A growing number of options are becoming available for non-pharmacological (non-drug) pain relief treatments. With more choices, it’s important that you stay informed about your options.
Acupuncture and dry needling (a modern-day version of acupuncture) are two therapies we now use to reduce and manage musculoskeletal pain. Here’s some helpful information that can help you make the best choices for your situation.
There’s no physical difference. In fact the techniques used for delivering acupuncture and dry needling are the same. Both involve inserting thin, solid acupuncture needles into a specific point in the body.
Dry needling differs from “wet needling,” which uses hypodermic needles to inject pain medication into trigger points. Since acupuncture needles, which are also used for dry needling, are slender and solid, insertion tends to be more comfortable.
The evidence shows inserting acupuncture needles, no matter what the technique is called, does reduce muscular pain and physical dysfunction.
Let’s explore the differences between dry needling and acupuncture.
Dry needling is often referred to as trigger point therapy. It’s based on Dr. Janet Travell’s work, which recognizes that pain can result from tight bands of tissue in the muscle and surrounding fascia (tissue under the skin that encloses muscles). These bands are called myofascial trigger points. These points can radiate pain in and around that part of the body.
Through dry needling with acupuncture needles, we can prompt a muscle twitch, which releases the tension in the trigger point and reduces pain.
To fully release the tightness in a trigger point, we may need to make several insertions into the same trigger point.
Acupuncture is the oldest continuously practiced medical system in the world. It’s used by one third of the world's population as a primary health care system.
Acupuncture recognizes the importance of anatomical structures along with the role that the mind-body connection plays in healing and wellbeing.
Because of the mind-body approach of accupuncture, certified acupuncturists can address not only the physical aspects of pain, but also the underlying psychological undercurrents involved in chronic pain. Issues such as depression are proven to impede healing and recovery.
Acupuncture can treat issues in all systems of the body, not just disorders of the musculoskeletal system. Research supports using acupuncture to stimulate the release of endorphins, your body's natural pain-killing chemicals, and endogenous hormones to reduce pain and inflammation.
In 2003 the World Health Organization recognized acupuncture as an effective treatment for 43 health conditions. We use acupuncture to treat a variety of pain, neurological, gynecological and other internal medical disorders.
Acupuncture is based on a whole-systems approach to assessing and treating musculoskeletal complaints. Studies have found that acupuncture treatments can also resolve other underlying health conditions such as digestion or sleeping problems.
When addressing muscular pain, acupuncturists have the knowledge to identify tight bands in muscle fibers and insert needles using a gentle lift and thrust technique to allow the bands of shortened muscle fibers to release. This practice effectively releases hyperirritable triggers points. These points parallel Dr. Travell’s myofascial trigger points and are referred to traditionally as “ahsi” or “ouch” points by acupuncturists.
This is only one technique used by acupuncturists to address pain. Acupuncturists will also use points elsewhere on the body – in locations that may be far from where the pain originates – to elicit a greater systemic response. This facilitates mind-body relaxation and enhances pain reduction. The comprehensive mind-body approach encourages a profound healing response.
In addition to relieving pain, acupuncture treatments have been proven to reduce emotional stress through the release of mood stabilizing hormones. This effect can break the cycle of chronic pain by decreasing cortisol levels (a stress-related hormone) and allowing the body and nervous system the opportunity it needs to recover.
Dry needling and acupuncture can both be used to release tight muscles and reduce pain. The difference is that an acupuncturist combines additional points to send a message through the nervous and endocrine system. These steps facilitate not only pain reduction but also promote a mind-body, or whole-systems response. This has been shown to enhance all physiological functions.
This approach can resolve musculoskeletal pain and enhance digestion and sleep. It can also reduce fatigue.
While dry needling may be appropriate for musculoskeletal conditions, acupuncture can be used as a comprehensive medical intervention that addresses all aspects of pain and dysfunction to restore optimal health and vitality.
Dry needling is a physical treatment, like manual therapy. It’s used by therapists, doctors of osteopathic medicine (DO) and physicians. At this time there is no Wisconsin or national regulation of dry needling. There is no regulatory body charged with the oversight of safe and ethical practices for dry needling. Most practitioners receive 100 to 200 clock hours of training.
Practitioners of acupuncture can have a variety of backgrounds and training. We recommend you see a certified acupuncturist who has completed a course of study in Oriental Medicine or Acupuncture. Certified acupuncturists must pass multiple national board certification exams administered by the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM®). Certified acupuncturists also complete certification in Clean Needle Technique to prevent patient injuries and infections.
Wisconsin requires a minimum of a two-year full-time course of study involving practicum and clinical work to become certified. Acupuncturists who hold master’s degrees or higher have completed a minimum of 2,826 clock hours of study and successfully completed a rigorous three-year clinical rotation.
Although there’s little difference in the physical aspect of releasing pain with acupuncture or dry needling, there is a tremendous difference in the course of study and competency of practitioners.
During their training acupuncturists receive thousands of hours of training on needle depth, insertion techniques and point location. They’re repeatedly tested during their three-year clinical rotation to ensure their practices are safe and effective.
A non-acupuncturist practitioner who provides dry needling has completed a continuing education course ranging from one weekend to 200 hours of instruction.
When you select a practitioner, do your research to ensure you are seeing a practitioner qualified to meet your needs.
No. While an acupuncturist may use terms like Qi (pronounced chee) and meridians, they’re well versed in understanding the physiological responses that are stimulated by the use of needles. Responses can include the release of endogenous hormones that are associated with reducing pain and stress.
Since acupuncture is over 4,000 years old, some practitioners continue to honor the roots of this ancient medicine by using these traditional terms. At the same time they recognize how acupuncture has evolved into an evidence-based medical system. Because of modern medical advances in imaging, we now understand the physiologic processes that these terms apply to.
No. When an acupuncturist says they’re moving Qi, they mean they’re restoring circulation, decreasing inflammation and releasing endogenous hormones. The ancient concept of “meridians” is currently used to describe the interconnectedness of the body through the nervous, lymphatic, musculoskeletal and cardiovascular systems. Acupuncture releases tight muscle fibers and decreases pain by working at a systemic level.
Absolutely. It may be appropriate to receive dry needling from your physical therapist, doctor of osteopathic medicine or physician while working through the initial stages of a musculoskeletal injury. An integrated approach between practitioners that includes an acupuncturist will provide you with an evidence-based intervention that addresses not only the body but also the emotions associated with your condition. This level of treatment will result in a deeper ability to heal and prevent relapse of injury and pain. Discuss this with your providers.
Be informed and understand the differences between practitioners. Dry needling is a therapy used solely for the purpose of reducing muscular pain by acting on trigger points. Acupuncture is a comprehensive approach that addresses all of the bio-psycho-social factors of a person’s pain.
Aurora Health Care is a not-for-profit health care provider.