Acupuncture has a remarkable legacy as a successful healing modality which continues to adapt and develop. Acupuncture began in China, and thrived for thousands of years, eventually spreading to all corners of the world. Acupuncture is not static, but has continually improved according to the needs of the population, incorporating new ideas and understandings of how the body works and how illnesses develop.
As the practice of acupuncture moved from place to place, experts in those countries developed new acupuncture techniques. In Japan, for example, acupuncture became one of the primary vocations of the blind; to this day, approximately 30% of acupuncturists in Japan are blind! Because of this, Japanese acupuncturists developed gentle, tactile diagnostic and treatment techniques using thinner needles with guide tubes, and shallow needling. This differs significantly from acupuncture in China, which tends to be more aggressive, with thicker needles, and uses free hand deep needling techniques. In France, after an enthusiastic french ambassador brought the knowledge of acupuncture back to his home country, the medical community there focused heavily on ear acupuncture and developed a unique microsystem of ear acupuncture considered today to be one of the best models of auricular acupuncture in the world. And in Korea, a hand acupuncture microsystem developed and flourished, and this microsystem is now taught in acupuncture programs all over the world.
Similarly, there have been many great developments in the acupuncture field in the United States. Acupuncture is even used in the US military as a way to treat pain and PTSD and by cognitive therapists as a way to treat substance addiction. One technique developed in the US for treating pain is ‘dry needling,’ although licensed acupuncturists usually refer to these techniques as local acupuncture or sports acupuncture; ‘dry needling’ is a term used by those without an acupuncture degree who practice local needling techniques.
What is Dry Needling?
Dry needling, a form of local acupuncture, primarily comprises of trigger point and motor point needling techniques—sometimes with additional electrical stimulation—and focuses on treating pain in the muscles, tendons, and joints.
The Foundations of Dry Needling
The foundations of dry needling have been around for thousands of years. Aside from electrical stimulation—which was not accessible to practitioners of ancient traditional medicine—local forms of acupuncture have long been used in Chinese medicine, although almost always in conjunction with distal points to treat the body holistically. Classical acupuncture texts didn’t use the modern terms, ‘motor point’ or ‘trigger point’ needling, which make up the bulk of dry needling techniques. But motor point and trigger point needling are not new to acupuncturists and are referred to in classical texts using different language.
For example, in classical acupuncture texts, the successful arrival of qi is often described as when the tissue being punctured grabs the needle ‘like a fish grabbing onto the end of a fishing line.’ This is exactly what happens when you needle a motor point of a muscle. The motor point is where the motor nerve innervates the muscle, and if functioning properly, causes the muscle to contract when engaged; thus when motor points are needled, the muscle contracts around the needle like a fish grabbing at a minnow on a fishing line. Almost all muscle motor points correlate to traditional acupuncture points or extra points found in Chinese medicine texts.
Classical acupuncture texts also inform the practitioner to palpate for tender points, called ‘ashi’ points, to find the exact spot to needle when needling locally. This is exactly how trigger point needling is done. Trigger points are local tender aggravated knots or bands of muscle fibers, often close to or extending from the motor points of the muscles. When trigger points are needled, local pain relief is accomplished through the release of natural pain killers and the disentanglement of muscle fibers.
What is the Difference Between Dry Needling and Acupuncture?
Simply put, dry needling is just one more acupuncture technique, and most acupuncturists incorporate it in their practice on a daily basis. The tools are the same; sterile, stainless steel single use filiform needles are used in acupuncture and dry needling to puncture the skin. Although, acupuncturists won’t often identify their process as dry needling. The term ‘dry needling’ is used primarily by non-acupuncturists to circumvent laws that prevent them from practicing acupuncture due to significantly lower standards of acupuncture/needling training compared to licensed acupuncturists.
To become a licensed acupuncturist, you need extensive training. At a minimum, licensed acupuncturists complete a Masters level education for for 3-4 years. Practitioners at Lakewood Community Acupuncture, for example, all accumulated over 3,000 hrs of clinical and didactic education during their initial training to receive a Masters Degree in Acupuncture and Chinese Medicine. In addition, they regularly train in continuing education courses to keep their state acupuncture license active as well as their national boards, which are certified by the National Certification Commission for Acupuncture and Oriental Medicine.
In most states, chiropractors and physical therapists aren’t allowed to say that they practice acupuncture unless they have gone through the same extensive training as a licensed acupuncturist. In order to get around this hurdle, those of other professions who wish to incorporate aspects of acupuncture into their practice, give it a different name: dry needling. To be certified to perform dry needling, physical therapists and chiropractors are usually only required to complete a couple of weekends of training. In some states they aren’t allowed to practice at all because of this lower standard. But in Colorado, for example, PTs are only required to do fifty hours of dry needling training before they can practice on patients. This training in dry needling is a very limited, narrow, and reductionist interpretation and understanding of acupuncture.
The training requirements to be licensed as an acupuncturist as compared to being certified in dry needling is one significant difference. But there are two other main differences: 1. Dry needling is often more painful, and 2. Dry needling doesn’t address the body holistically.
Dry needling techniques tend to be more painful than acupuncture because those who practice dry needling—usually a physical therapist or chiropractor—often need to accomplish results within a short appointment time-slot. Thus they tend to plunge the needle repeatedly into the tissue in order to get a strong motor point or trigger point response. This absolutely can be effective, but is often unnecessarily painful. Most acupuncturists don’t need to perform strong technique because they allow more time for their patients to rest with the needles once they have been appropriately placed. This allows the needles to affect the tissue gradually and gently. In addition, acupuncturists are always striving to balance the entire body, not just treat the symptoms; they apply a global approach to address the root cause of the dysfunction, through addressing the differential diagnosis. Dry needling is focused only on the branch, or symptom, and doesn’t attend to the underlying conditions. This works well, if still an incomplete treatment according to Chinese medicine, when the symptoms are simply a result of a sprain from running or playing a sport. But is less adept at resolving chronic pains and issues, which often have underlying root causes, such as nutritional deficiencies, or imbalances in the organs and vessels.
What Type of Practitioner Should I Choose?
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