What is Dry Needling?
The term Dry needling was first introduced in the early 1940s by Janet Travell and David Simons. The technique they introduced originally was the use of hypodermic needles to inject and/ or stimulate trigger points or myofascial trigger points with medcines- such as corticosteroids, analgesics, or saline solution. The analgesics/corticosteroids were being injected to help reduce local pain in the area. The first instance of the term dry needling being used, was by Dr Travell in her book ‘Myofascial Pain and Dysfunction: Trigger Point Manual’ which was spoken about as a different technique that focused on needling the myofascial trigger points, but did not include injection of a substance (which was known as wet needling).
What is a Trigger Point or Myofascial Trigger Point?
The term “Myofascial Trigger Point” (MTrP) was first used by John Kellergen in 1938, which he described as an area that when pressed will create referred pain somewhere else.
A MTrP is usually a point found within the muscle fibre where there is a small knot or area of isolated tightness, pain or contraction.
In the 1970s Chan Gunn coined a different technique/term called Intramuscular Stimulation (IMS) where you neelde directly into these areas to try and create a muscle twitch or nerve response.
Why call it dry needling instead of acupuncture?
Originally the term ‘dry needling’ was created by to differentiate between injecting a substance (wet needling), and using a hyperdermic needle without injecting anything. As it became more poplar within Western medicine the terminology was adopted because much of Chinese Medicine terminology was seen as ‘unscientific’ or having no scientific basis.
It is important to note that during the 1980’s and 1990’s even though Chinese Medicine was not accepted, a shift started to happen when acupuncture needles started being used instead of hyperdermic needles, as they caused less tissue damage, and less pain while still garnering results.
A lot of the terminology that is used within Chinese Medicine is very traditional as it is an old medicine (4500+yrs!), and it references not only organs, but also nature (Wind, dryness etc) which can seem quite odd to someone with medical background.
So, rather than associating the method with acupuncture (which it is), the term ‘dry needling’ was adopted by Western Medical practitioners who performed it.
While the language used by Chinese Medicine practitioners and acupuncturists can seem strange or different- it helps to provide a framework around how a treatment strategy is created, and helps to determine the different points that are to be used during the treatment.
There was a recent literature review which highlights significant benefits of acupuncture in supporting a wide range of conditions.
The more research that is done on acupuncture, the more it shows that it promotes the circulation of blood, endorphins, hormones, as well as having an influence on nerve transmission.
Is Dry Needling different to Acupuncture?
In short- No.
As explained above, while Janet Travell, David Simons, John Kellergen and Chan Gunn “came up with new techniques”, they were all just renaming techniques that have been used for centuries in China.
In Chinese Medicine the ‘trigger points’ are referred to as ‘Ashi Points’ (translates to “Ah Yes!” because you hit the sore point) is first discussed by Sun Simiao in 652AD (over 1300 years ago!) in his book Qian Jin Yao Fang.
In Chinese Medicine the first description of needling into the tender point where there is tension until you get “twitch” response was in The Yellow Emperor’s Internal Canon which was written in 100BC. This sensation is referred to as “de qi” in acupuncture.
The techniques described as ‘dry needling’, ‘intramuscular stimulation’ or ‘myofascial trigger point’ needling are specific techniques that have been described in classical and contemporary Chinese medicine literature.
So are Acupuncture and Dry needling different- No! Dry Needling technique was discussed in the Chinese Medicine classical literature over 1000yrs ago, it is just a fancy name for one acupuncture technique used.
What are the benefits of seeing a registered Acupuncturist over a dry needling practitioner?
There are many benefits of seeing a registered Acupuncturist for needling rather than someone who does dry needling.
The first is less pain. I can’t count the number of people who come to me after having recieved dry needling from another modality and they complain of how painful it is.
More options of points, when seeing someone for dry needling they only know how to needle directly into the area that is sore/has the problem. As a registered acupuncturist that is just one needling technique that can be used- one of the big benefits of extra options is that you don’t necessarily need to get a needle directly into an area of the body that is already sore.
