Acupuncture and dry needling – what’s the difference?

I get asked this question all the time by my patients, and there are a few facets to the answer, so I thought it would be helpful to lay it all out here in a post. 

In brief, dry needling is a form of acupuncture, but the main points of difference are:

  • The system and intent in which it is applied; and
  • The level of training and experience with needles of the person applying the acupuncture.

There are several things to understand within each of these points, and I’ll go through these below. 

Dry needling is a form of acupuncture

Dry needling is a trigger-point therapy where fine needles are inserted into areas of tight muscle fibres, usually to achieve a twitch response in order to relieve pain.  The term ‘dry needling’ was coined by Dr Janet Travell in the 1940s in her book ‘Myofascial Pain and Dysfunction: Trigger Point Manual’.

Dry needling is a form of acupuncture, a modern term applied to a practice that has been described in Chinese medicine texts written more than 1300 years ago.  ‘Ashi’ points were described in Chinese medicine in 652 A.D. as points that are tender to touch.  Ashi translates as “Ah Yes!” It’s the point of muscle tension where your body is telling you that’s the place. Ashi points include (but are not limited to) ‘myofascial trigger points’ in modern terminology.

Acupuncture performed by an ‘Acupuncturist’ is a therapy of Chinese medicine; dry needling by a non-Acupuncturist is applied through a different lens

Dry needling is specific to using needles in cases of musculoskeletal pain. When practiced by a non-Acupuncturist (someone not trained in Chinese medicine) it is applied with an understanding of muscles and joints with a specific intent to generate a twitch response and/or help to relieve muscular tension.  In the right hands it can be very helpful and assist with an overall physical treatment. 

When acupuncture (including dry needling) is practiced by an Acupuncturist, we employ the knowledge of Chinese medicine which is based on a multi-layered channel system. This includes the sinew channels of muscles/tendons/ligaments as well as channel systems that are related to the many functions of the body and include connections with the organs.  When we look at a tight muscle band, we also look at the whole sinew channel of which it is one part, which may travel from the head all the way to the feet (which is why you might end up with needles in your ankle or toes for a back problem).

An Acupuncturist will consider a multitude of signs and symptoms, including feeling the pulse, before deciding on the course of needling and other therapies. Other therapies include moxibustion, cupping, guasha and dietary therapy.

Dry needling is just one technique an Acupuncturist might use to relieve muscular pain.  Personally, I very rarely use this form of needling.  Needles applied very shallowly with the intent to access the sinew/muscle layer of the body can be extremely effective for relieving pain and improving movement and function.

The intent and system within which a form of needling has been learned is important because this informs its appropriate use in practice.  An Acupuncturist works with the body’s flow of Qi and Blood, and we are trained to understand the interactions of Qi throughout the channel systems and organs. This means we apply acupuncture to assist in a variety of health presentations from pain through to digestive upset, fertility and menstrual disorders to pregnancy and birth preparation.  A ‘dry-needler’ has learned to use needles to facilitate a trigger-response or relieve muscle tightness and thus their use of needles within this context is appropriate. 

I once had a patient tell me that their chiropractor was using needles to help them prepare for birth, using points within the Chinese medicine system and not in a context of pain relief.  This is highly inappropriate because a dry-needling training does not equip one to understand the impact of needles on the body’s Qi, or to understand the subtly of the Chinese medicine system of channels, and such an application could well cause (unintended) harm.

Acupuncturists have more extensive training with needles

Chinese medicine and acupuncture are regulated under the Australian Health Practitioner Agency (AHPRA) and the Chinese Medicine Board of Australia (CMBA). As such, only those practitioners who are registered with AHPRA may claim to be ‘Acupuncturists’. To be a registered Acupuncturist or Chinese medicine practitioner requires completion of a four-year full-time University (or equivalent) degree in Chinese medicine, maintaining relevant insurances, membership with a professional body such as AACMA and ongoing continuing professional development. It is a breach of national law to claim to be an acupuncturist or to imply you are an acupuncturist without being registered.

Acupuncturists must complete 750+ clinical hours as part of their training.  The course also includes detailed instruction in needling technique and point location with focussed instruction on safe practice to prevent issues such as organ puncture and nerve damage.  A dry-needling practitioner may have as little as 16 hours of training in the use of needles.

