Acupuncturist Questions Acupuncture

Should I go for dry needling or acupuncture?

I have chronic pain all along my back, and I just can't take it any more. I need to find a way to get rid of it, and I've been considering acupuncture to help. But my friend also suggested dry needling might be a little better. Should I try dry needling, or should I go for acupuncture? What are the benefits for both of these treatments?

17 Answers

Dry needling is when a physical therapist uses some of the largest acupuncture needles available and does something on you that is not acupuncture. When I was in school, there had been 3 pneumothoraxes documented in the entire nation (this is where someone punctures the pleural cavity where the lungs are housed with a needle causing air or blood to get into the pleural cavity which impairs breathing and can be seriously life threatening). All three were committed by a physical therapist doing dry needling. The requirements to become certified in "dry needling" are minimal--few hours on a weekend. So let me say this as clearly as I possibly can-- I would NEVER let a physical therapist near me with an acupuncture needle. NEVER. I would also never let a chiropractor or medical doctor near me doing acupuncture who doesn't have at least a master's degree level of training in Chinese medicine.

So, to recap: Chiropractor, physical therapist or doctor with needles--less than 300 hours of training.

Acupuncturist (with master's degree or more)- 1200 hours of hands on experience using needles in a clinic on patients as part of our training, not including the academic training.

And whomever told you dry needling might be better--I would never listen to that person's advice again, because they give advice about things they clearly know NOTHING about.
Dry needling is actually a practice done by acupuncturists. If someone offers this service but is not certified or licensed in acupuncture, do NOT see them. Dry needling is now being taught in some states as a simple certification course. Those who take this course but do not have an understanding of how deep the needles can actually penetrate can cause serious damage to the body, including but not limited to collapsed lungs, punctured organs, arteries, or veins, etc. Certified and licensed acupuncturists are trained and tested on needle depth around the entire body.

Dry needling is a technique used to release trigger points, aka knots, in the muscles by forcing the muscle to twitch. That twitch response is the muscle fully contracting so it can fully release and therefore, alleviate pain. Wet needling, or trigger point injections, is a service provided by some pain management doctors that releases these knots using a steroid injection. Both techniques are very effective but only if the primary cause of the pain is the trigger points. Typically, trigger points are almost always involved, but the reason why they're forming may be the true cause of your back pain. Acupuncture can work both to alleviate the trigger points, and the true cause of your pain. Being able to attack from both sides (treating the central and surrounding reasons for pain) makes acupuncture very effective in pain management.
Definitely, you should go to a person who has knowledge of Chinese medicine and acupuncture. Dry needling is given by somebody legally allowed to do acupuncture, but they do not know about the acupuncture system and combination of points. It's like going to somebody who's totally blind with this science.
Dry needling uses acupuncture needle on the trigger points for pain control. Acupuncture has a very complete theories and philosophy to guide for differentiation of syndromes to help patients. There are many reasons to cause pain. Licensed acupuncturists will take history, check tongue and pulses to find the real etiology of pain. So acupuncture is not just release the pain. It also finds the root of pain and take care of the root to remove the pain. I will recommend you to get acupuncture for your pain condition.
This is a very interesting question. Acupuncturists go to Graduate School or Doctorate School and must pass National or State licensing exams. Physical therapists, chiropractors, and others take a few hour weekend classes to do "dry needling." The depth of acupuncture study, differential diagnosis and point prescriptions require deep knowledge that cannot be attained in a short time. Acupuncturists also need 50 continuing education classes every 2 years to maintain our license.
Dry needling is usually performed by physical therapists and their aim is to address trigger points. They usually study the technique for a short time and they receive a certification for dry needling. The practice of acupuncture requires, in California, 4000 hours of training, including theory and clinical hours and a California State examination. This information is available on the acupuncture.gov website.

It takes a long time to learn how to practice acupuncture and how or where to apply the therapy. It is more than just a medical application, it is a healing art.

Alexandre Hillairet, DAOM.
Acupuncture is dry needling, because nothing is injected into the body, as with IV needles. If you are referring to the so-called “dry needling” that Physical Therapists are attempting, they are wrongfully using a technique that is outside their scope of practice and, state by state, are currently being stopped. They have taken a weekend crash course in needling trigger points which offers woefully inadequate experience and guidance and could result in organ puncture, etc. With regard to your pain, acupuncture and accompanying techniques can certainly help. It would require an in-person assessment to ascertain the cause of your pain, but if the pain is muscular, acupuncture can lessen muscle tension, circulate blood and fluids, decrease inflammation and improve energy flow. I suggest meeting with an Acupuncturist to get a better sense of how the medicine can particularly help your condition.
Acupuncture is not a procedure, but the dry needling is. Acupuncture treats the entire body and mind based on the Chinese medicine system. Drying needling is a part of trigger point needling technique. Dry needling is only for musculoskeletal pain.
Great comparison here from healthline.com:

Dry needling or acupuncture?

If you only compared dry needling and acupuncture with a photo, you might be stumped to identify each. Both acupuncture and dry needling use thin, stainless steel needles. For both practices, needles are inserted into the skin and both also claim to treat pain.

