Pain reduction is often a primary reason for persons to seek medical care. Physical therapists and other alternative medicine providers are tasked with using non-pharmacological pain management strategies to manage neuromusculoskeletal pain conditions to include dry needling/ acupuncture, exercise, cupping, tool assisted tissue mobilization, massage, mobilization, manipulation, among others (Schug et al, 2015).

A common question asked by consumers of these techniques is, what is the difference between Dry Needling and acupuncture? Although the interventions look very similar, one should not be confused with the other since the underlying philosophy driving the technique differs (Butts et al 2021). There are a few key differences. Good news, there are also some beneficial similarities.

Dry needling is a technique in which small needles (aka monofilaments without injectate) are inserted into peripheral structures including nerves, neurovascular bundles, muscles, ligaments, tendons, subcutaneous fascia or scar tissue in order to treat bodily pain (Butts et al 2021). The depth of needle insertion in dry needling is variable depending on the target tissue and treatment objective. Acupuncture, on the other hand, is a technique that has been in place for thousands of years with needles inserted 3-5 mm in depth along specific “pathways” or meridians in the body (Kelly & Willis, 2019).

In dry needling, tissue is stimulated to induce local and central pain blocking effects, increase blood flow and stimulate cellular remodeling, effects based heavily on principles of Western medicine. In acupuncture, however, traditional points in the body are stimulated for the purpose of moving energy flow in the body (qi) thereby treating conditions associated with traditional Chinese medicine (Dunning et al, 2014; Butts et al 2021). In both techniques, the number of needles used, the time needles remain in place and the application of an electric current through the needles is variable and can enhance the therapeutic effect (Butts et al, 2016).

In spite of these differences in philosophy and technique, recent advances in imaging, namely functional MRI’s of the brain, has helped solidify brain changes that occur with traditional acupuncture and nontraditional methods such as dry needling. Both are emerging as effective pain management techniques in their own right and have been shown to have an effect on peripheral and central pain centers (Kelly & Willis, 2019), including the activation of the body’s natural pain-fighting systems, the body’s own opioid system and hormones with strong anti-inflammatory effects (Butts et al 2016).

Therefore, whether you choose one technique or the other, you are likely to experience a beneficial response. There is nothing new under the sun; we continue to benefit from the wisdom of those who came before us all these thousands of years later!

By: Germaine Herman, PT, DPT, OCS, FAAOMPT, Cert-DN