This is a great topic of discussion to unpack, because from the perspective of a client on a treatment table, these two needle-based modalities could seem exactly the same: the practitioner inserts needles into the body to help relieve the problem they have come to the clinic to get treated, dry needling and acupuncture must be the same thing then right?
Well they are actually quite different.
So why is it important to clarify the difference? From an acupuncturists' perspective (mine), I think it is an important education matter, so that patients can understand just how broadly acupuncture, as a medicine, can be used to support the body, not just the musculoskeletal aspects of the body.
I would also like to state how much I love the fact that more Osteopaths, Physiotherapists, Myo-therapists and other body workers are incorporating dry needling into their practice. I see this as a way of introducing a larger portion of the community to the benefits of acupuncture.
Once a patient has a sense of familiarity with needles being used in a clinical setting (and they are comfortable with that), I would love to see the awareness continue to grow around what acupuncture is able to do for a persons' mental, gut, gynaecological, and internal health, as well as help to manage and reduce pain in their musculoskeletal system.
So the following are some points of clarification that I would like to share about the differences between acupuncture and dry needling:
1. All dry needling points (trigger points) are acupuncture points, but not all acupuncture points are trigger points.
Broadly speaking, my understanding is that dry-needling is like a subcategory modality of Acupuncture.
The points of the body needled by someone using dry-needling in their practice are likely to be selected from a series of trigger points. There are many trigger points all over the body, and they tend to relate to muscles, and/or the attachment sites of tendons and ligaments to bones. Often you can use your own hand/finger and apply pressure to a trigger point and feel a large sense of radiating sensation through a broad section of the body.
A trigger point is usually related to the tissue of the body. Whereas an acupuncture point may or may not be related to the tissue of the body in that region. So a point like Stomach 36 for example, which sits high up in the muscle belly of the Tibialis Anterior, could be needled by a dry-needler to help clear some kind of pain or discomfort at the front of the shin local to the trigger point.
For an acupuncturist, ST 36 is a major point to support the gut, the stomach, the yang, energy and blood levels in the body. So an acupuncturist would not necessarily be needling that point because of pain or muscular reasons, as the functions related to that point are much more broad than the local area the point exists within.
Outside of the known trigger points in the body, are many more points that can be needled for different reasons by an acupuncturist. So it is a bit like the acupuncture points of the body include all of the stars in the night sky, and the maps of trigger points are smaller constellations within the sky.
2. The needles are used differently for each treatment.
The types of of needles used in dry needling and acupuncture can be exactly the same.
Same brand, same length, same thickness. So to the patient watching and receiving, the needles themselves don't really create a point of difference for these two kinds of therapies, which makes it very easy to think they are the same treatment.
Sometimes thicker needles are used by a dry needler, especially if the muscle or tissue of the patient is very dense. But then again, an acupuncturist might choose to use a thicker needle from time to time depending on what they are trying to achieve in the session.
From my experience receiving dry needling, the forceful use of the needles has been very strong. The needles have been inserted into muscular regions of my body and stimulated strongly trying to get the muscle to have a therapeutic spasm (or many therapeutic spasms). This has not always been pleasant, but then again I have had particularly "knotty" tissue that probably required that level of intensity. In fact, one of my shoulder muscles was so knotted up that the needle bent in half trying to stimulate the tissue (thank you 7 years of University knotted up my right shoulder!). After that particular treatment I had to drive home with one arm because my right arm felt like it needed to be in a sling! Don't get me wrong it really helped to get things flowing through my muscles. But if I didn't know that acupuncture could be gentle, sometimes not even felt upon needle insertion, I might be apprehensive to say yes for another round of "acupuncture"!
This might be why people tell me they have had acupuncture before and it was really painful and they were sore for days afterwards. I then ask them when and where they had the acupuncture, and if they tell me it was with their Osteopath or physiotherapist then I need to gently explain that this treatment will likely be quite different and that what they received was called dry needling.
Of course some acupuncturists can be very rough with their insertions and stimulations of needles (I can personally vouch for being on the receiving end of that). I have also had very intense dry needling treatments with a body worker before.
There are some styles of acupuncture, say 5 element acupuncture for example, where the needles might be inserted into a point and then taken straight out. So the needles are not left in the body for a length of time, but rather, used to help clear a blockage.
And in many cases, especially with the way that I use needles in clinic for pain management, I will find a distal point or related point far away from the site of pain to needle in order to clear that pain. So an acupuncturist may not always use the needles on locally sore tissue, we may seek out alternative points.
3. Training for use of needles.
An acupuncturist in Australia must undertake at least 4 years of full time tertiary education in their field to acquire certification and registration in order to practice.
Most dry needling courses are taught as short courses or weekend seminars.
The body workers that want to add dry needling to their repertoire of skills have also studied their primary craft for many years. So everyone has been at school for a long time!
My point here though, is that, the actual study of using the needles, their applications, indications for use, and internal medicine branches are understood on a deeper level by an acupuncturist, because they have studied it for longer. Whereas a dry needler will have learnt the basics in order to use the needles in clinic for their musculoskeletal indications.
So now that we have clarified a few of the differences, my hope is that you, the reader, will be a little more informed about what kind of treatment you want to seek out according to what your body and internal health requires. Perhaps you have a really sore tendon, or a muscle that is not firing properly, and some dry needling with your Osteopath is exactly what you need.
And maybe after reading this article, you might be thinking about some of the other ails you have in your body such as bloating, poor digestion, insomnia, painful periods, anxiety, or pain, and you are now curious to see if acupuncture can help to bring your body back towards a state of balance?
I am grateful to be living in a time and place where we have so many amazing health practitioners and modalities to choose from when it comes to healthcare. With such a plethora of choice, everyone can explore their options and find the system and practitioner that suits them the best.