It’s always an awkward moment – my new patient is laying on the table, I’ve got needles out ready to stab them and I ask the innocent question “so, have you had acupuncture before?”
It goes one of three ways – either I get a “no” and I’m super happy to get a first-timer. Or I get a “yes” I saw Grand Master Wu Tching Tching and he also gave me herbs – I’m cool with that…or I get “oh yes, I get acupuncture from my physio all the time”.
The third response generally sees a cold quietness begins to blanket the room as I put my needles down. “Oh?” I respond. “Tell me more”. Usually the patient blunders on, unaware of what is about to come.
A cold quietness begins to blanket the room….
For the record, I don’t have the time to get all upset about Physiotherapists or any other modality doing dry needling. In fact, in the right situation, I like dry needling and I think it is super useful! I’m all about using what ever you have in your toolbox to help someone get better.
But due to a loophole in the Australian Health Practitioner Regulation Agency (“AHPRA”), anyone can hang their shingle out and say they do acupuncture, as that isn’t a protected title. And given most people have heard of acupuncture, that’s what Dry Needling Therapists say they do. I mean, let’s face it: dry needling sounds scary.
This is the part that is upsetting, as acupuncture and dry needling are different crafts – even if they do use the same tool. It’s like a Podiatrist saying they are a Chiropractor – nope, not even close.
Dry needling – what, who and how
Dry needling is the type of ‘acupuncture’ that is done by Physiotherapists, Podiatrist, Chiropractors, Osteopaths, Occupational Therapists and other allied health professionals. Some Massage Therapists also go down this path.
The skill of dry needling is becoming very popular in many clinics that deal with musculoskeletal pain, and the truth is, in the hands of a skilled practitioner, dry needling (or, more accurately, trigger point dry needling) is an excellent aid in healing musculoskeletal injuries and problems.
Most practitioners can get started doing dry needling over a weekend. Many educators are offering an online theory course of around 8 hours and a practical component of 12 hours. Combined with the allied health professional’s prior understanding of human anatomy, this is the training required to receive a Certificate of Completion and become a qualified Dry Needling Therapist.
Of course, you can go on and do extra studies in this area, however the concepts of Dry Needling remain the same.
Dry needling aims to reduce pain through needling trigger points, also known as muscle knots, (which help muscles release “inactivating” trigger points) and creating micro injuries to the area (good for increasing blood flow and therefore oxygen and nutrients to the area).
For chronic injuries, this style of therapy is amazing, and I’m all for it! I’ve seen dry needling work wonders for muscle tightening in injuries, lower back pain and even plantar fasciitis. In the hands of a qualified and experience practitioner, dry needling therapy is good stuff.
Acupuncture – what, who and how
Acupuncture is done by Acupuncturists.
The skill of acupuncture takes several years to learn, as there is more to acupuncture than tapping a needle into the body and skewering someone. It is a modality that is gaining traction year on year here in Australia, and for very good reason: it gets results!
To call yourself an Acupuncturist, you must be registered under that modality with the Australian Health Practitioner’s Agency, which requires you to have completed a 4 or 5 year degree that includes either a Bachelor of Health Science or Biomedical Science underpinning your Chinese medicine studies.
During the degree, we not only study acupuncture theory, acupuncture point location, Chinese herbal medicine and treating in the student clinic, Chinese exercise and Chinese medicinal nutrition, but we also study western medicine subjects such as biology, anatomy and physiology, pathology, biochemistry, pharmacology, research methods, clinical examination and public health.
The practical component of needling people is over 650 hours.
Just for the record, dry needling is loosely known as “ah shi” needling in Chinese medicine – we learn it too as part of our training. It is just one of scores of different needling techniques. I think it’s pretty brutal and I rarely use it as a technique.
Acupuncture reduces pain and inflammation, and restores homeostasis to the body by understanding the person in a holistic way through a Chinese medicine diagnostic framework.
There are many conditions in addition to musculoskeletal pain that can be assisted with acupuncture, these include digestive issues, trauma, stress and anxiety, and many other internal medicine complaints.
So, how are they similar?
The ways in which they are similar include they use the same needles and aim to help people with their health issues.
The ways in which they are different fall into two sections.
First, the way in which needling is done.
Generally Dry Needling Therapists will use much thicker needles and will go much deeper with the needle. Also, manipulation of the needle is common. I have often seen the results of this style of needling produce bruising and pain for the patient. It isn’t for the faint hearted!
Usually the therapist will wear gloves and the needles are concentrated in the area of concern.
Acupuncturists tend to use finer needles, the depth varies…and the technique is much gentler!
The second way the two modalities differ is in the framework through which point insertion is decided.
For Dry Needling Therapists, the points revolve mostly around trigger points (knots of muscle) and the site of injury or pain. Acupuncture considers the injury over a framework and the weakness that have pre-disposed the injury or symptom. Then, points are chosen to resolve the issue and bring balance back to the body (i.e. healing from symptom or pain). I rarely put a needle in the midst of an injury.
Which one should you use?
That’s a hard question – often dry needling therapy is combined with other therapies, such as manipulation, exercises and/or massage. As a whole, it can work quite well. The only little issue with dry needling is that it isn’t considering the whole picture, and so often it can bring about relief, but only temporarily. You would usually have less sessions than with acupuncture.
Getting acupuncture done is almost always combined with other therapies, including food, exercise and likely herbs and supplements. The number of sessions are generally more than with dry needling, and concurrent to sorting out your symptoms, we are working in the background to bring about restoring your health so the injury or symptoms do not recur.
My thoughts are that if you are say, a sporty kinda gal and you have a physio you like who does dry needling for you when you get hurt, stick with it. Acupuncture will approach your injury differently and look to understand why it happens…but the initial result will be the same with both – resolution of your pain and symptoms.
On the other hand, if you are a sporty kinda gal who keeps getting the same injury, then you need to sort things out on a deeper level. This can take time to fix up the background problems so that you stop getting injured, but it is totally worth it!
So, the difference between acupuncture and dry needling?
Nothing, and everything.