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Dry Needling or Acupuncture?

Updated: Jul 9, 2018

If you were to be faced with the choice of Dry Needling or Acupuncture, would you know the differences? While they may look and sound similar, they are two wildly different practices, and each have their own benefits and drawbacks. What sets Dry Needling and Acupuncture apart? Let’s expand.

Dry Needling

Dry Needling is defined by the American Physical Therapy Association as “a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. Dry needling (DN) is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and, diminish persistent peripheral nociceptive input, and reduce or restore impairments of body structure and function leading to improved activity and participation.” (APTA, 2013). In layman terms, Dry Needling involves inserting stainless steel filiform needles into or around pressure points, or trigger points, to help alleviate tension caused by pressure points or “knots”, and “release” the affected areas, thus helping the associated symptoms to subside. The needles themselves do not contain liquid of any sort, so nothing is injected into the treated areas. (Fletcher & Wilson 2018).

Dry Needling can be classified into three techniques. The first technique, which is the most common, involves the needles being inserted directly into the affected area, whether it be a trigger point or “knot” or tense muscle, and being left in said area for 10-30 minutes. The second technique also involves the needle being inserted into the immediate affected area, however the needles are not left inserted for any length of time. Rather, they are immediately removed. This method has been reviewed and suggests that there are little to no benefits associated with this technique. The third method requires that the needles not be inserted directly into the affected area, but rather the surrounding muscular areas. (Fletcher & Wilson 2018). As long as the needles are properly sanitized, the only risks or negative side effects associated are bruising and soreness of the treated area. However, if the needles are not sterile, the patient will be at risk for contracting bloodborne pathogens or infections.

The reported benefits are very skewed regarding Dry Needling. Some reports show improvement, however it is believed that the same level of improvement could have been achieved with stretching or through therapeutic massage. Other reports show substantial improvement, and the Physical Therapists that use Dry Needling place high regard for the practice due to the incredible results they have seen first hand.

The most controversial aspect of Dry Needling is the lack of any formal regulation of the practice. There is minimal training involved, a total lack of regulation or guidelines, and there is no licensure involved. It is difficult for the patient to discern whether the practitioner is knowledgeable and trained, whether they are performing the procedure correctly. (Fletcher & Wilson).


According to the Mayo Clinic, “Acupuncture involves the insertion of very thin needles through your skin at strategic points on your body. A key component of traditional Chinese medicine, acupuncture is most commonly used to treat pain. Increasingly, it is being used for overall wellness, including stress management.” (Mayo Clinic, 2018). To simplify and summarize, Acupuncture is a practice derived from traditional Chinese medicine practices that involves tiny needles being inserted into pressure points to induce relaxation, relieve pain, reducing stress, and improving overall wellness. Traditional Chinese believe the technique to balance chi (qi) or energy that is believed to flow through pathways (meridians) throughout the body. Western practitioners have a less holistic view, and believe that the Acupuncture points help to stimulate nerves, muscles, and tissue which holds a positive return of increasing the body’s natural functions. (Mayo Clinic, 2018). Regardless of the basis for the belief, almost all practitioners can agree that Acupuncture is beneficial.

There are various techniques for Acupuncture. Some techniques involve the patient sitting upright, while others require the patient to recline or lay flat. The insertion time can range from immediate removal, a few minutes with manipulation, or even as long as 15-30 minutes. The needles can be twisted and manipulated by hand, or by electrical stimulation which electronically vibrates the needles. Other techniques involve electrical stimulation pads to be placed over areas of skin to stimulate the muscles. Although the pressure points are most commonly stimulated with needles, they can also be stimulated with pressure, lasers, ultrasound, or even audible sound. (Methods of Acupuncture). As long as the patient does not have preexisting conditions such as a bleeding disorder, a pacemaker, or pregnancy, the risks and side effects of Acupuncture are very minimal. The patient may experience soreness and bruising of the treated area. (Mayo Clinic, 2018).

Unlike Dry Needling, Acupuncture is very well regulated and mandated. The practitioner is required to complete three or more years of related coursework or training and pass an exam conducted by the National Certification Commission for Acupuncture and Oriental Medicine before they can receive their license or related certification to practice Acupuncture. After receiving the necessary licensure, they must pass the exam and apply for license renewal yearly. (Fletcher & Wilson).

The Takeaway

Dry Needling and Acupuncture both have their benefits and drawbacks, and they each have mixed reviews as to their effectiveness. Hopefully this analysis has been helpful in helping to navigate your options when it comes to seeking treatment. If you are interested in either procedure, talk to your Primary Doctor or your Doctor of Physical Therapy to determine what is best for you.

- Author: Alexa Smith


American Physical Therapy Association. (n.d.). Retrieved June 27, 2018, from http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/

Fletcher, J. (2018, May 31). Dry needling vs. acupuncture: What the research says (D. R. Wilson PhD, MSN, RN, IBCLC, AHN-BC, CHT, Ed.). Retrieved June 27, 2018, from https://www.medicalnewstoday.com/articles/321989.php

Mayo Clinic Staff (2018, February 14). Acupuncture. Retrieved June 27, 2018, from https://www.mayoclinic.org/tests-procedures/acupuncture/about/pac-20392763

Methods of Acupuncture. (n.d.). Retrieved June 27, 2018, from http://www.drmanik.com/chap4.htm

Image from http://www.fehresianenergetics.com/2016/08/04/acupuncture-vs-dry-needling/

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