Dry Needling vs. Acupuncture. What is the Difference?

By: Allison France, L.Ac.

In order to best answer this question I will pull from my experience as a licensed acupuncturist as well as from an article published by the American Society of Acupuncturists: The Relationship Between Acupuncture and Dry Needling - Clarifying Myths and Misinformation.

The short answer is this:

Acupuncturists use a variety of techniques, one of which is dry needling. Other practitioners who are trained in dry needling are not practicing acupuncture in its complete form and can't call what they are doing acupuncture. Dry needling falls within the umbrella of acupuncture, however acupuncturists don’t tend to refer to their techniques as “dry needling,” they just call it acupuncture. An example of a dry needling technique is to needle directly into the musculature or neuromuscular junction. Acupuncturists also insert needles along energetic meridians or fascial lines.

For a more detailed explanation, continue reading.

During graduate school, I spent my last year of study focusing on sports acupuncture. A small group of us went to the University of Colorado campus in Boulder, where we treated athletes using acupuncture, gua sha, electrical stimulation and cupping. To be qualified to do so we were first required to take advanced classes in anatomy and acupuncture techniques for orthopedic complaints. We learned to assess and treat musculoskeletal patterns of pain and injury. We called it sports acupuncture. If we were physical therapists, chiropractors or other pain therapists we would have called it dry needling. Tomato. Tomaahto.

Most people are surprised to hear that acupuncturists undergo 3.5 to 4 years of schooling (over 1300 hours of education), a certification in clean needle technique and four national board exams. During this time we learn traditional Chinese medical theory as well as western biomedical anatomy and physiology. We are not trained to give a biomedical diagnosis as your doctor or physical therapist is. However, we are trained to recognize musculoskeletal patterns and assess the cause of pain or injury. After four years of postgraduate education with countless hours of classroom technique practice and professional clinics, we are well prepared for inserting needles into the area of pain or discomfort in order to effect musculature, fascia and healing.

There are many different styles of acupuncture. Depending on the practitioner, they may gravitate towards a more energetic approach to treatment or they may utilize a musculoskeletal based approach. Most acupuncturists integrate the two styles while a practitioner utilizing only dry needling would avoid a holistic energetic approach.

The term dry needling came about as a way for other practitioners to utilize the benefits of acupuncture (needling into musculature) without having to become an acupuncturist.

Now of course, a non-acupuncturist pain therapist providing dry needling to treat back pain isn’t going to look at your tongue, feel your pulse, or ask questions about your urinary bladder meridian because they are only using the needles with one intention - to affect local tissue and musculature.

The term “dry needling” is relatively new compared to the ancient history of Chinese medicine. It refers to the fact that the needles are not inserting any fluid into the body, they are “dry”. The needles used in your acupuncturist’s office are the same needles used for dry needling in your physical therapist’s office. If your acupuncturist is looking through their “anatomy lense” during treatment they are inserting these needles into trigger points and motor points, just like other professionals providing dry needling. In Chinese medicine we like to call these areas of needle insertion "ashi points".

For the purpose of pain relief and injury healing, dry needling is a technique adapted from an orthopedic style of acupuncture. The difference lies in the accompanying modalities and techniques.

Acupuncture is currently one of the most widely studied medical interventions, and much of the literature used to justify the clinical legitimacy of dry needling is drawn from acupuncture research studies. As of now, there are no objectively determined standards of education, curriculum and national examination in place for dry needling and there are no standards for clinical mentorship.

If you would like to read more about clarifying the myths and misinformation around dry needling and acupuncture, visit the American Society of Acupuncturists at www.ASAcu.org