Advanced knowledge and training– in order for someone to become a registered acupuncturist the training involved includes hundreds of hours, whereas dry needling courses are often only 16-20hrs.
Additional tools– Chinese Medicine includes a whole range of therapies including acupuncture, diet therapy, Chinese Herbal Medicine, exercise therapy, as well as cupping, gua sha, and massage or moxibustion.
Are trigger points and ashi points the same?
As discussed above- absolutely they are!
From a Western Medicine perspective, trigger points are sites where neuromuscular junctions occur- which is where the nerve meets the muscles and are activated by the nerves.
Ashi points include trigger points, but are not limited to the neuromuscular junctions- because there are many more of them, they allow a much wider range of areas to treat when used to treat pain.
How is the training different for dry needling and acupuncture?
In orders for Acupuncturists to be registered in Australia they require degree certification which usually includes approximately:
- 150 hours of Anatomy and Physiology outlining location of organs, nerve structures and arteries
- 100 hours of point location including how to needle in order to prevent issues such as organ puncture, nerve damage, artery damage and pain.
- 200 hours of needling training.
- 400 hours of supervised clinical practice
Dry needling practitioners on the other hand require as little as 16 hours in training before they can be qualified to perform dry needling. While practitioners usually will have additional knowledge of Anatomy and Physiology, the point location, needle training and supervised clinic practice falls short.
Currently within Australia there are no registering body or legal requirements for dry needling practitioners other than those placed on them around local government regulations in regard to skin penetration laws (which are to do with hygeine rather than skill set!).
Are there greater risks receiving dry needling from a practitioner not registered as an acupuncturist?
There hasn’t been any research looking into frequency of injuries associated with dry needling practitioners compared to acupuncturists.
However, due to the significantly fewer hours required in the training, it is recommended that you seek out an acupuncturist rather than a dry needling practitioner for your own safety!
You will not only recieve a treatment that is more specific, but you are less likely to leave with an additional injury due to inexperience.
Acupuncture/ acupuncturist what’s the difference?
Acupuncturist in Australia is a regulated term, which means that you are not allowed to use the title Acupuncturist, or imply you are unless you are registered under the Australian Health Practitioner Agency (AHPRA) and the Chinese Medicine Board of Australia (CMBA).
If you imply you are an acupuncturist and you do not registered it can be seen as “holding out”by misleading the public. There can be significant fines for practitioners who are found to be holding out.
As part of registration there is a strict code of conduct that needs to be followed, as well as being required to have ongoing training yearly (specifically in Chinese Medicine). There are also rules are r
Currently in Australia Chinese medicine and acupuncture are regulated under the Australian Health Practitioner Agency (AHPRA) and the Chinese Medicine Board of Australia (CMBA). It is illegal to claim to be an acupuncturist or be seen to imply you are an acupuncturist without being registered. Under the national law this can seen as ‘holding out’ or creating the perception that the practitioner is an ‘acupuncturist’ and is not permitted. Significant fines are imposed for those found to be in breach of the national law. Strict codes of conduct are required including ongoing training specific to Chinese medicine and appropriate insurance.
When can dry needling be used?
Dry needling is most commonly used for pain, especially when it is muscular in nature (rather than say bone, tendon or ligament issues):
- General pain relief
- Headaches and migraine (especially when caused by tight shoudlers/tension)
- Neck and shoulder pain
- Low Back pain
- Hip pain
- Sciatica
- Plantar Fasciitis
- Tennis or Golfers Elbow
- Carpal Tunnel
How do I know if I am seeing a fully qualified acupuncture practitioner and dry needling practitioner?
The easiest way is to do a search on the AHPRA website here using the practitioner’s name.
If a practitioner is registered as an acupuncturist their name will have “Chinese Medicine Practitioner” listed as their profession, then you will see the Division/Registration type as Acupuncturist if you click onto their name.
A registered acupuncturist will also have a CMBA (Chinese Medicine Board of Australia) registration number which starts with CMR.
