Dry Needling: Why Acupuncturists Do It Better

I often encounter patients that ask if I do dry needling, generally confused about the difference between "dry needling" and "acupuncture". The simplest answer is, yes, I do. And as a licensed acupuncturist, I'm better equipped than most to do so.

Procedurally, there is no difference between dry needling and acupuncture. You actually use the same codes when billing each of these treatments as insurance claims. Thus, it is not a matter of procedure - it is a matter of intent, application, and understanding how needles affect the targeted tissue as well as the global myofascial system. It is a matter of skill, of experience, and it requires the recognition of a traditional medical system that's been practiced for thousands of years.

A growing number of medical practitioners can obtain a simple weekend certification and various sports organizations, professional and collegiate alike, are certifying athletic trainers and physical therapists to dry needle their athletes. Clearly, needling is a sought after, effective treatment modality. Since it’s being utilized in all of these spaces, wouldn’t it be beneficial if it was performed by the most specifically trained and best suited practitioners?

Dry needling is defined as “an advanced needling skill limited to the treatment of myofascial pain, using a single-use, single insertion, sterile, filiform needle that is inserted into the skin or underlying tissues to stimulate trigger points", per the Illinois Physical Therapy Act (1). As an acupuncturist, I happen to exclusively use sterile, single-use, single insertion, filiform type needles. I also frequently stimulate trigger points.

What are trigger points? Dr. Janet Travell, a renowned expert in myofascial and referred pain, defined trigger points as "hyperirritability in a tissue that, when compressed, is locally tender" (2). This is the same concept as "ah shi" points, which are acupuncture points on the body that are painful to palpation, or painful when pressed.

A trigger point is a taut, rope-like band that forms when a few muscle fibers bundle together - either due to an acute injury or continual stress that leads to fibrosis, thickening, and adhesions between tissues that should, otherwise, move in a supple, fluid manner. Pain can radiate from these tight bands, which is why releasing them alleviates discomfort as well as returns blood flow to the area, improving neuromotor function and myofascial health. 

Now, to obtain a dry needling certification within the state of Illinois, one only needs 30 hours of coursework specific to dry needling and 54 hours of supervised needling practice (3). That's less than a week's worth of experience for a practitioner to begin needling patients’ bodies, legally. 

An acupuncturist must, at minimum, obtain a Master's degree, which includes over 2500 didactic hours and over 900 hours of clinical internship. Then, they must be certified in clean needle technique and pass a minimum of 3 national board exams to gain licensure in Illinois. 

Acupuncturists not only know how to release trigger points, but how to apply the foundation of traditional Chinese medicine and a holistic understanding of the body to myofascial and musculoskeletal pain. We consider entire fascial chains and channels so that we can address the local symptom as well as the root dysfunction. We understand fluid dynamics, how to move blood to increase perfusion across tissues, how to affect the central nervous system by stimulating the peripheral nervous system, as well as have extensive experience in needling that awards a deft perception of exactly which tissues we are targeting with the needle. 

More notably, a skilled hand does not need as thick of a needle to find the desired tissue. Meaning, a thinner needle can be used and a less painful experience can be had - without the aggressive piston-action and thrusting that is taught in dry needling certifications. 

So, if you are searching for dry needling, may this provide you with more information on where to seek it and with whom you may have the best results. For more information on acupuncture, sports acupuncture, or traditional Chinese medicine, reach out to me or schedule with me at Midtown Chiropractic & Natural Medicine. Follow me on this blog or @kaseyjmckenney on Instagram for more.

Author: Kasey McKenney, L.Ac (July 2023)

1. Illinois Physical Therapy Act. https://www.ilga.gov/legislation/ilcs/ilcs3.asp?ActID=1319&ChapterID=24

2. “Myofascial Pain and Dysfunction: The Trigger Point Manual” Travell and Simons. 

3. “Dry Needling Legislation Update”. Illinois Physical Therapy Association, 2017. https://www.ipta.org/news/349691/Dry-Needling-Legislation-Update.htm