Physical Therapy Dry Needling vs Acupuncture

What is the difference?

Dry needling and Acupuncture both use very fine, almost hair fine needles, to promote healing. The theories and applications behind their use, however, are quite different. 

Acupuncture is an ancient practice based on a theory that the human body is filled with and a force called ‘qi’. When qi is flowing well, a person experiences good mental and physical health. When qi is blocked or insufficient, acupuncture can help restore it’s flow. It is an over 2000 year old practice with extensive research in the literature.  Acupuncture treats many conditions. These conditions may affect organs, the mind, and the musculoskeletal system. 

Dry needling is based on a western medicine model and follows an orthopedic and neurological approach. Needles are placed in certain patterns to stimulate healing of the tissues. Treatment is focused on the musculoskeletal system. 

In short, one is based more on an energy model, the other on a physical model. Both work well.

Some examples of orthopedic dry needling may be: 

Trigger point needling. When muscles are under chronic strain, tiny tight bands form. These tiny muscle bands are  contracted and unable to release themselves. Over time, the tightness decreases blood flow. The muscle can not contract properly, and it can not stretch properly. It begins to send pain signals not only from the local tissue, but referral pain, which is pain felt in another area. Inserting a needle causes the tiny bands to let go and begin to heal. Often the decrease in referral pain and the local pain happens quickly, over a few sessions. 

Peri-neural dry needling. This type of needling is done for peripheral nerve dysfunction. Think carpal tunnel syndrome. Needling increases beta-endorphins and decreases cortisol, while also increasing micro-circulation. This has a direct effect on pain. In the case of peripheral nerve syndromes like carpal tunnel, needling would also be used in the muscles around the nerve, allowing a release of tension and increase of circulation. 

Needling of tendons. Fibers in a healthy tendon are aligned in one direction. When a tendon has been injured abruptly or by chronic strain, it’s collagen fibers re-form in a criss-cross pattern instead of the parallel alignment that is natural. Then, every time the tendon is pulled, there is a painful reaction. The fibers become angry, producing pain and inflammation when pulled.  Introducing micro needles in a controlled environment stimulates the collagen to form correctly, and in time, the tendon becomes strong again. 

Physical therapists in the state of New Jersey are required to have 7 years of schooling, plus a separate certification in dry needling if they wish to practice this modality. In addition, they must learn dry needling only from other practitioners who have a minimum of 5 years practicing dry needling.