What Is Dry Needling?
Dry needling is a needling technique commonly used for muscular and myofascial problems, including trigger points, muscle tension, and movement restrictions. Although the term is often presented as something completely separate from acupuncture, dry needling and acupuncture share important similarities in their use of fine needles, needle manipulation, treatment locations, and approaches to painful or tender areas.
Dry needling generally refers to the insertion of a thin, solid filiform needle into or around muscles, connective tissues, or other anatomical structures without injecting medication or another substance. It is commonly discussed in relation to myofascial trigger points and musculoskeletal pain.
What is sometimes overlooked is that the physical act of inserting and manipulating a fine needle is not unique to modern dry needling. Acupuncture has a long history of using different needle techniques, including techniques involving lifting, thrusting, rotating, repeated stimulation, and needling painful or sensitive areas.
This creates an important area of overlap. From a Traditional Chinese Medicine perspective, many areas that are described in modern terminology as trigger points may also correspond with acupuncture points, extra points, or Ashi points—areas identified because they are tender or painful.
What Is Dry Needling?
Dry needling is a needling approach primarily discussed within a modern anatomical and musculoskeletal framework. The needle itself is a solid filiform needle, and the term “dry” distinguishes the technique from procedures in which a needle is used to deliver an injectable substance.
Depending on the clinical approach, dry needling may involve superficial or deeper needle placement and may target muscles, myofascial trigger points, connective tissues, or other anatomical structures. A published review of dry needling literature describes dry needling as using thin monofilament needles, similar to those used in acupuncture, without an injected substance.
Dry Needling Is Not Completely Separate From Acupuncture
The terminology and clinical framework may be different, but the physical tools and some of the techniques overlap considerably.
Acupuncture uses fine filiform needles and has developed a large range of needling methods over thousands of years. Modern dry needling also uses fine filiform needles and may use techniques such as rotation, repeated insertion and withdrawal, lifting and thrusting, or stimulation directed toward a muscular response.
The important distinction is therefore not simply the needle itself. The difference often lies in the clinical framework used to assess the patient, select treatment locations, interpret the condition, and determine why and how the needle is being used.
What Are Myofascial Trigger Points?
Myofascial trigger points are commonly described as sensitive areas within taut bands of muscle that may produce local tenderness and sometimes pain that is felt elsewhere. They are frequently discussed in relation to muscular tension, movement limitations, and myofascial pain.
Trigger-point needling is one area in which modern dry needling and acupuncture can look particularly similar. Both may involve identifying a tender or sensitive area and inserting a fine needle into or around that region.
Trigger Points, Acupuncture Points & Ashi Points
Acupuncture does not use only fixed classical points. Traditional Chinese Medicine also recognizes extra points and Ashi points, which are areas identified by tenderness or pain rather than necessarily by a standardized anatomical point location.
Classical Acupuncture Points
Established points located along the traditional acupuncture channels and used according to TCM theory and clinical presentation.
Extra Points
Acupuncture points recognized outside the primary classical channel systems and commonly used for specific clinical presentations.
Ashi Points
Tender or painful areas that may be selected for needling because of the person’s individual presentation rather than because they correspond to one fixed named point.
Myofascial Trigger Points
Areas described within modern musculoskeletal and myofascial terminology, often associated with local tenderness and referred pain.
Significant Overlap
A comparative review found substantial anatomical overlap between commonly illustrated myofascial trigger points and classical acupuncture points.
Different Frameworks
Similar physical locations do not necessarily mean identical clinical systems. The terminology, assessment process, diagnostic framework, and treatment reasoning may differ.
One comparative review of acupuncture and dry needling reported that 238 of 255 commonly illustrated myofascial trigger points corresponded anatomically with classical acupuncture points. That represents approximately 93.3% correspondence within the specific set of points examined. This does not mean that every trigger point is an acupuncture point, but it demonstrates how substantial the anatomical overlap can be.
Do Acupuncture and Dry Needling Use Similar Needle Techniques?
Yes. There are important similarities in needle manipulation techniques, although the terminology and purpose assigned to a particular technique can differ between clinical systems.
Lifting & Thrusting
The needle may be repeatedly lifted and inserted or “thrust” within the tissue. Similar forms of lifting and thrusting are described within traditional acupuncture needling.
Twirling & Rotation
Rotating or twirling the needle is used in both acupuncture and some dry needling approaches, although the clinical reasoning behind the technique may differ.
Repeated Needling
Some techniques involve repeated insertion, stimulation, withdrawal, or reinsertion of the needle rather than simply inserting and leaving it in place.