In conclusion

Dry needling is a form of acupuncture and may be used appropriately to help relieve muscular tension. Before receiving needling from a practitioner, be clear on the training they have received and what their intent of treatment is.  Is your practitioner an Acupuncturist (Chinese medicine practitioner) registered with AHPRA?  What do they propose to use needles for in your treatment – muscular pain or something else? With the elements presented above, you should now be able to make an informed decision as to the appropriate use of needling for your condition.

Harmonising with the Qi of Summer

It feels like it’s been a strange summer this year in the Illawarra, with frequent bouts of cold, wet, windy weather dispersing the usual fine, hot days. Nonetheless, we are still riding the Qi of Summer in these final weeks of February.

We can enhance our mental-emotional-physical health by harmonising our body’s Qi with that of the season. This applies to what we eat, how we behave and our attitudes. A classic text of Chinese medicine (which is 2000 years old), the Huangdi Neijing Suwen, tells us about Summer:

The three months of summer, they denote opulence and blossoming. The qi of heaven and earth interact and the myriad beings bloom and bear fruit.“  (Suwen 2)

Yang has reached its maximum. The days are longest, it is a time of growth and activity – look outside and observe the trees full of vigour and rustling with birds as the young are learning the ways of the world. Summer is ruled by the fire phase which corresponds with the organ of the Heart (the emperor of our body), the emotion of joy, sound of laughter, and the colour red.

To be in harmony with the atmosphere of summer we want to cultivate our yang energy:

  1. rise early and go to bed later
  2. be inspired, move, get outside and enjoy the sun
  3. welcome a joyful mood, express the principles of lightness, brightness, creativity and expansion.

Summer is a time to favour brightly coloured fruits and vegetables, lightly cooked.  Plenty of variety in the diet helps to replace the minerals and oils sweated out.  Cooking methods to use are a light steam/simmer; or saute on high heat for a very short time.

It is OK to use some pungent or spicy flavours to align with the season ruled by fire.  A little hot spice (such as fresh ginger, black pepper) brings body heat out the surface to be dispersed.  Take care to use only a little, as too many dispersing foods lead to loss of yang which makes us ill-prepared for staying warm in the approaching cooler seasons.  In a similar line, taking warm showers and drinking hot liquids helps to bring warmth to the exterior to generate sweat and cool the body. This is counter to using overly cold ways to reduce our heat such as iced drinks and ice cream.  Using cold causes contraction which blocks sweating, holds in heat and interferes with digestion. 

On hot days instead of using ice-cold foods, make use of naturally cooling fresh foods to balance the heat. These foods help the body cool, even if served at room temperature. Good choices are salads, sprouts, fruit (watermelon, apples, lemons, limes), cucumber, tofu, flower teas (chrysanthemum, chamomile). 

But I get it, it’s summer and who doesn’t love ice-cream! If you’re lucky enough to have plenty of yang you’ll likely get away with eating ice-cream more often than someone who tends to feel the cold. The joy that ice-cream brings my partner is priceless (and summer is the season of joy!). As with most things, trust your own knowledge of your body and apply this information in a way that works for you. If you tend to feel the cold and have excess fluids/damp/phlegm, then steer clear of cold foods, even in summer.

Take care of your Heart during summer, the organ of the fire element. The Heart connects to our speech and our mind. Practice being aware of the words you choose to speak to strengthen the Heart. Avoiding mental hyperactivity (e.g. screens at night time, refined sugar, caffeine, late-night eating) can also help maintain a calm and anchored Heart.  

Please note that this blog provides general lifestyle seasonal information and does not constitute health advice. Please contact your health professional for individual-tailored advice.

Photo by Chris Galbraith on Unsplash

Acupuncture and acupressure for pre-birth and labour

Pregnancy and birth can be a major transformative life journey on many levels – physical, emotional, spiritual and sexual.  Acupuncture and acupressure are valuable tools to support a woman and her partner on this journey.

In the weeks leading up to birth, acupuncture is a wonderful support to help prepare the mind and body.  I recommend starting regular acupuncture from 36 or 37 weeks, and evidence suggests this is more helpful than only seeking acupuncture as an alternate method of induction at term.  During these weeks, acupuncture promotes relaxation, reduces stress and anxiety, prepares your ligaments for the coming birth, and enhances cervical ripening. When the nervous system is in a parasympathetic (rest/relaxed) mode, blood flow is directed to the uterus, hormones are supportive (increased oxytocin and endorphins) and muscle tension and the perception of pain is reduced. This is a state of mind and body that supports the approaching birthing process. Giving yourself the dedicated “time out” for regular acupuncture sessions in the final weeks can go a long way to support this natural process. 

