Dry Needling is Acupuncture

By Chris Helmstetter, LAc

We get many questions from patients asking us how dry needling is different from acupuncture.  Physical therapists claim that dry needling is not acupuncture because it is based on Western anatomy, not meridians and energy flow.  They also say that there is a comprehensive training program to get certified in dry needling that prepares them to practice an invasive procedure like this.  But they use acupuncture needles.  And they insert them in trigger points just like acupuncturists do.  This is very confusing to the public.  What is the difference between dry needling and acupuncture?

Acupuncture is the insertion of solid filiform needles into the body for diagnostic and/or therapeutic purposes.  Acupuncture treats myofacial pain by inserting needles into trigger points, tender points, muscles and muscle motor points, ligaments, tendons and other soft tissue structures.  This practice is called ashi acupuncture, orthopaedic acupuncture, trigger point needling, or dry needling.  Dry needling is acupuncture.  More specifically, dry needling is a sub-set of acupuncture.  This is because acupuncture can treat many more conditions than just pain.

Most licensed acupuncturists (LAc) have over 3200 hours of training in anatomy, physiology, biology, clinical research, Western disease differentiation, traditional acupuncture theory, needling techniques and clinical practice.  This includes over 660 hours of supervised clinical training.  It takes 3 to 4 years to gain the necessary knowledge and skill to use acupuncture safely and effectively.  And this training is a synthesis of Western anatomical concepts and more traditional concepts of meridian pathways and energy.  This is in contrast to the 54 hours of training that physical therapists receive to start dry needling on patients.  Even if they just treat pain conditions, this is inadequate training.

The only professionals in NC allowed by law to do acupuncture are licensed acupuncturists, as well as MDs and chiropractors that have completed at least 300 hours of training in acupuncture.  The NC Rules Review Commission agreed with this precedent earlier this month when they rejected the NC Physical Therapy Board of Examiners proposed rule to allow dry needling with only 54 hours of training.  They ruled that physical therapists cannot perform dry needling without changing their scope of practice through the NC General Assembly.  And several Rules Commissioners expressed strong concern about the inadequate proposed training and safety risks associated with dry needling.

There are over 8000 physical therapists in NC doing excellent work with people all over our state.  Only a hundred or so are attempting dry needling on North Carolinians.  Those few are practicing outside of their scope of practice.  Dry needling is acupuncture and should only be administered by those licensed and properly trained to provide it.

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