Making a point: Dry needling versus acupuncture

Mention acupuncture to someone and they likely envision a bunch of needles sticking out of a person’s skin. A significant part of traditional Chinese medicine, it’s been practiced for 2,500 years, maybe 3,000. So, we’ve had plenty of time to imagine what acupuncture is.

Mention dry needling, however, and you might get confused looks, head shakes and, potentially, the question: “Isn’t dry needling acupuncture?”

No, it’s not.

But it’s close enough to create confusion.

Acupuncture is a form of dry needling. Both use the same dry – without liquid – needles that are placed through the skin at certain locations to relieve and/or manage pain and improve one’s ability to complete daily tasks.

The needles for acupuncture and dry needling are solid and much smaller than the hollow ones used by medical personnel to administer shots or draw blood. Unlike those larger needles that cut into the skin, acupuncture and dry needles are pointed and push through the skin and into the muscles and connective tissues.

So, the tool is the same and the concept is similar; the methodology, however, is significantly different.

What is dry needling?

Based in Eastern medicine, acupuncture is a treatment that unlocks or balances the body’s flow of vital energy called qi (pronounced chee) through invisible channels known as meridians. There are 14 meridians that run in pairs throughout the body and acupuncture needles are placed along those meridians, depending on the illness or discomfort of the patient.

Dry needling is an evidence-based, Western medicine technique that targets muscles and connective tissue that contribute to a patient’s pain or decline in daily movement. Although the trigger points are often similar to acupuncture locations,  the specific placement of the needles is more aligned to a patient’s individual needs with dry needling. There are typically fewer needles used in dry needling and those sessions are shorter than acupuncture appointments.

That’s because dry needling is only one part of a physical therapy care plan – sometimes only a few minutes to kick off a 45-minute session – whereas acupuncture typically is a standalone intervention during a session, which generally lasts between 30 minutes and an hour.

Both techniques start with an initial evaluation of the patient’s concerns. But dry needling is administered by a physical therapist, who will also assess a patient’s overall strength and movement and then work on diagnosing the root problem.

The goal of dry needling is often to relieve pain quickly, so that patients can move better and spend the rest of their time in physical therapy – stretching and completing exercises to improve their strength and range of motion.

With acupuncture, patients often return multiple times per year for additional sessions – it can become an ongoing treatment throughout someone’s life.

With dry needling, the hope is the root issue is resolved through holistic physical therapy, and, after a few treatments, the treatment is no longer needed.

Pinpointing various conditions

Although associated most with muscular discomfort, dry needling is used for various pains and conditions throughout the body, including:

• Chronic ankle instability
• Chronic lower back pain
• Chronic neck pain
• Headaches
• Hip arthritis
• Knee arthritis
• Pickleball/tennis elbow
• Plantar fasciitis
• Scar tissue buildup
• Shoulder issues

In dry needling, the clinician places each needle, which is housed in a small tube, around the body part that is the primary source of the patient’s discomfort. The needle is tapped to enter the patient’s skin, then the tube is removed to allow the clinician to more deeply insert the needle into the  affected muscle or connective tissue. Sometimes, dry needling includes a mild electrical current, hooked to a battery-operated device, to further stimulate the tense and fatigued muscles.

Because the needles are inserted into the body, the therapist can reach muscles and tissues more deeply than one can by using fingers or tools during manual therapy. Therefore, dry needling theoretically can better reset any issue in an injured area, whether that is muscle weakness or nerve impairment or other physical dysfunction causing pain.

The size of the needles depends on what body part is being worked; breaking up scar tissue in the face requires a much smaller needle than muscle discomfort deep into the hip.

Regardless, if done by an experienced practitioner, there typically is  little or no pain involved in the dry needling process. Oftentimes, the patient doesn’t even feel the needle being inserted.

More about dry needling

Some other things to know about dry needling if you are considering trying the treatment:

• All Select Medical clinicians who offer dry needling have undergone additional advanced training before administering needling therapy.
• Although it is available in most states, dry needling is not practiced in California. Select Medical also does not offer the service in Pennsylvania. If you are interested in dry needling, contact your local center to make sure it is offered.
• A clinician will evaluate your condition to make sure you are a viable candidate before administering dry needling. Patients with bleeding disorders and pregnant women, particularly in their first trimesters, should not undergo the treatment.
• Side effects are typically minimal, but may include bruising, soreness and fatigue.

The bottom line

Dry needling benefits most musculoskeletal issues, especially when paired with full, physical therapy sessions.

It’s not magic.

Dry needling is an evidence-based therapy that can relieve aches and pains and act as one pathway back to health and vibrancy.

Clinical contribution to this blog provided by Physical Therapist Jon Beougher, national coordinator of dry needling.