Acupressure can be continued at home to help prepare for birth, and specifically used during labour.  Evidence has shown that acupressure during labour can reduce the pain intensity and the need for pharmacological pain relief, as well as reducing the likelihood of needing a caesarean section. Acupressure also provides the support person (such as the woman’s partner) a valuable and central role to support her throughout the labouring; building intimacy, trust and a shared experience in the journey.

The literature suggests that greater satisfaction with childbirth is linked with a woman’s sense of agency in decision-making and participation during pregnancy and birth. For this reason, as well as for women who desire a natural birth without pharmacological analgesia, acupressure can provide a sense of empowerment and agency through the labour.  

The acupressure points to use are easy to learn, and can be accessed freely online here.  If a personal session is preferred, you can also book a session with me to go through the points or keep an eye out on my Events page for group workshops.

Beyond birth, it is from Chinese medicine that the “zuo yuezi” practice of postnatal care (literally “confinement”) comes – the 40 days after birth where the all needs of the new mother are taken care of traditionally by her extended family, so she can be nourished, bond with her new baby and rebuild her strength. But that is a subject for another time…

As always, if you have any questions you are welcome to get in touch.

Spring: the return of the light, let your hair down, and take care of one another

Spring has sprung in the Illawarra! And just as the movement of Qi in Spring is “upwards and outwards”, my little beets are pushing up through the soil in my garden, eager to be plucked.

We can enhance our own mental-emotional-physical health by harmonising our body’s Qi with that of the season.  This applies to what we eat, how we behave and our attitudes. The Classic of Chinese medicine (which is 2000 years old), the Suwen, tells us thus about Spring:

“The three months of spring, they denote effusion and spreading. In heaven and earth everything comes to life; the myriad beings prosper. Go to rest late at night and rise early. Move through the courtyard with long strides. Dishevel the hair and relax the physical appearance, thereby cause the mind to come to life. Generate and do not kill. Give and do not take. Reward and do not punish. This is correspondence with the qi of spring, and it is the Way to nourish life. Opposing it harms the liver. In summer, this causes changes to cold, and there is little to support growth.” (Suwen 2)

Yang is rising. Spring is ruled by the wood phase and it is a time of opening and spreading. It is a time to eat less and lightly – young plants, fresh greens, sprouts.  Raw and sprouted foods can be taken (though take care and moderate if your digestion is weak).  The rising quality of sweet-pungent foods is beneficial. E.g. drink honey/mint tea, use basil, fennel, and rosemary herbs in cooking; and eat young beets and carrots for a refreshingly sweet flavour.  Favoured cooking methods are light – saute and light steaming, which is a change from the longer stewing methods of winter.

Take care of your Liver (the organ of the wood element). Emotionally this means staying calm, breathe, minimising stress, and not holding on to anger or frustration – find a way to release or express these healthily.  Opening and nourishing your Heart can assist the Liver to flow naturally and minimise emotional stagnation or repression. Physically this means moving, relaxing a little, opening the body – walking or a flowing yoga sequence can be great.  

On a more sombre note, but one which I feel needs to be raised given the year we’re in, is that suicide rates are highest in Spring. This is most pronounced in the northern hemisphere where the seasonal changes are more dramatic, however with COVID-19 lockdowns we may be more at risk than usual in Australia. Why is this? We really don’t know. One social theory proposed is that the pressure of social connection after the winter hibernation can be a significant source of stress for some. Another theory is the physiological inflammation that occurs in Spring (think hayfever!) is connected to mood disorders. A friend of mine from Sweden once suggested to me that the reappearance of the light is simply too much for some, coming out of the long darkness of winter. Whatever the cause, the statistics show this to be real.

Thinking in Chinese medicine terms, the Liver is associated with anger, and stress or repressed emotions can disrupt its smooth flow.  A Liver disharmony is commonly diagnosed in people with mental-emotional challenges, and these people are likely to be most at risk of imbalances at the start of Spring when the energy of the Liver rises. I expect this risk may be compounded this year when the bloom of Spring coincides with a year of lock-down, especially for those just emerging in Melbourne – it’s like a double Spring.  

Spring is a beautiful time.  Maybe it’s even my favourite season.  Let your hair down, munch on young beets, move, and also be particularly mindful of your emotional health.  Pick up the phone, check in on someone.  Melbourne peeps, please take extra care and look after one another.

