Dry needling vs. acupuncture: Risks and differences

Dry Needling vs. Acupuncture

The world of alternative and complementary medicine is vast, offering a variety of treatment methods to suit different needs. Techniques such as dry needling and acupuncture are often used interchangeably. Both techniques involve inserting fine needles into specific points on the body, which can be confusing for potential patients.The goal of this blog is to delineate the differences between dry needling and acupuncture, from their origins and scientific basis to techniques, side effects, and more.

Historical context

Dry needle

Dry needling is a relatively modern development in the field of physical medicine. Originally used as a diagnostic tool in the early 20th century, it evolved into a therapeutic technique in the mid-20th century. Dry needling, which has its roots in Western medicine, has become increasingly popular among physical therapists and chiropractors for the treatment of musculoskeletal pain and dysfunction.

Acupuncture

Acupuncture, on the other hand, has ancient roots dating back to China over 2,500 years ago. It is a key part of Traditional Chinese Medicine (TCM), which also includes herbal medicine, dietary therapy, and exercises such as tai chi. Acupuncture was originally documented in the foundational text “Huangdi Neijing” (The Inner Canon of the Yellow Emperor) and has evolved over the millennia to integrate both traditional and modern approaches.

Scientific foundations

Dry needle

Dry needling is based primarily on knowledge of anatomy, neurophysiology, and Western medical science. The technique involves inserting needles into “trigger points,” hyperactive areas found in skeletal muscle. The goal is to induce a “twitch response” that leads to the release of the muscle knot, thereby reducing pain and improving function.

A growing body of research shows that dry needling can effectively treat conditions like chronic back pain, migraines, and even carpal tunnel syndrome, but more scientific research is needed to definitively determine the long-term benefits.

Acupuncture

Acupuncture revolves around the concept of “qi,” the life force or energy that flows through the body. In TCM, a balanced and uninterrupted flow of “qi” is considered essential to health. The aim of acupuncture is to remove imbalances in this flow by inserting needles along specific pathways or “meridians.”

Over the years, numerous studies have been conducted to examine the effectiveness of acupuncture in treating a wide range of conditions. Some studies confirm its effectiveness in treating pain and various ailments such as insomnia and digestive problems, but the scientific community remains divided. Nevertheless, acupuncture continues to gain worldwide recognition and acceptance.

Techniques and procedures

Dry needle

In a typical dry needling session, the practitioner begins by identifying trigger points through palpation (examination by feeling) or muscle testing. Once the trigger points are located, a thin, sterile needle is inserted into the skin and muscle directly at the point.

Patients often report a cramping or twitching sensation, which is generally a good sign that the trigger point has been stimulated. This twitching response helps to reduce muscle tension and relieve pain. The equipment used is minimal – usually just sterile, single-use needles and perhaps antiseptic wipes to clean the site before injection.

Acupuncture

The acupuncture procedure is somewhat more complex and begins with a detailed diagnosis to determine any qi imbalances. The acupuncturist then inserts very fine sterile needles into specific points along the meridians to regulate the flow of qi. The depth and angle of the needles may vary depending on the condition being treated.

There are different styles of acupuncture, including traditional Chinese acupuncture, Japanese acupuncture, and even electroacupuncture, in which a weak electrical current is passed through the needles for stronger stimulation.

Side effects and risks

Dry needles

Common side effects of dry needling may include temporary soreness or bruising at the injection site. More serious risks, although rare, include infection, nerve damage, or organ puncture.

Therefore, it is very important that the procedure is performed by qualified professionals to minimize these risks. People with bleeding disorders or those taking blood-thinning medications should consult their doctor before undergoing dry needling.

Acupuncture

Side effects of acupuncture are generally minimal, but may include minor bleeding, bruising, or soreness where the needles are inserted. In some cases, people may feel light-headed or sleepy after a session. Because acupuncture needles penetrate deeper into the body, there is a small risk of infection unless performed under sterile conditions.

Frequently asked questions

Can you do dry needling and acupuncture at the same time?

Yes, it is possible to undergo both treatments, but it is essential to consult with your healthcare provider for a customized treatment plan. Both therapies target different issues and operate on different philosophies, so they may complement each other well in certain cases.

