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Acupuncture vs Dry Needling

Updated: Feb 2

Have you ever wondered what the difference was between acupuncture and dry needling? It’s a lot like rectangles and squares: all squares are rectangles, but not all rectangles are squares. All dry needling techniques and applications are borrowed from acupuncture, but acupuncture techniques and applications go far beyond the scope of what is possible, and in some cases legally allowed, for dry needling.

The practice of acupuncture requires understanding the fundamental theories of Traditional Chinese Medicine, over 800 clinical hours of training specifically dedicate to acupuncture, and in most states a graduate of a CCAOM accredited school must pass national board certification before they can apply for licensure in that state. Acupuncture works by facilitating your body’s innate ability to self-heal; thus a myriad of conditions can be treated with acupuncture. Among those conditions are musculoskeletal and other pain conditions that often incorporate the use of what we call ashi (pronounce “ah, sure”) needling; here the practitioner locates areas on the body that have muscular and/or fascial irregularity that are sore upon pressure, and then performs needling into those specific areas. When someone says they do dry needling, this is basically what they mean. Dry needling is ashi needling.

If a patient has pain somewhere in their body, then the person doing dry needling, assuming acupuncture is not legally within their scope of practice, can only insert needles into the area where there is pain or dysfunction.

For example, if you have neck pain and you go to see a physical therapist who performs dry needling, they can only insert needles into the neck; if you have hip pain, needles can only go into the hip. Acupuncturists can make use of other needling techniques like distal needling (inserting a needle further out on a limb to treat something closer to the center of the body) and contralateral needling (stimulating the mirror opposite, for example using needles around the left elbow to treat the right knee) because as a part of their training they receive instruction in the locations, trajectories, and functions of acupuncture channels. Acupuncture channels are the spaces in between all the other structures of the body that allow for nutrition, metabolic waste, and information to flow to and from our tissue cells; the existence and function of the channels are what allows an acupuncturist to put a needle in a patient’s wrist to stop nausea, or to put a needle in the ankle to treat low back pain.

Dry needling is strictly for the treatment of musculoskeletal conditions and is only to be applied to the area of pain, and the needles cannot be left in the body for any duration for additional effect. When asked if they do dry needling, an acupuncturist might feel conflicted in saying “yes” because what they are trained in is ashi needling, along with all the other techniques within acupuncture. Any acupuncturist can do the same work as someone schooled in dry needling. So instead of asking an acupuncturist, “do you do dry needling?” it might be better to ask, “do you treat musculoskeletal conditions?” to which the answer will almost every time be, “yes.”

For a more detailed description on the differences between acupuncture and dry needling (when performed by a physical therapist in the state of Illinois), see this fantastic comparison chart put together by ILSA, the Illinois Society of Acupuncturists.

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