Acupuncture: natural relief from migraine and tension headache

Headache is one of the most common health problems we suffer.  People can suffer from migraines or tension headaches for years and begin to accept this as how life is, a new normal.  But it’s not normal, it’s a sign that something is not working properly in your body-mind.  We can use Chinese medicine and acupuncture to identify what is not working and re-establish health so that headaches no longer occur.

What is a headache and what causes them?

Migraine is a severe form of recurrent headache, lasting from four to 72 hours, on one side of the head and often associated with nausea and vomiting, light and sound sensitivity.  Migraine is commonly triggered by stress, fatigue, menstruation and weather changes.

A tension headache is usually felt as bilateral severe continuous pressure. It may last a few weeks or longer and is commonly associated with stress and depression.

Other common causes of headaches include pregnancy, poor posture, sinus congestion, high blood pressure, overwork and fatigue.

How can acupuncture help?

Acupuncture is an effective and natural approach for relieving migraine and tension headaches.

Taking a painkiller simply masks the symptoms of a headache.  It may be helpful in the short term however it will not resolve the issue and headaches will continue to recur.  You can instead use acupuncture to move towards long-term resolution.

The Chinese medicine system identifies headaches arising from dysfunction in various organ systems or channels (meridians), each of which will present differently in terms of location and nature of pain.  We will identify which type of headache you suffer from and what is causing it, and then we use acupuncture to help your body-mind re-establish health and correct the cause of the headaches.

What can I expect in an acupuncture treatment?

I will initially ask you many questions – about the nature and location of pain (is the pain dull or sharp, is it mostly on your forehead or temples, behind the eyes or base of the neck), and about your overall health (your digestion, skin, diet, work habits and personal history).  This helps me identify where the dysfunction is occurring, and what may be causing it in the first place.

A key to understanding your health is that symptoms are a sign that something in your life is not working.  By simply masking symptoms we keep living lives that are out of balance and the issue doesn’t resolve.  Through the course of treatment, we need to understand what’s really going on for you and tailor the treatment accordingly.  It is highly individualised.  You may also discover changes you need to make in your life – such as changing unhelpful habits – that will assist long-term resolution.

How many treatments do I need?

How many treatments you need will depend on how long you have had suffered from migraines/ headaches and how quickly you respond to acupuncture. In recent clinical trials, patient’s with migraines typically received 15 acupuncture treatments over a 12-week period to experience a significant reduction in frequency of attacks.

What other resources are available?

I have found that patients who present with migraine commonly experience stress and anxiety, and stress is a common trigger for tension headaches.  I developed a routine of simple meditation-acupressure-qigong-relaxation techniques to help bring a sense of calm and groundedness, suitable for anyone to do. It’s available to download as a video, here for free.

Where to from here?

You can book an appointment to see me here.  If you’re new to acupuncture and would like to have a chat first, you’re welcome to book a free 15-minute phone consultation to discuss your situation.   Contact me here.

Most importantly, begin to imagine what your life may feel like without headaches!

Keen to delve into the scientific literature supporting acupuncture for headaches?

Linde K, Allais G, Brinkhaus B, Fei Y, Mehring M, Vertosick EA, et al. ‘Acupuncture for the prevention of episodic migraine’. Cochrane Database Syst Rev. 2016(6):Cd001218. https://doi.org/10.1002/14651858.CD001218.pub3

  • Acupuncture is effective to relieve migraine. Acupuncture can reduce the frequency of attacks and is at least as effective as prophylactic drugs but with fewer reported side effects. Patient’s with migraines typically received 15 acupuncture treatments over a 12 week period to experience a significant reduction in frequency of attacks.

Linde, K., Allais, G., Brinkhaus, B., Fei, Y., Mehring, M., Shin, B.-C., Vickers, A. & White, A.R. 2016, ‘Acupuncture for the prevention of tension-type headache’, The Cochrane database of systematic reviews, vol. 4, p. CD007587.

  • Acupuncture is effective to reduce the frequency of chronic tension-type headache.

Your emotions may be contributing to your health issue, here’s what you can do about it (Part 2)

We learned in Part 1 that emotions often contribute to health issues – including back, neck and shoulder pain, digestive complaints, fertility, migraine and high blood pressure. We also learned that by avoiding excess and not repressing emotions, our Qi and blood can flow unhindered which is necessary for good health. In this Part 2, we discuss common causes of mental and emotional imbalance and what you can do about it.