Dry Needling for Acupuncturists
Integrating Dry Needling into Your Acupuncture Practice
Dry needling is gaining widespread popularity, especially in treating musculoskeletal pain and dysfunction. For acupuncturists, integrating dry needling into an acupuncture practice offers new ways to expand services and help patients. By enhancing their skill set, acupuncturists can cater to a broader range of patients seeking effective pain management solutions and stay competitive in the evolving healthcare landscape.
Key Points:
Dry needling is in high demand due to its effectiveness in treating pain and musculoskeletal issues.
Dry needling operates under a different diagnostic paradigm than traditional acupuncture, focusing on myofascial trigger points and their referral patterns.
Needle techniques in dry needling differ, requiring specific training and knowledge of musculoskeletal anatomy.
Acupuncturists who do not adopt dry needling risk losing ground to other healthcare practitioners.
As needle experts, acupuncturists are in an ideal position to excel in dry needling compared to non-acupuncturists.
Integrating dry needling into acupuncture is seamless and complements traditional acupuncture techniques for more comprehensive care.
Dry Needling is in Demand
Dry needling is rapidly becoming a sought-after treatment in pain management clinics and physical therapy practices due to its ability to address myofascial pain and trigger points efficiently. According to Google Trends, searches for dry needling treatments and related keywords have been steadily rising over the past 5 years.
As patients become more aware of dry needling's benefits, they are increasingly seeking it out for musculoskeletal issues like neck and back pain, frozen shoulder, and other orthopedic conditions. Unlike traditional acupuncture, which is often seen as an energy-balancing therapy, dry needling specifically focuses on musculoskeletal pain relief, offering rapid results.
For acupuncturists, this growing demand presents an opportunity to expand services. By offering dry needling, they can attract new patients who might otherwise seek treatment from physical therapists or chiropractors. Not only does adding dry needling broaden a clinic’s scope, but it also helps retain patients who may be looking for both immediate relief and long-term, holistic care. In the competitive field of healthcare, being able to offer both traditional acupuncture and dry needling sets acupuncturists apart and eliminates a situation where has to choose on treatment over another with different providers.
Dry Needling Involves a Different Diagnosis Paradigm
While both dry needling and traditional acupuncture use the same fine needles, their diagnostic approaches are distinct. Traditional acupuncture is rooted in Eastern medicine and focuses on meridian lines, energy flow, and balancing the body’s qi. Diagnosis in acupuncture involves understanding the body’s energy patterns and restoring harmony through needle retention at key points along the meridians.
In contrast, dry needling is based on Western musculoskeletal anatomy and focuses on identifying and treating myofascial trigger points. Trigger points are tight knots of muscle fibers that refer pain to other parts of the body. This approach is mechanical, with the goal of targeting and releasing these points to relieve pain and restore mobility and function. The diagnostic process in dry needling requires palpation to locate these points and knowledge of muscle referral patterns rather than relying on traditional energy channels.
Although these two paradigms differ, they can be complementary. Acupuncturists already possess the fundamental skills of needling and palpation, allowing them to seamlessly integrate dry needling into their practice with proper training. Understanding how to identify trigger points and knowing how these points correspond to muscle referral patterns expands the scope of their practice and enhances their ability to treat musculoskeletal pain.
While many acupuncturists say “dry needling is acupuncture” - it may use an acupuncture needle, but it requires an entirely different lens in both diagnosis and treatment skill that is vastly different than what is taught in TCM acupuncture schools.
Needle Techniques in Dry Needling
Dry needling employs needle techniques that are not always used in classical acupuncture. While traditional acupuncture often involves needle retention for a specific duration to influence the body’s energy systems and may even include more aggressive and deeper needling techniques, dry needling focuses on quicker insertions and manipulations designed to elicit a response from the muscle tissue. Techniques such as "pistoning" (inserting and removing the needle rapidly) or deep needling to target a specific muscle knot with the intention of releasing a trigger point differentiate dry needling from the generally more static approach of traditional acupuncture.
A key goal in dry needling is to achieve a localized twitch response, which indicates that the needle has successfully reached the trigger point, causing the muscle to contract and release. This helps to alleviate muscle tension and increase circulation, ultimately reducing pain. Unlike traditional acupuncture needles that may remain in the body for several minutes, dry needling needles are typically not retained once the trigger point has been released.
Acupuncturists familiar with classical techniques can quickly adapt to dry needling by expanding their understanding of musculoskeletal anatomy and learning to apply different insertion techniques. The hands-on nature of dry needling, combined with its reliance on direct palpation and anatomical knowledge, makes it a powerful tool in treating acute and chronic pain conditions.
Why Dry Needling Should Be Part of Every Acupuncturist’s Toolbox
Acupuncturists are the original needle experts, trained extensively in the use of filiform needles for therapeutic purposes. Despite this, many acupuncturists remain hesitant to adopt dry needling, seeing it as separate from their traditional training or fearing that it might undermine their core practice. However, dry needling is a natural extension of an acupuncturist’s existing skill set. By integrating dry needling into their practice, acupuncturists can offer more versatile treatment options, particularly for patients with musculoskeletal pain.
There is a growing trend of physical therapists (PTs), chiropractors, and even athletic trainers incorporating dry needling into their services. In a 2020 survey of U.S. physical therapists, more than half of respondents reported practicing dry needling, despite often receiving limited formal training. Most PTs reported performing just 0-3 dry needling sessions per day, typically lasting less than 15 minutes. In contrast, acupuncturists are far better equipped to master this technique, given their extensive training in needling, palpation, and anatomy.
