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.

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.

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.