Acupuncture vs. Dry Needling: Are they the same? (And which is better?)
Updated: Sep 25
Let’s start with some history.
Chinese doctors created and fine-tuned acupuncture over the past 2,500 years, as they discovered the most effective ways to use needles in the body to treat illness and pain. Dry needling is an needling technique that was popularized in the 1980's and is practiced almost exclusively by practitioners other than acupuncturists, such as medical doctors, physical therapists and chiropractors.
Are they the same?
Yes and No. Here are some key similarities:
Dry needling and acupuncture use the same needles. (Though acupuncturists use a wider variety of needles.)
Both can be very effective for treatment of physical pain.
Both acupuncture and dry needling may treat the local area of pain. Dry needling always does; acupuncture may, if it is appropriate for the situation. For example, if you have jaw pain, physical therapists performing dry needling will always put needles in/near the jaw. Acupuncturists may or may not – we use needles in the context of a complete system of medicine, which gives us access to more nuance and more options.
Here are the critical differences:
Acupuncturists have 20x more training.
Acupuncture is performed by a licensed acupuncturist with a minimum of 1,900 hours of training and a masters degree. Dry needling is performed by physical therapists who have limited training in needle insertion (in some states, 50 hours – only 10 of which are in person). There are many documented cases in recent years of physical therapists causing pneumothorax in patients, a puncturing of the pleura surrounding the lung.
Dry needling hurts more.
In dry needling, the physical therapist often heavily manipulates the needles (called "pistoning"), which can cause pain and dizziness with too much movement of energy. Intense needle manipulation does not make for a more effective treatment, and in some cases can have the opposite effect.
By contrast, acupuncture rarely hurts. It is gentle. The needles are placed and left to do their work with your body. If there is any pain upon placing a needle, the acupuncturist will adjust it to relieve pain before proceeding with treatment.
Acupuncture looks at the root of the issue whereas dry needling only addresses the branch.
Acupuncture treats the local area of pain where appropriate, but looks at the whole body to heal your underlying pattern to avoid re-injury. It works to engage the circulation in your whole body to support local healing. Dry needling focuses only on the local area of pain.
What this looks like in practice is that when you come in for an acupuncture treatment and your main problem is shoulder pain, an acupuncturist will likely put a couple of needles in/near your shoulder, but also in your arm/hand and your legs/feet.
Acupuncture is part of Chinese medicine, a complete form of medicine. Dry needling is a technique.
Chinese medicine is like Western medicine in that it is a comprehensive view of the body that addresses every possible health issue. Acupuncture is a primary modality of Chinese medicine that addresses everything from back pain to fertility, headaches to insomnia.
Dry needling is a technique, one way of using needles in the body, that is completely isolated from a holistic system. Imagine if an acupuncturist learned how to do a chiropractic adjustment on the neck. Just because the acupuncturist has an understanding of anatomy and has learned a particular technique does not mean they have the judgment or depth of understanding to appropriately apply that technique. To put it bluntly: If all you have is a hammer, everything looks like a nail.
