Differences on Dry Needling & Acupuncture

4 Crucial Info On Dry needling You Need to Know

This article is to help you be informed of what dry needling therapy is, potential dangers of it, & if it is something that you actually need albeit many clinicians providing them. We cover the top 4 questions that will help understand this topic

1. What is the difference between acupuncture and dry needling?
2. What is dry needling good for?
3. How painful is dry needling?
4. Is dry needling dangerous?

What's the difference between acupuncture & dry needling?

With a widespread of therapists now equipped with the knowledge of treating physical pain by applying dry needling in a treatment session, & looking strikingly similar to acupuncture, how do you tell the difference, or if there's even an actual difference with just using a different name? 

Similarities

• Acupuncture & dry needling therapy are both an invasive modality to treatment of patients of different conditions & clinical practise, in which a needle pierces through the skin & into the local muscle. Both of them insert the needle by placing it directly on the skin & applying a physical flicking motion or tapping of the finger technique. 

Then, we try & separate how each (acupuncture & dry needling) separates itself. 

Acupuncture

Acupuncture procedure are ought to be performed only by a qualified TCM (traditional Chinese medicine) physician, which is a minimum of 5 years of study to qualify as a TCM Physician. In Singapore, the professional title of a TCM Physician is regulated & governed by the TCM Practitioners Board. 

A TCM doctor is a non-allopathic medical doctor who uses a systemic approach derived from the Chinese medical system which has been around for thousands of years. TCM practice sees & treats a wide variety of patients with health illnesses or disease, & uses a wide approach to the treatment which may involve natural herbal remedies, acupuncture, moxibustion, & soft tissue manipulations. 

Acupuncture therapy is only done after a comprehensive assessment, following the signs & symptoms of the presented case, & according to that, if they decide to use acupuncture needles, it will follow the TCM principles of meridian channels which may blocking certain pathways of the functions of the body, causing a disharmony. 

The acupuncture needles (thin filiform) that are used during a TCM treatment are hardly deep enough to cause any twitch response from deep muscles, though patients may still feel slightly sore but is dependent on person to person & the application of the acupuncture techniques & placements of it. Under supervision, a TCM student practices acupuncture throughout their studies up to graduation.

On another note, there are licensed acupuncturists with the title  Lic.Ac or L.Ac, who are also licensed & as well regulated in most countries to do acupuncture based on both western & eastern theory approach of needling, with the base of the studies being TCM still. Licensed acupuncturists typically go through full-time studies of 3-4 years depending on their specialisation. 



Dry Needling

Dry needling is also referred to by various names which can include: 

• Myofascial trigger point needling 
• Trigger point needling 
• Trigger point dry needling 
• Dry needling treatment
• Neuro- Myofascial dry needling treatment 

While the names can be different, all of them uses the same principle aspect of treating a trigger point using sterile needles such as filiform to induce inflammation & to elicit healing process. 


Dry needling therapy is currently not regulated, despite it being open to anyone who is present for the course, however, the procedure is mainly performed by a wide range of western/ modern science clinicians such as physical therapists, chiropractors, Osteopaths, sports medicine doctors, & other qualified professionals. A dry needling inclusive treatment can be used during physical therapy, or as a conjunct to other modalities such as prior/ post manipulations, etc. Being an evidence based modality, it's a go to for physical therapists used in physical therapy. Dry needling is only administered after a full diagnosis related to MSK pain. It's been reviewed that a mix of physical therapy alongside the needling therapy shows better outcome than just just a standalone therapy. 

Dry needling is based on the theory of treating trigger points that may be the cause of referred pain, using a filiform needle (same ones as acupuncture needles), to provoke & promote healing process via inflammatory response & the spindle activity. The clinicians are taught to look out for "twitch response" from the muscles while doing a technique referred to as "fishing", which is a sign of eliciting a response of a trigger point(s) in the affected muscle or area. 

Trigger point dry needling was found by Dr Ida Rolf who developed the theory of needling into the muscle to help treat pain that is linked to dysfunction of the musculoskeletal system from the development of myofascial pain/ trigger points. What we know of as dry needling today, was termed wet needling as fluid was used to inject into a trigger point (in muscle) & was later progressed to a more effective method to treating the trigger points. 

