The needling of hyper-irritable areas or palpable nodules in muscle fascia has existed since at least the era when the very first acupuncture book was written in China sometime between 440 BC- 220 CE. This book, known as the Huangdi Neijing (Yellow Emperor's Inner Classic), describes in detail how to discover and needle into these tender and knotted spots, or ashi points, to eliminate pain. This method has been known and taught to acupuncturist for millennia as the ashi method, and is usually learned within the first year of hands-on training.

But the origins of the use of the term "dry needling" can be traced to a much later time that coincides with the invention and use of hypodermic needles.

The term "dry needling" was first used in China sometime around the late 19th Century with the arrival of Western medicine. For about 2000 years prior, the Chinese had continuously developed their own unique system of therapeutic needling methods known simply as zhen (针), which translates into English as “needling”. In contrast to hypodermic needling, zhen uses very thin solid needles for treatment. To avoid confusion, the Chinese added the word gan (干), or “dry”, to zhen (needling) to differentiate it from the hypodermic needles that were recently introduced to inject or withdrawal fluid, or "wet" material, into and from the body.

Ironically, about a century before hypodermic needles were introduced in China, zhen became the inspiration for the invention of the hypodermic needle in Europe. Basic therapeutic needling techniques had been imported from China and Japan into Europe since as early as the 16th Century and named acupunctura (Latin acus for "needle", and punctura for "to pierce with"). By the 18th and 19th Century, medical books discussing acupuncture's effectiveness in the treatment of pain were widely circulated throughout European medical communities. As word spread around, so did the idea that acupuncture could be even better at alleviating pain if drugs could be injected into the same area through a hollowed needle. Soon after, the hypodermic needle was invented and went on to become one of the most important tools used in modern medical treatment.