Local Twitch Response
Some dry needling approaches intentionally seek a local twitch response when working with a trigger point. This is one specific dry needling strategy rather than a requirement of all needling.
Superficial Needling
Needling does not always need to be deep. Both acupuncture and dry needling literature describe approaches involving more superficial needle placement.
Depth & Direction
Needle depth, angle, direction, stimulation, and retention can all be adjusted according to the target tissue, treatment approach, and individual presentation.
The World Health Organization’s acupuncture benchmarks describe acupuncture manipulation as including techniques such as thrusting, lifting, twirling, and rotating. These are not techniques invented specifically for modern dry needling.
So What Is the Difference Between Dry Needling & Acupuncture?
The distinction is better understood as a difference in clinical framework rather than simply a difference in the physical needle.
Dry Needling Framework
Typically uses modern anatomical, musculoskeletal, and myofascial terminology to identify tissues and structures being treated.
TCM Acupuncture Framework
May consider acupuncture points, channels, Qi, Blood, internal patterns, and the person’s broader TCM presentation when selecting treatment.
Western Anatomical Assessment
May emphasize muscles, tendons, joints, nerves, connective tissues, movement patterns, trigger points, and functional limitations.
Traditional Acupuncture Assessment
May incorporate observation, palpation, tongue and pulse assessment, channel relationships, symptom patterns, and other TCM diagnostic information.
A comparative review examining acupuncture and dry needling found similarities in their applications and needle techniques while also identifying differences in terminology and clinical frameworks.
How Does Dry Needling Work?
Dry needling is commonly explained through modern anatomical and physiological models. Depending on the technique and target tissue, needling may mechanically stimulate muscle, connective tissue, and sensory structures.
Research into dry needling has proposed several possible local and nervous-system responses to needling. However, the exact mechanisms and the relative importance of different physiological responses remain areas of ongoing research.
Needling Technique Matters
“Dry needling” describes a broad family of needling approaches rather than one single technique. The location, depth, direction, amount of manipulation, retention time, and treatment rationale can all vary.
This is another reason why comparing acupuncture and dry needling simply by the name of the technique can be misleading. Two practitioners may use a similar needle in a similar anatomical location while working from different clinical models.
What Are the Potential Benefits of Dry Needling?
Muscular Comfort
Needling may be used as part of an approach to areas of muscular tension, tenderness, or discomfort.
Trigger-Point Treatment
Some dry needling approaches specifically target areas identified as myofascial trigger points.
Movement Support
Treatment may be incorporated when muscular tension or pain is contributing to restricted or uncomfortable movement.
Pain Management
Needling is sometimes used as one component of a broader treatment plan for musculoskeletal pain.
Soft-Tissue Treatment
Depending on the clinical approach, treatment may focus on muscular and other soft-tissue structures.
Complementary Care
Needling may be combined with exercise, manual therapy, movement work, or other appropriate approaches.
What Conditions Can Dry Needling Be Used For?
Dry needling is commonly discussed in relation to musculoskeletal and myofascial conditions. Examples include:
Neck & Shoulder Pain
Muscular tension and myofascial discomfort involving the neck, upper back, and shoulder region.
Back Pain
Muscular and myofascial contributors to discomfort in the upper, middle, or lower back.
Sports Injuries
Muscular and soft-tissue problems that may occur with athletic activity, training, or repetitive loading.
Repetitive Strain
Muscular tension and discomfort associated with repetitive work, exercise, or sustained positions.
Jaw & TMJ Problems
Myofascial approaches may be considered for muscular contributors to jaw and temporomandibular discomfort.
Movement Restrictions
Needling may be incorporated when pain or muscular restriction is affecting comfortable movement.
What Does Dry Needling Feel Like?
The sensation varies depending on the location, depth, technique, and individual sensitivity.
Some people feel only a brief pinch or pressure as the needle enters. Others may notice an ache, heaviness, twitching, tingling, or a brief cramping sensation when the needle is manipulated.
A local twitch response can occur during some trigger-point dry needling techniques, but it is not necessary for every needling approach. The experience also differs between dry needling and acupuncture because practitioners may use different needle techniques and treatment strategies.
What Should I Expect During a Dry Needling Treatment?
Assessment
The practitioner reviews the symptoms, relevant history, movement, and the area of concern to determine whether needling is appropriate.
Treatment Planning
Treatment locations and needling techniques are selected according to the individual’s presentation and the practitioner’s clinical framework.