If you’ve ever received dry needling from a non-acupuncturist, you may have experienced more painful needle insertion, poor needle manipulation, or unsafe needling practices due to their lack of training. Acupuncturists are in a position to offer more comfortable and safer dry needling treatments due to their extensive needle training.
Acupuncturists who integrate dry needling into their practice can provide superior care, offering patients a more complete treatment for pain management. The comprehensive approach of combining traditional acupuncture’s holistic methods with dry needling’s targeted pain relief ensures better outcomes for patients and allows acupuncturists to remain competitive in the marketplace.
Acupuncturists Are Losing Ground by Not Training in Dry Needling
Acupuncturists risk losing ground to other healthcare practitioners if they do not integrate dry needling into their practice. The demand for dry needling has grown rapidly, especially as physical therapists, chiropractors, and even athletic trainers incorporate it into their services. These practitioners typically have minimal training compared to the rigorous instruction acupuncturists receive, yet they are still drawing patients seeking dry needling for musculoskeletal pain relief.
According to the 2020 survey, many physical therapists perform just a few dry needling sessions per day and have limited hands-on training in needle techniques. This highlights the need for acupuncturists to step up and assert their expertise in needling. With their in-depth knowledge of anatomy, refined needle techniques, and broader training hours, acupuncturists are in the best position to offer superior dry needling treatments. By failing to adopt dry needling, acupuncturists risk allowing other professions to dominate a field where they are naturally the most qualified experts.
Integrating Dry Needling into Your Existing Practice
Integrating dry needling into an acupuncture practice is easier than many acupuncturists realize. The two modalities complement each other, providing both immediate and long-term relief for musculoskeletal and systemic issues. Dry needling can be used alongside traditional acupuncture techniques to enhance treatment outcomes.
For instance, an acupuncturist may begin a session by using dry needling to release myofascial trigger points in a specific muscle group, then follow up with traditional acupuncture to restore balance and improve systemic health. Another way to integrate is to insert traditional acupuncture points first and then release trigger points at the end of the session. Acupoints that coincide with trigger points can also be retained with needles, merging both approaches seamlessly. This versatility allows acupuncturists to provide comprehensive care tailored to the patient's needs, addressing both localized pain and overall well-being.
Integrating Acupuncture and Dry Needling
Brief History of Dry Needling
Dry needling emerged from the practice of trigger point injections, which were initially developed as part of Western medical practices. Pioneers like Janet Travell and David Simons, who researched myofascial trigger points, were instrumental in shaping dry needling as we know it today. The term "dry needling" was coined to distinguish the technique from injection-based therapies (or "wet needling"), which involved injecting medications into trigger points.
The understanding of trigger points has evolved significantly since their discovery, highlighting their role in musculoskeletal pain and dysfunction. These insights have paved the way for therapies like dry needling that specifically target trigger points to relieve pain and improve function. Since traditional acupuncture and dry needling both use needles to treat pain, it should be no surprise that this is a lot of overlap between myofascial trigger points and acupuncture points.
In the 1970s, as acupuncture gained popularity in the West, dry needling began to evolve into a standalone therapy using acupuncture needles. Over time, the technique became more widely adopted in physiotherapy and chiropractic settings for treating musculoskeletal pain and dysfunction. Today, dry needling is a popular modality in many healthcare professions, including acupuncture, where it offers an evidence-based approach to treating pain.
Dry Needling vs. Acupuncture: Understanding the Overlap
While dry needling and acupuncture share similarities in their use of fine needles, the two therapies stem from different philosophies and diagnostic approaches. Dry needling was developed from Western medical practices, with a focus on musculoskeletal pain and muscle referral patterns. Acupuncture, by contrast, is rooted in Eastern medicine, emphasizing energy flow, meridians, and qi.
Despite these differences, there is considerable overlap between the two approaches, particularly when trigger points correspond with acupuncture points. Acupuncturists who understand both paradigms are uniquely positioned to offer a well-rounded approach to treatment, addressing both structural and energetic imbalances. This allows them to provide a more comprehensive treatment plan, catering to the specific needs of each patient.
Conclusion: The Future of Dry Needling in Acupuncture
Dry needling offers acupuncturists a valuable opportunity to expand their practice and meet the growing demand for musculoskeletal pain treatments. By integrating dry needling into their existing services, acupuncturists can attract new patients, provide more versatile care, and remain competitive in the healthcare marketplace. As needle experts with extensive training in anatomy and needling techniques, acupuncturists are in an ideal position
Over to you
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Sources:
Travell, J. G., Simons, D. G. (1993). Myofascial pain and dysfunction: The trigger point manual. London: Lippincott Williams & Wilkins.
Biel, A., & Dorn, R. (2010). Trail guide to the body: A hands-on guide to locating muscles, bones and more. Boulder, CO: Books of Dicovery.
Gattie E, Cleland JA, Snodgrass S. A survey of American physical therapists' current practice of dry needling: Practice patterns and adverse events. Musculoskelet Sci Pract. 2020 Dec;50:102255. doi: 10.1016/j.msksp.2020.102255. Epub 2020 Sep 5. PMID: 32932050.
Legge, D. (2014). A history of dry needling. Journal of Musculoskeletal Pain, 22(3), 301–307. https://doi.org/10.3109/10582452.2014.883041
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