The filiform needle is inserted into the muscle where a trigger point is present

Dry needling is limited to the treatment &  management of acute chronic pain/ injury relating to the musculoskeletal system. A non-exhaustive list of what it may include may be: 

• Myofascial restriction (deep muscle)
• Trigger point release
• Range of motion 
• Movement dysfunction 
• Low Bain Pain
• Muscle spasm

 It does not treat any form of illness of health conditions (diseases). 

What's dry needling good for?

Dry needling may be good for patient who has pain from dysfunctions of the musculoskeletal system. For both acute & chronic pain, dry needling can be used effectively as an intervention to help promote the body's natural healing response. The effects of dry needling on myofascial trigger points on the shoulder muscles which is a common condition with patients suffering from shoulder pain have been reported to have an almost immediate reduction of pain & increased range of motion by many clinicians & education provider's case studies. It's usually best used for Myofascial Trigger Points (MFTrP). 
​

Is dry needling painful?

Unlike trigger points that may be slightly tender (pain)to the touch, irritable & in some case even radiate upon manual palpation, dry needling  or trigger point needling does not hurt, however it may feel slightly uncomfortable. The reason for the low pain trigger is the size & type of needles (a thin filiform). A dry needling needle (filiform) is not hollow like an injection needles that is used to inject fluid into our body, & it is about a hairline in thickness. If you haven't read a more comprehensive write up about dry needling, you can do so here. 

From how the fishing technique procedure & the muscle twitch response on the trigger points using filiform needle, it has been reported that patients may feel sore after the treatment, & soreness will usually last anywhere from 1-3 days time to recover from.  ​


Often time, the patient will not even have been inserted the thin solid filiform needles have punctured through the skin & into the connective tissue (muscle)

with the use of the flicking motion technique

The entrance of the needle from the skin into the muscle, referred to the flicking technique itself is not painful, often times it will not be noticed by the patient. Once the thin solid filiform needle is inside the muscleThe flicking technique is where the physical therapist or any qualified provider places the needle 

Is dry needling dangerous?

In short, YES. Let's be honest here, there have been cases that dry needling has punctured an athlete's lung causing detrimental health conditions & needless to say the performance of the athlete being affected. Even under the hands of an experienced & qualified healthcare practitioner, results & safety will differ. However, your risks involved are lowered automatically, if it's done by a qualified healthcare professional. The simple reason is their background of anatomy studies, clinical expertise, & a systematic approach to pain treatment makes the world of a difference to someone who has little to no knowledge about anatomy & is providing dry needling. Often times, a person who has studied anatomy would think that the information is enough but advanced & an indestructible knowledge of anatomy needs to be present as every individual human body will have their landmarks shift around the nerves, blood vessels, & other crucial vital organs close by. 


A dry needle certified provider usually attends a typical weekend course & gets a certificate to provide extra services that are seen picking up now. The reason for this flaw in the course providers is lack of regulation, as currently there are no regulations on dry needling so it's not regulated in Singapore, Malaysia, Taiwan, UK, USA, Australia, South Africa, & many other countries. These courses are made for advanced clinicians who have enough complex knowledge of the working human body, thus it's highly suggested to avoid receiving any form of dry needle therapy as when something wrong happens, there is no insurance covering them professionally (biggest red flag).

The list below are as exhaustive as we can make it to be to those who we believe have enough training & using guidelines their individual scope of practise to provide safe, evidence based treatment:

• Physical therapists
• Chiropractors 
• Osteopaths 
• Sports Medicine Doctors 
• Licensed Acupuncturists 
• LMT (Licensed Massage Therapists)
• RMT (registered Massage Therapists)

Highly suggested avoiding to receive dry needle from: 

• Personal Trainers 
• Fitness Coach 
• Massage therapists (that falls below the 2200hours education)
• Deep Tissue massage therapists 
• Sports Massage therapists 
• Sports therapists (Singapore)
• Musculoskeletal therapists (with less than a 2 year full time studies or equivalent)

Please seek expert advice & treatment from a qualified healthcare professional that has enough clinical training to provide safe & effective treatments for pain at a physical therapy clinic, sports medicine centre, chiropractic, & so on. If you're looking to support & provide relief to patients who have chronic pain, look for our next available dates for a research -based course here.