Needling
Fine sterile needles are inserted into selected areas. Depending on the approach, the needles may be manipulated, retained, or stimulated in a particular way.
Reassessment
Movement, symptoms, and treatment response can be reassessed to help determine what should be considered during subsequent care.
Is Dry Needling Safe?
Dry needling is an invasive procedure and should be performed by a properly trained and appropriately regulated healthcare professional within their scope of practice.
As with any needling procedure, there can be temporary soreness, bruising, bleeding, dizziness, or other adverse effects. The specific risks depend on the area being treated and the technique being used.
Proper anatomical knowledge, sterile technique, appropriate patient assessment, and awareness of contraindications are important components of safe needling practice.
Dry Needling, Acupuncture & Other TCM Treatments
Acupuncture is broader than trigger-point needling alone. Within Traditional Chinese Medicine, treatment may involve a combination of acupuncture points, Ashi points, channel-based treatment, distal points, and other techniques according to the individual’s presentation.
Other treatment approaches may also be incorporated when appropriate:
Acupuncture
Uses fine needles according to an individualized treatment strategy that may incorporate both anatomical and TCM considerations.
Cupping Therapy
Uses controlled suction and may be used alongside needling when appropriate for muscular tension and soft-tissue complaints.
Gua-Sha
Uses a smooth-edged instrument with controlled pressure and directional strokes as part of a broader TCM treatment approach.
Dynamic Tuina
Uses hands-on movement, manual techniques, and assisted stretching to address muscular tension and movement restrictions.
Why Can Dry Needling & Acupuncture Look So Similar?
They can look similar because they share a physical tool and, in some circumstances, similar treatment locations and needle techniques.
Different Names Do Not Always Mean Completely Different Physical Techniques
A person may see a practitioner insert a fine needle into a tender muscle and describe the procedure as dry needling. Another practitioner may use a very similar needle and technique while describing the treatment as acupuncture, Ashi-point treatment, or another form of acupuncture needling.
The terminology alone does not tell you everything about what is being done. The relevant questions are what is being assessed, where the needles are being placed, how they are being manipulated, and what clinical framework is being used to guide treatment.
Dry Needling in Edmonton
At my Edmonton acupuncture practice, I use acupuncture within an individualized Traditional Chinese Medicine framework while also considering anatomical, muscular, and movement-related factors when appropriate.
This means that when muscular pain or a tender area is part of a person’s presentation, treatment does not necessarily have to be understood as belonging to only one modern category. Acupuncture can incorporate local needling, Ashi-point approaches, distal treatment, anatomical considerations, and different forms of needle manipulation according to the individual presentation.
My primary practice is acupuncture rather than a separate dry-needling service. Understanding the overlap between the two approaches can nevertheless be useful for people who have encountered the term “dry needling” and want to understand how it relates to acupuncture.
Frequently Asked Questions About Dry Needling
Is dry needling the same as acupuncture?
Dry needling and acupuncture are not identical clinical systems, but they share important similarities. Both can use fine filiform needles, similar needle manipulation techniques, and overlapping anatomical treatment locations. The main differences often involve the clinical framework, terminology, assessment process, and treatment rationale.
Are trigger points the same as acupuncture points?
Not necessarily. Trigger points and acupuncture points come from different clinical frameworks, but there can be substantial anatomical overlap. Some tender areas described as trigger points may also correspond with classical acupuncture points, extra points, or Ashi points.
Does acupuncture use the same needle manipulation as dry needling?
There is significant overlap. Acupuncture has traditionally used techniques involving lifting, thrusting, rotation, repeated stimulation, and different depths and directions of needling. Some of these techniques are also used within modern dry needling approaches.
What is an Ashi point?
An Ashi point is a tender or painful area identified during acupuncture assessment. Unlike a fixed classical acupuncture point, an Ashi point is identified according to the person’s individual presentation and may vary in location.
Can acupuncture treat trigger points?
Acupuncture can include needling of tender or painful areas, including approaches commonly described as Ashi-point treatment. Whether a particular area is treated directly depends on the individual’s assessment and the overall treatment strategy.
Interested in Acupuncture for Muscular Pain or Tension?
If you are experiencing muscular pain, tension, restricted movement, or another musculoskeletal concern, an individualized acupuncture assessment can help determine whether acupuncture may be appropriate for your situation.
Contact MeThis article is provided for general educational purposes and is not a substitute for individualized medical assessment or diagnosis. Treatment suitability depends on the individual’s health history, symptoms, medications, and clinical circumstances. Seek appropriate medical care for severe, sudden, worsening, or unexplained symptoms.
