Dry Needling or Acupuncture – What’s the Difference?
What is Dry Needling?
Dry needling is a technique developed in the 1940s by Janet Travell and David Simons. The procedure involves the use of hypodermic needles or needles placed immediately beneath the skin to stimulate trigger points or myofascial trigger points with substances such as corticosteroids, saline solution and analgesics. The term dry needling was first coined by Dr. Travell in her book ‘Myofascial Pain and Dysfunction: Trigger Point Manual’ as opposed to the application of a different technique that involved no injection of substances (called wet needling) but focused on the triggering of myofascial trigger point.
What is a Trigger Point or Myofascial Trigger Point?
In 1938 John Kellergen coined the term “Myofacial Trigger Point’ (MTrP) as being an area of sensitivity that when pressed created referred pain locations. A Trigger Point or Myofascial Trigger Point is essentially a site of irritation within the muscle fibre which can form knots or small area of muscle tightness, pain or contraction. Another term Intramuscular Stimulation (IMS) was developed by Chan Gunn in the 1970s and is a technique associated with needling tight bands of muscle, creating a nerve response irritation or muscle twitch.
Why call it dry needling instead of acupuncture?
The term ‘dry needling’ was created as western-based practitioners who believed Chinese medicine terminology was seen as mythical and ‘unscientific’. However it is important to recognise that Chinese medicine terminology is over 4600 years old and it would be like using Shakespearean era language today, it would seem odd and so it does. However, it is far from unscientific. A recent literature review showed significant benefits in the use of acupuncture in the treatment of a wide range of conditions.
The language of Chinese medicine does, however, provide the practitioner with a framework and the skills to be able to use acupuncture in the treatment of a wide range of diseases based on empirical evidence and now modern scientific evidence. What we now know is that the mechanism of acupuncture does follow scientific principles as it promotes the circulation of blood, endorphins and hormones as well as influences nerve transmission.
Is Dry Needling different to Acupuncture?
The techniques described as ‘dry needling’, ‘intramuscular stimulation’ or ‘myofascial trigger point’ needling are specific techniques that have been described in classical and contemporary Chinese medicine literature. Trigger points are defined in these texts as ‘Ashi Points’. The first reference of ashi points – which literally translates as ‘Ah yes!’ – was by Sun Simiao in his book Qian Jin Yao Fang (Thousand Ducat Formulas) in 652A.D.. over 1300 years ago.
Ashi points are defined as points that have muscular tension and are tender to touch. These points are needled in such a way as to create a twitch response in the muscle called the arrival of ‘De qi’. This term was described in the ‘Yellow Emperor’s Internal Canon ’ which is believed to have been written in 100B.C.
In short, this is not a new technique developed in the 1930s, dry needling is essentially a term that is used to describe a technique that has been used in Chinese medicine acupuncture for over 2000 years.
What are the benefits of seeing a registered Chinese medicine practitioner over a dry needling practitioner?
- Less pain more options:
Dry needling is only one needling technique used by a registered acupuncturist. It also tends to be one of the more painful ones. At Elevate Acupuncture we use more gentle needle techniques to help you get better results than just dry needling. - Improved safety
Much longer and more specific training in using acupuncture needles so you are in safer hands. - Improve function and Pain relief:
Acupuncture is just one technique we can use for muscle pain and dysfunction. We also have additional tools including diet, Chinese herbal medicine, pain relief supplementation and exercise therapy.
Are trigger points and ashi points the same?
Trigger points are sites of pain and contraction and are seen as sites where neuromuscular junctions occur. This is where the nerve meets the muscle to allow a nerve impulse to activate a muscle. Ashi points include but are not limited to the specific points defined as trigger points as neuromuscular junctions are far higher in number and therefore offer a far wider range of areas that can be used when using acupuncture for musculoskeletal pain.
How is the level of training different for dry needling?
Dry needling practitioners require as little as 16 hours in training before a practitioner can be qualified to perform the practice. There is no registering body and no legal requirements, except for local government regulations regarding the premises facilities where skin penetration is being performed.
Registered acupuncturists have significantly more training in acupuncture and dry needling as this is their primary modality, not an add on. On average a registered acupuncturist would have approximately:
- 150 hours of Anatomy and Physiology outlining the location of organs, nerve structures and arteries
- 100 hours of point location including how to needle in order to prevent issues such as organ puncture, nerve damage, artery damage and pain.
- 200 hours of needling training.
- 400 hours of supervised clinical practice
Are there greater risks receiving dry needling from a practitioner not registered as an acupuncturist?
As yet there is no clear research detailing injuries associated with dry needling practitioners and acupuncturists.
However, dry needling practitioners may have as little as 16 hours training whereas your Elevate Acupuncture practitioners are registered Chinese medicine practitioners and have over 850 hours of training related to dry needling and other acupuncture techniques. It’s kind of like asking your plumber to fix your electrical problems. They might be in a similar area of work but the training is much more specific and the problems could result in significant injury.
Acupuncture/ acupuncturist what’s the difference?
Currently, in Australia Chinese medicine and acupuncture are regulated under the Australian Health Practitioner Agency (AHPRA) and the Chinese Medicine Board of Australia (CMBA). It is illegal to claim to be an acupuncturist or be seen to imply you are an acupuncturist without being registered. Under the national law, this can be seen as ‘holding out’ or creating the perception that the practitioner is an ‘acupuncturist’ and is not permitted. Significant fines are imposed for those found to be in breach of the national law. Strict codes of conduct are required including ongoing training specific to Chinese medicine and appropriate insurance.
What conditions is dry needling used for?
Dry needling is most commonly used for musculoskeletal problems including:
- Neck and shoulder pain
- Knee pain
- Headaches and migraine
- Tennis elbow
- Plantar fascitis
- Carpal tunnel
- Low back pain
- Sciatica
- General pain relief
How do I know if I am seeing a fully qualified acupuncture practitioner and dry needling practitioner?
Make sure when you seek the services of an acupuncture practitioner that they are registered under the national scheme under acupuncturist or Chinese medicine practitioner.
If your practitioner is registered under AHPRA it is important to make sure it is for ‘Acupuncture’ or ‘Chinese medicine’ that way you know you are getting a highly skilled and well-trained acupuncture practitioner.
A registered practitioner will have a CMBA registration number starting with CMR. Make sure you ask your practitioner to provide you with this number as this gives you the knowledge that you are with a highly trained practitioner and are in the safest hands.
You can find out here by doing a search of the practitioner name.
Are the practitioners at Elevate Acupuncture registered Chinese medicine practitioners?
Samuel is a registered Chinese medicine practitioner so you can be sure that when receiving acupuncture treatment you are getting the best level of care with the highest level of safety.