That’s where the similarities end. Unique qualities help differentiate the two. One practice has been used for thousands of years as an alternative treatment and has some solid research of effectiveness. The other’s been adopted in the last couple of decades.
Hello,

Sorry to here about your pain. Both may help. It really matters on who the individual is that’s treating you. Dry needling is acupuncture needling done without an acupuncture license or education on how/why it is performed. The needles will probably be placed only in the location of back pain (which may offer relief). With acupuncture, points will be in locations on the back in addition to points within the vast channel system. There will be a diagnosis based on looking at your tongue and feeling your pulse to see what’s happening to you internally. Why is this even happening to you and not heeling on its own? The acupuncturist will figure out why you have this severe back pain and address the root cause. Is it do to deficiency, excess, stomach issue, blood stagnation, cold, heat, bladder problem, etc? Treating the root of the problem will offer long term results. Needling solely the back is like watering leaves on a plant, without nourishing the root. I’m also a physical therapist and have a colleague that performs it. He took a 6-month course and became certified to do needling that I was trained for 6 years to do safely. The treatment approaches and point selections will be completely different, though. (A nail technician is legally able to give massage, but if I was in pain, I would choose a licensed massage therapist instead.)
Hope you obtain long-lasting relief soon.

David G. Hanley, Dipl. OM
They are one in the same. The therapy using those needles depends on the practitioner. Traditional Chinese medicine practitioner will treat you as a whole. PT or MD or chiro will use the needles for only local area treatments. So depends on what kind of healing you are looking for. Deep healing? TCM. A hopeful quick fix, any of the others. But, know this, it may come back, because the whole body wasn't addressed.
I would definitely suggest acupuncture. Other people who do dry needling do so after just a few hours of training, but are using needling techniques that acupuncturists spend many, many hours learning. There are often accidents and injuries when people use this technique without being properly trained.
Good afternoon,

You should do acupuncture, not dry needle, because with dry needle, they put the needle wherever it hurts and the practitioner only has 100-180 hours of training.

Good luck,

David
Thank you for your question about the best way to address your chronic pain -- using acupuncture or dry needling. Dry needling is generally done by a physical therapist and involves using thick acupuncture needles to stimulate a strong response. It can be uncomfortable, but it can be effective. This approach only addresses the pain. Acupuncture is done by a
practitioner who has had thousands of hours of clinical education.
All acupuncturists have a minimum of 2 to 4 years before sitting for there state boards. People doing dry needling are taking as little as 20 hrs and think that they are qualified. Dry needling is ACUPUNCTURE.
If you have chronic pain I would suggest acupuncture. Dry needling is mainly used for acute pain and deals only with relieving the specific area and not the root of the problem. Acupuncture addresses the pain, the root of the pain and also balances the whole body and mind so that you are your best and healthiest for continued wellness. Your sleep, mental clarity and energy will be improved and any issues with other areas also will be addressed. The cost of both treatments is similar but with acupuncture you get the benefit of 3000 years of practice, a physician with a four year post-graduate education, and a whole body and mind balance/treatment. Dry needling does not require any formal education and often provides at most, temporary relief. It seems that dry needling is good for muscle aches and pains from improper exercise and minor sports strains and pulls. It is also worth mentioning that if not done properly, dry needling can be quite painful.
This is a very complicated issue/question and in the interest of full disclosure, I'm an extremely biased source when it comes to the subject of dry needling.

Are there people out there who provide dry needling services who are quite good at what they do? Certainly. The problem is: there are no national certifying agencies, no course curriculum guidelines, very few hours of training required and no required continuing education. In essence, there's no quality control and, in my opinion, you're rolling the dice when you allow someone to treat you using solid needles who doesn't carry some sort of nationally recognized board certification.

The American Medical Association's position is: dry needling is acupuncture and those providers who offer the service need to have substantially similar training, certification and continuing education requirements as acupuncturists. As I noted above, usually they do not have these qualifications.

Generally speaking, dry needling is targeting so-called "trigger points". The thing about trigger points is: they have a very narrow set of diagnostic criteria. A trigger point is defined as a point of highest tension in a muscle that, when pressed, creates a radiating pain pattern characteristic of that location on that muscle. If it doesn't fit that definition, even if the point is tender, it's not a trigger point and may or may not benefit from having a needle stuck in it. Most folks offering dry needling are flexing the definition somewhat and will simply needle any point that is painful when pressed, regardless of whether the pain radiates in a characteristic way.

The other issue is: your back pain may or may not be related to muscular issues/trigger points. If your back pain is trigger point related, then this type of treatment can sometimes help. If your back pain is not trigger point related, then this type of treatment is usually a waste of your time and money.

An acupuncturist who specializes in musculoskeletal treatments/pain management can locate and treat using trigger points (if they are part of the problem) and they can also address other, non trigger point, issues which may be causing your discomfort/pain. Generally an acupuncturist is going to have much more experience using needles to address problems like this, your experience will be more comfortable (dry needling tends to be very painful) and you're less likely to be injured by the needling process. Back treatment can be tricky, especially if needles are required over the lung/chest cavity. There is a risk of tension pneumothorax due to a needle penetrating the pleural cavity. This is extremely painful and can be life-threatening. It can happen to anyone who is using needles over the chest, but it tends to happen more often with providers who have sub-standard training and then attempt to dry needle.

The question you have to ask yourself is: do I want someone who qualified for, took and passed a set of nationally recognized board exams after taking thousands of hours of class work and having several hundred supervised treatment hours under their belt treating me OR do I want someone who took a weekend seminar, maybe inserted a handful needles under supervision and has no national qualification to perform the procedure in question?

You could also think about it like this: if you found out you had a brain tumor would you let your kids' pediatrician operate on it just because they had an interest in neurosurgery or would you try to find a board certified neurosurgeon to do the work?

Ultimately it's the same question. Do I want a board certified specialist or am I willing to roll the dice with just any old provider?

I suggest starting with the "Find a Practitioner" page at NCCAOM.org. Get a list of credentialed acupuncturists in your area and call around to see if you can find someone who specializes either in pain management or musculoskeletal acupuncture. In my opinion this will give you the best possible result and the safest, most comfortable treatment experience.