(This is adapted from Clare Mallory O’Nan’s thoughtful Facebook post)

Many of my patients have been asking me about dry needling lately. Dry needling (DN) is included in the scope of practice of physical therapists (PTs) in Colorado, which is why you’re hearing the term more and more. As it gains in popularity, many people are expressing confusion about the difference between acupuncture and DN, so I thought I’d try to help clarify it a bit.

Dry needling is the needling of myofascial trigger points using an acupuncture needle. Physical therapists work a lot with trigger points, and adding the application of needles to their work extends the scope of effects they are able to achieve through working with trigger points. Dry needling, therefore, is based purely on a Western anatomical and physiological understanding of the body.

I have seen it mentioned online and in many places that because DN is based on a Western vs Eastern approach, it is backed by science where acupuncture is not (inferred). I believe there is some confusion here regarding what acupuncture is and what acupuncturists are trained in.

Licensed acupuncturists are fully trained in Dry Needling. We learn DN in the course of our required Western neuro-musculoskeletal courses in our second, third, or fourth years of school. We are taught trigger point therapy and the application of both pressure and needles in the relief of pain. Licensed acupuncturists (L.Ac.’s) are trained in Western medicine as well (in fact, in some states, an L.Ac. can serve as a patient’s primary care provider on their insurance). And, obviously, we are also trained in Eastern medicine.

In practice, most licensed acupuncturists use a combination of the various techniques we learn in our three to four-year, 3000-hour masters degree. Sometimes this involves plain-and-simple DN, but more often than not when we use “DN,” it is in the context of a holistic approach to the body, whereas in PT it is not.

So here we come to the essential difference between the two. Acupuncture is holistic: it addresses the entire body. It relies on a picture of the body as a whole, working together to achieve optimal health. A person can come to an acupuncturist with many different complaints and a skilled L.Ac. can address all of them with a small combination of needles – including pain in multiple areas – because we see the body as a smooth, single unit. Acupuncture is also extremely relaxing. DN, on the other hand, is purely Western in its approach: it relies on a medical picture of the body as a sum of its parts and has very local effects; i.e., you needle the area of pain or the trigger point associated with it. You can’t treat anxiety or tinnitus or infertility with DN.

Finally, there is a difference in training involved in DN vs acupuncture. PTs and L.Ac.’s both have extensive training: PTs train for roughly three years at the master’s degree level, and L.Ac.’s three to four, also at the master’s degree level. L.Ac.’s complete 3000 clinical hours before they sit for their boards, with an entire year of observation before ever inserting a needle into a patient. PTs are highly trained in Western theory, including biomechanics, neuroanatomy, other therapeutic procedures including trigger point therapy, and human growth and development; L.Ac.’s are highly trained in all areas of health and are extremely proficient in the art of needling for the relief of pain and the treatment of multiple health conditions.

So, can a licensed acupuncturist perform dry needling? Yes, absolutely! But they likely won’t call it that. Can a physical therapist perform acupuncture? No more than an acupuncturist can perform physical therapy; they would first need to complete their master’s degree in acupuncture and then obtain national board certification and licensure by the Colorado State Board of Medical Licensure, all of which are required to practice acupuncture in Colorado. Similarly, an acupuncturist can’t and wouldn’t claim to practice physical therapy without fulfilling the requirements that accompany that licensure.

Does dry needling work? Absolutely! And does acupuncture work? Well, I think you know my answer to that :)