Dry Needling vs Acupuncture

When seeking treatment from a physiotherapist for mobility issues, aches, pain and injuries, you will likely have seen dry needling listed as a method of treatment. Many patients assume that dry needling is the same thing as acupuncture, but there are notable differences between these treatments. Whilst both dry needling and acupuncture employ very fine needles to treat a range of conditions, this is about where the similarities end.

Let’s look at dry needling and acupuncture, and why you might opt for one treatment over the other.

Dry Needling

Dry needling is a commonly used treatment in physical therapy for musculoskeletal dysfunction and pain. Dry needling involves the use of filiform needles, which are inserted into myofascial trigger points (the tight muscle knots that can cause pain and restrict movement). This insertion elicits contraction in the muscle, which can help to disrupt pain cycles, release tension and restore muscle function. Practitioners may use either deep needling, or superficial needle entry, to induce the desired muscle response.

Deep dry needling to treat trigger points was first introduced in 1979 by Czech neurologist Karel Lewit, who had observed that the pain relief achieved from injecting a trigger point with an analgesic appeared to be unrelated to the analgesic used, suggesting the needle insertion itself was the chief reason for success. The term ‘dry needling’ was later coined by Janet G. Travel in her 1983 book, Myofascial Pain and Dysfunction: Trigger Point Manual.

What does Dry Needling Treat?

Dry needling is used, amongst other techniques, to improve muscle function and relieve pain. Dry needling can help with the following conditions:

• Muscle Tension & Pain: Muscle tightness, spasms, fibromyalgia, myofascial pain syndrome.

• Recovery and rehabilitation: Used as pain relief and to restore mobility after an injury and/or surgery.

• Neurological and Chronic Pain: Sciatica, migraines, tension headaches, temporomandibular (TMJ) joint dysfunction.

• Postural & Functional Issues: Carpel tunnel syndrome, back and neck pain, postural imbalance.

• Soft Tissue & Joint Injuries: Hip, knee and shoulder pain (rotator cuff, frozen shoulder), and Achilles tendinopathy

• Overuse & Sports Injuries: RSI, golfer’s and tennis elbow, golfer’s elbow, runner’s injuries, IT band syndrome, plantar fasciitis, muscle strains.

Areas of the Body Treated with Dry Needling:

Dry Needling is typically used in areas where muscular pain is common, such as the legs, lower back, glutes, shoulders and neck.

Acupuncture

Acupuncture is a key healing practice used in Traditional Chinese Medicine (TCM) that originated in China more than 2,000 years ago. Using the concept of Qi (energy flow) and meridians (a circulatory system of energy), acupuncture works to enhance the flow of vital energy in the body, thus, improving overall health.

Acupuncture treatment involves fine, sterile needles being inserted into the body at particular points related to the meridians. The intention of using the needles is to promote energy flow, to heal, restore balance in the body and reduce or eliminate pain.

Whilst acupuncture points are chosen based on meridians in Traditional Chinese Medicine, in Western Acupuncture (an adaptation of traditional acupuncture), acupuncture points are chosen based on anatomical structures, with the focus being on the neurophysiological benefits of inserting the needles into nerves, muscles and trigger points. In this regard, Western Acupuncture is more closely aligned with dry needling, although it is still a different treatment.

The case for acupuncture:

Recent research indicates that acupuncture may help stimulate both the nervous system and blood circulation. It is also understood to trigger the release of endorphins, which can result in reduced pain. It may also influence neurotransmitters and hormones that regulate pain, mood, and immune function.

What does Acupuncture Treat?

Many people use acupuncture as a way of supporting their general well-being and to relax. It is also used to treat a range of other issues, including:

• Chronic pain (back, neck, and joint pain)

• Headaches and migraines

• Women's health issues relating to fertility and menstruation

• Anxiety and stress

• Sleep difficulties

• Issues with digestion.

Areas of the body treated with acupuncture:

• Traditional Acupuncture can be applied across the entire body, including the back, neck, arms, legs, face, and even ears, based on meridian pathways.

• Western Acupuncture focuses on specific points that align with modern anatomical knowledge to address pain and muscle tightness.

Which Should You Choose - Acupuncture or Dry Needling?

Both acupuncture and dry needling have their own benefits. Acupuncture would more likely be a treatment you would actively seek out through a Western acupuncturist or Traditional Chinese Medicine practitioner, whereas dry needling is more likely to be one technique in a suite of techniques used by a physiotherapist (or other practitioner treating musculoskeletal issues).

Opt for acupuncture: If you are seeking relief from stress or chronic pain, you have issues with reproduction, or you want to improve your general wellness.

Opt for dry needling: If your health concern relates to localised muscle pain, such as back pain, tendon pain, muscle tension, overuse and sports injuries, soft tissue and joint issues, chronic and neurological pain, or postural and functional issues. Dry needling will likely be combined with other physiotherapy treatments to increase its effectiveness.

Dry Needling vs Acupuncture - Which hurts the most?

Both dry needling and acupuncture use fine needles, however the sensation differs. Traditional acupuncture results in, at most, a dull ache, whereas dry needling can cause a brief muscle twitch or cramping sensation.

Are there any risks with dry needling?

Both dry needling and acupuncture are considered relatively safe, when administered by a trained professional. (With dry needling, the most you should expect in terms of side effects is mild bruising or soreness, which would be similar if you had received a deep tissue massage.)

Given that needles penetrate the skin for both treatments, there is the potential for infection, or injury to nerves, vessels, implanted devices, the spinal cord and internal organs. However when properly administered, the risk is very low. Practitioners should gain a full picture of the patient’s health history before commencing treatment.

Another safety issue with any kind of treatment that utilizes needles is accidental needle stick injury, which can be prevented by following all appropriate precautions.

Contact District Performance & Physio for assistance with musculoskeletal dysfunction and pain.

Can’t get to our Downtown Dupont or Navy Yard clinic? We offer virtual physical therapy, where we can assist with a range of conditions remotely. (Obviously we can’t administer dry needling virtually, but we can make a number of assessments virtually, as well as take you through physiotherapy exercises remotely.)