If you've ever wondered whether acupuncture or dry needling could help you, or what the difference is between the two, then this article is for you.
As a doctor of acupuncture and Chinese medicine, I have been asked by a growing number of patients in recent years whether I do dry needling in addition to acupuncture. My response is "Of course! Acupuncture is dry needling."
However, this response needs clarification. Acupuncture is dry needling, but the term "dry needling" is often used to refer to the unregulated, unlicensed practice of acupuncture. The issue is not just one of semantics, but also of patient safety and treatment efficacy.
Since I have a doctorate degree in acupuncture, as well as a nationally recognized certification and a state license to practice acupuncture in the state of Arkansas, I do acupuncture (which is dry needling), but I do not do "dry needling" (the unlicensed, unregulated practice of acupuncture).
Why acupuncture is dry needling
The term dry needling simply means the insertion of a solid, filiform (non-hollow) needle into the body. This is in contrast to wet needling, which is the use of a hypodermic (hollow) needle for either injecting something into the body (such as a vaccine) or drawing something out of the body (such as blood).
Acupuncture is dry needling. Doctors of acupuncture use hair-thin, single-use, disposable, solid, filiform needles that are hypo-allergenic and typically made from stainless steel. These needles are usually inserted into the dermal layers of the skin or the muscle fascia.
Because the needles we use are not hollow like a hypodermic needle, these needles don't hurt when they're properly inserted. Instead, the needles stimulate your body's own "feel good" chemicals and self-healing mechanisms - but only when inserted correctly and in specific points on the body that stimulate the parasympathetic nervous system.
A doctor of acupuncture will not insert an acupuncture needle into a nerve, vein, artery, gland, internal organ, or any part of the body in which the patient is not comfortable having a needle inserted. We must master extensive training in body anatomy during our first year of acupuncture school so that we know the right location, depth, and angle to insert a needle for maximum efficacy and safety.
Acupuncture techniques
There are many different techniques that can be used when inserting, stimulating, and removing the needles. These techniques can depend on what conditions we are treating, patient preference, or the personal style of the acupuncture doctor.
Some acupuncturists use a lot of stimulation on the needles, either through a lifting and thrusting technique, electrical stimulation, or moxibustion (burning herbs) on the tops of the needles. Others use a more gentle technique, especially for patients who are new to acupuncture or for the needle-phobic.
Doctors of acupuncture may insert a needle, stimulate it, and then remove it quickly. Others may leave the needles in for 20 - 40 minutes while the patient relaxes or takes a nap. Again, this depends on the condition we're treating, patient preference, and the individual style of the acupuncturist.
What does acupuncture treat?
Because acupuncture reduces the stress hormones and pro-inflammatory cytokines (substances that can cause high blood pressure, type 2 diabetes, bone loss, immune deficiencies, digestive problems, and weight gain around the midsection), and stimulates your body's production of endocannabinoids (your body's built-in chemicals similar to those found in cannabis), acupuncture can be effective for a wide range of conditions.
If your body is struggling to heal from something on its own, you likely have an excessive amount of stress hormones and pro-inflammatory cytokines and/or a deficiency of endocannabinoids that is blocking the healing process.
Throughout my career, I've seen acupuncture help people suffering from depression, addiction, recurrent miscarriage, insomnia, migraine headache, back pain, nausea, chronic fatigue, hand tremors, and old injuries, among other things. And more recently, acupuncture seems to also be helping people suffering from long COVID-19, or post-acute sequelae SARS CoV-2 infection (PASC).
Dry needling as the unlicensed, unregulated practice of acupuncture
Acupuncture has been a successful healing modality for over 2,000 years, but has become increasingly popular in recent years thanks to Oprah, Gwyneth Paltrow, Dr. Oz, the growing number of licensed acupuncturists and doctors of acupuncture worldwide, and of course just the fact that acupuncture works so well.
With this popularity, more people are interested in becoming acupuncturists, but don't necessarily want to go through the intensive training required for credentialing and licensure. Licensed acupuncturists must complete four to six years of graduate-level training in the modality (the equivalent amount of time it takes to get an MD, PhD, or DDS). That's because acupuncture is highly regulated, just like any other professional medical practice.
Dry needling, on the other hand, is not a regulated practice. There is no standard entry-level academic curriculum that offers training in dry needling and there are no national psychometrically validated examinations to test competency in the practice of dry needling. Most practitioners of dry needling have had one to three days of training in dry needling and no other training in the use of needles inserted into the body.
The American Medical Association classifies dry needling as an invasive procedure and maintains that dry needling should only be performed by licensed medical physicians and licensed acupuncturists.
Dry needling that is performed by minimally educated practitioners can cause extreme harm. Any invasive medical procedure has associated and potentially serious risks and is safe only if performed by a properly educated, trained, and experienced health professional.
The technique of dry needling frequently involves deep needling of muscular structures that are close to sensitive structures and organs, including blood vessels, nerves, and organs. Risks can include hematoma, pneumothorax, nerve injury, vascular injury, and infection. A needle inserted at an incorrect angle could puncture a lung, for example. A less serious adverse event could include pain during or after treatment.
Questions or comments? Email [email protected] or visit DrJamieKoonce.com.