Acupuncture or Dry needling?
Acupuncture
Acupuncture is one of the modalities of Traditional Chinese Medicine (TCM) in which solid, thin, metallic filiform needles are used to penetrate the skin. Then the needles are activated through gentle manipulation of the practitioner's hands or with electrical stimulation. Acupuncture has a well-established tradition going back more than 2000 years. Most historians believe that the practice started in what today is known as China.
The first document that unequivocally described an organized system of diagnosis and treatment which can be recognized as acupuncture is The Yellow Emperor’s Classic of Internal Medicine, dating from around 100 BCE (1).
Traditional Chinese Medicine parts from the idea that there are more than 2,000 acupuncture points connected by channels (also called meridians). These pathways allow the flow of energy “Qi (氣)” through the body that is responsible for overall health. Disruption of the energy flow can cause disease. By applying acupuncture to certain points, it is thought to improve the flow of Qi, thereby improving health. Acupuncture is most commonly used to treat pain, though increasingly, it is being used for overall wellness, including stress management and internal ailments.
Studies have shown that acupuncture is effective for a variety of conditions. If you choose to see an acupuncturist, discuss it with your doctor first and find a practitioner who is licensed and who has the proper training and credentials (2).
Dry Needling
The history of dry needling dates back to the 1940’s with Dr. Janet Travell. She identified muscular trigger points and referral patterns that were elicited with pressure and hypodermic needles. Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders (3).
Trevell’s “wet needling”, consisted in the use of syringes filled with an innocuous isotonic solution of sodium chloride to “release” those trigger points. Later she discovered that the use of the isotonic solution was unnecessary to produce similar results hence the term “dry needling”. She and Dr. David G. Simon carefully identified most of the trigger points located in the human body. Thus, the first generation of modern dry needling was established (4).
Trigger point dry needling is a treatment technique used by physical therapists around the world. In the United States, trigger point dry needling has been approved within the scope of physical therapy practice in a growing number of states. There are several dry needling techniques, based on different models, including the radiculopathy (pain coming from pinched nerve roots in the spinal column) model and the trigger point model. Trigger point dry needling is a relatively new technique used in combination with other physical therapy interventions (5).
Acupuncture currently has more definitive research and practitioners are regulated in training and practice. If you prefer a well-established alternative treatment option from a highly-trained therapist, acupuncture is the safest option for you. Dry needling is rather new, so research remains limited. Existing research shows very few side effects and potential as a treatment for pain relief. Still, large-scale studies are lacking. Additionally, there is little consistency in training, certification, or licensing at this time. This can lead to unsafe needle practices (6).
Of course I’m biased but, in my opinion, dry needling claims to treat some of the same ailments that acupuncturists have been treating for thousands of years and only from the most superficial perspective. The Ashi (7) (musculoskeletal) approach is one of the most basic techniques of acupuncture.
Within Chinese medicine, treating the location of discomfort or pain without addressing its underlying causes is regarded as giving a “branch” treatment instead of fixing the “root” cause of the condition. Ashi needling is not complicated. In fact, the discovery that injuries improve after massaging a particularly painful spot likely constitutes one of the first and most fundamental discoveries of every medical system on the planet (8).
References
(1) White, A., Ernst, E. Rheumatology. A brief history of acupuncture. (2004) Volume 43. Issue 5. Pages 662–663. Retrieved from (23 Sep 2021): https://academic.oup.com/rheumatology/article/43/5/662/1788282
(2) Johns Hopkins Medicine. Health. Acupuncture. Retrieved from (23 Sep 2021): https://www.hopkinsmedicine.org/health/wellness-and-prevention/acupuncture
(3) Alvarez, D., Rockwell, P. American Family Physician. Trigger Points: Diagnosis and Management. (2002). Retrieved from (23 Sep 2021): https://www.aafp.org/afp/2002/0215/p653.html
(4) Gargano, F. Integrative Dry Needling. History of dry needling. Retrieved from (23 Sep 2021): https://integrativedryneedling.com/history-of-dry-needling/
(5) Holland, K., Wilson, D. Health Line. Dry Needling vs. Acupuncture: Which Is Right for You?. (2018). Retrieved from (23 Sep 2021): https://www.healthline.com/health/dry-needling-vs-acupuncture#acupuncture
(6) Ibid
(7) Literally “ouch points”. Points that are sensitive to palpation and chosen as sites for acupuncture treatment. Practical Dictionary of Chinese Medicine. Wiseman, N.
(8) Nugent-Head, A., Journal of Chinese Medicine. Ashi Points in Clinical Practice. (2013). Retrieved from (23 Sep 2021): https://www.liveoakacupuncture.com/wp-content/uploads/2021/06/JCM-Ashi-Points-Article.pdf