Is dry needling/acupuncture painful?

Both treatments are associated with some degree of discomfort, commonly described as a “sting” when the needle is inserted, followed by a “dull ache” or “warmth.” Pain tolerance varies from person to person.

How many sessions do I need?

The number of sessions varies depending on the condition being treated and the individual's response to treatment. While some may experience immediate relief, chronic conditions often require multiple sessions to achieve optimal results.

Are the needles sterile?

Usually, sterilized disposable needles are used. It is rare for doctors to reuse needles and treat them with a sterilization process. We insist on using the highest quality needles made of steel and copper handles. They are very smooth and not painful.

Comparative analysis and conclusion 

Philosophy: Western Medicine vs. Traditional Chinese Medicine

Dry needling is rooted in Western medicine and focuses on treating musculoskeletal problems by stimulating trigger points. However, acupuncture is based on the philosophy of traditional Chinese medicine, which aims to balance the body’s “qi” to treat a variety of ailments. These different philosophies influence not only the techniques but also the range of ailments they can treat.

Use: Treatment range

Dry needling is most effective in treating musculoskeletal disorders such as chronic back pain, muscle tension, and migraines. Acupuncture has a wider range of uses, and is claimed to treat everything from digestive problems and insomnia to emotional disorders such as anxiety and depression.

Target Points: Meridian Points and Acupuncture Points: Trigger Points vs. Meridian Points

In dry needling, needles are inserted directly into muscle trigger points. In acupuncture, needles are placed at specific points along meridians and their goal is to correct imbalances in the flow of “qi.” These target points are determined by the underlying philosophy and diagnostic approach.

Required Education: Licenses and Qualifications

Acupuncturists typically have extensive training in TCM and are often licensed by state acupuncture boards. In contrast, dry needling is often performed by physical therapists and chiropractors who have received specialized training in this particular technique.

Conclusion

The practices of dry needling and acupuncture may seem similar at first glance, both involving the use of needles to relieve pain and improve well-being. However, their differences are as deep-rooted as their history and philosophy.

Dry needling is more focused and often used as an adjunct to other physical therapies for musculoskeletal problems. It is based on a biomedical understanding of anatomy and pain and offers targeted relief from muscle tension and related problems.

Acupuncture, on the other hand, offers a holistic approach to treatment, drawing on the ancient wisdom of traditional Chinese medicine. It aims not only to relieve symptoms but also to address the underlying imbalance, offering a broader range of applications than just musculoskeletal problems.

In summary, your choice between dry needling and acupuncture should depend on your specific health needs, belief in the underlying philosophy, and comfort level with the procedure. Always consult with qualified healthcare providers to determine the most appropriate treatment for you.

We hope this blog has clarified the differences between the above-mentioned techniques and will help you decide which treatment is best for you.

Reference

1. Dommerholt, J., & Gerwin, RD (2015). Trigger point dry needling: An evidence and clinical-based approach. Churchill Livingstone.

2. Ma, W. (2013). The roots and development of Chinese acupuncture: From prehistory to early 20th century. Acupuncture in Medicine.

3. Cochrane, DS (2013). Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomized controlled trials.

4. Cochrane, DS (2013). Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomized controlled trials.

5. Dunning, J., & Butts, R. (2014). Dry needling: A literature review with implications for clinical practice guidelines.

6. Deadman, P., Al-Khafaji, M., & Baker, K. (2007). A Manual of Acupuncture. Journal of Chinese Medicine Publications.

7. White, A., & Ernst, E. (2004). A brief history of acupuncture. Rheumatologists.

8. Cummings, M. & White, A. (2001). Needling Therapies in the Management of Myofascial Trigger Point Pain: A Systematic Review. Archives of Physical Medicine and Rehabilitation.

9. Cummings, M. & White, A. (2001). Needling Therapies in the Management of Myofascial Trigger Point Pain: A Systematic Review. Archives of Physical Medicine and Rehabilitation.

10. Tough, EA, White, AR, Cummings, TM, Richards, SH, & Campbell, JL (2009). Acupuncture and dry needling in the management of myofascial trigger point pain: a systematic review and meta-analysis of randomized controlled trials.