seriously.
No treatment is completely risk-free. What matters is understanding the risks, putting them in perspective, and deciding whether dry needling is the right choice for you at the right time.
That is how we approach dry needling at Phenom Sports & Rehabilitation. If you are wondering whether dry needling is right for you, talk with our team or schedule an appointment.
We are always happy to answer your questions and clear up any doubts.
Frequently Asked Questions
Can dry needling actually puncture a lung?
Yes, but it is very rare. A pneumothorax can happen if a needle reaches the pleura, the thin membrane around the lung, allowing air to collect around the lung and causing part of it to collapse.
How common is a collapsed lung after dry needling?
A collapsed lung appears to be very rare. Research on dry needling has found serious complications in roughly 0% to 0.43% of treatments, and pneumothorax represents only a small portion of those events.
What are the warning signs of a collapsed lung after dry needling?
The main warning signs are new chest pain, shortness of breath, chest tightness, pain when taking a deep breath, or unusual difficulty getting a full breath. Normal muscle soreness after dry needling is different.
How soon would a pneumothorax happen after dry needling?
Symptoms can start during treatment or within a few hours, but published cases show they may also appear the next day or occasionally several days later. New chest pain or breathing difficulty after needling near the chest or upper back should be medically evaluated.
Is dry needling near the upper back, shoulder, or neck safe?
Dry needling can be performed in these areas, but they require more anatomical precision because parts of the lung may be relatively close underneath the muscles. Needle location, depth, direction, practitioner training and clinical judgment all matter.
Sources and Further Reading
Dry Needling Safety and Adverse Events: 2026 systematic review covering 59 studies.
Adverse Events Associated With Dry Needling: Prospective study covering more than 20,000 treatments.
Pleural Depth and Dry Needling Safety: Ultrasound research examining how close the pleura can be to the rhomboid region.
Pneumothorax After Dry Needling: Published case series of four patients.
