Recently, we’ve had more questions around the difference between Acupuncture and Dry Needling, a procedure performed by Physical Therapists. Let’s address a few basics about the two modalities.
Definitions:
the insertion of fine needles into sites on the body known as Acupuncture Points. Each of these sites have known effects on the function of various body systems. A number points are combined to increase circulation to an area of the body to stimulate healing. The area starts to heal, and the pain goes away.
the insertion of similar needles into “trigger points” in the muscle body to relieve tension, spasms, and pain in that local muscle. The placement of the needles is in the area of the specific pain. The goal is to illicit a “twitch” response, which then releases muscle pain.
History and Background:
Acupuncture was developed in China about 2000-3000 years ago. Its usage was refined and developed over a large area of Eastern Asia, including China, Japan, Korea and Vietnam. Although it was known and studied in Europe in the 1800’s, it became more widespread after the 1970’s in the U.S.
Dry needling is a derivative of an earlier Western medical therapy called Trigger Point Injection. Trigger points (specific areas of muscular pain, tension, or spasm) were injected with a fluid to relax the muscle tissue and relieve local pain. After the 1980’s, the use of non-injection (or dry needle) was used to create the same response in muscle trigger points.
Training:
3-4 year Master’s Degree, 705 hours of Chinese Medical theory, point locations, usage, and safety. 660 hours of clinical training.
50 hours of dry needling training to be certified to perform dry needling.
The Difference:
Acupuncture is often performed on points distal to the action area of symptom/complaint. The points are chosen not just for specific symptoms, but after an in-depth history and exam indicates deeper functional issues that act as underlying cause to the symptoms that a patient is experiencing. Because of this functional approach of restoring circulation and health in organ and tissue systems of the body long-term, chronic and deeper health issues can be addressed; creating overall increase in circulation and body function and therefore lessen the presence of unpleasant symptoms for the patient.
Insertion of the needles tends to be rather shallow in most areas. Long hours of study are required to know just how deep and at what angle it is safe and effective for each specific acu-point. The needles are left in the patient for 20-30 minutes, on average, while the body relaxes and circulation is restored to the affected areas. Acupuncture usually requires a series of treatments to restore proper function.
Dry needling is a local area of effect therapy useful for muscular pain caused by “Trigger Points”, spasm or tightness which causes pain, discomfort or a lack of movement in a specific area of the body. The needles are generally inserted quite deeply into the tissue to create the desired “twitch” which releases the muscle fibers. The patient is expected to experience some discomfort during and possibly after the technique. Local soreness, bruising, or tiredness are common. Because of the deeper insertion of the needles, there is a greater risk for deep bruising or the event of a broken needle – which usually occurs where the needle shaft meets the handle (the little wound wire looking part at the end for the therapist to grip). There have been some reports of lung collapse when deep needling is performed over the chest, upper back or shoulder areas; or other organ injury can occur.
Final Thoughts:
While it is not my intent to downgrade any Physical Therapists (they are wonderful, caring people who have and can help so many folks who are struggling with musculo-skeletal injury and recovery) dry needling has a much more limited potential of benefit for most patients.
Dry needling, like much of our modern medicine of today; is very much focused on a specific area with a specific symptom. It can release a spastic muscle, but does not aim to create greater health, vitality or strength in that muscle.
Acupuncture, on the other hand, takes the approach of restoring health to a weak or injured area of the body. We are always concerned with the “why” of any health complaint and, while we also aim to resolve symptoms like pain and spasm, we are concerned with creating an environment in the body where those symptoms go away because the organs, blood flow and tissues of the body are healthier and more resilient to the demands that the individual’s activities put on them.
