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Dry needling vs acupuncture is no comparison

Dry needling vs acupuncture and 13 other facts about the technique for muscle pain -- patients can reap great benefit from the...

Dry needling is not acupuncture and 13 other facts about the technique for muscle pain

With back pain and posture issues ever on the rise in society, there is now an increased need for more advanced muscle pain and myofascial treatments. From treating skeletal muscle and connective tissue to improving or regulating structural or functional damage, one technique is on point with healing.

Enter dry needling, an alternative-medicine technique used to treat muscle pain, myofascial dysfunction or myofascial pain syndrome (MPS). This therapeutic technique uses solid filiform needles or hollow-core hypodermic needles to precisely pinpoint and treat “trigger points” — the points causing pain or issues — in the body.

As the treatment is not yet mainstream, there are a lot of misconceptions about it.

Here are 14 facts about dry needling:

Dry needling is not acupuncture

While both acupuncture and dry needling involve a filament needle used to prick specific spots in the body, they differ in how they actually treat the body.

Acupuncture is used to treat internal issues such as digestive problems, stress and allergies. Alternatively, dry needling is used to treat muscular pain and myofascial dysfunction or MPS. Acupuncture can be used to treat chronic pain and inflammation as dry needling does, but that is not the focus of the treatment.  

Targeted dry needling is better than PT

In a 2010 technological innovation and literature review on dry needling, it was reported that the level of effectiveness of dry needling is up to 93% after an average of 10 sessions. Physical therapy has not seen the light of those results in that number of sessions.

A 2014 study even determined dry needling is the most effective method for frozen shoulder, an issue often treated with physical therapy, but with lower-quality results.

Dry needling is evidence-based

Dry needling hit a progression after it became integrated with imaging techniques in 2012 studies. The specific imaging technique used is ultrasound. Dry needles are connected to ultrasound machines, allowing health providers to visually see exactly where the dry needle is placed.

Therefore, there is no room for error with dry needling due to the ultrasound-guided technology. In fact, the duo now has a combined name, ultrasound-guided dry needling (UGDN).

Dry needling is physiological

Dry needling is physiological because it affects the way organisms and bodily parts function. By insertion into muscle trigger points, dry needles cause change to those areas — positive change, of course, being a treatment. 

Dry needling is not so painful

When comparing pain levels of dry needling to intramuscular injection or regular physiotherapy, the pain is far less, even nonexistent to some, with dry needling. 

Even getting pricked on the finger is more painful than dry needling.

Dry needling has a strong anatomical effect

Just as surgery has the ability to do, dry needling effectively reduces myofascial pain, and ameliorates symptoms of neuropathy and local muscle hypo-motility in low-back pain.

Dry needling is a safer alternative to surgery that can yield the same results. Patients should be open-minded to dry needling before resorting to surgery.

Dry needling can alter posture

Dry needling is not only a method for treating myofascial pain, but also restoring posture. Because dry needling improves muscle spasticity and restricted movement, it naturally corrects posture as well.

Dry needling is a sophisticated approach

It is mandatory to conduct a whole-body neuromuscular ultrasound with dry needling, making it a more sophisticated approach. Patients will holistically learn about their posture, muscle spasms and muscle pain.

Dry needling expertise is required

Health providers are only able to perform dry needling if they have expertise in muscle anatomy, pain medicine, neurology, ultrasound and muscle physiology.

The entire physical and mental state of patients is taken into account when dry needling, and to perform the treatment effortlessly, health care providers must be experts at a plethora of health specialties. 

Dry needling has been revolutionized by ultrasound

If trigger points are not targeted, dry needling is unsuccessful. Ultrasound-guided technology has eliminated any risk of failure in dry needling by providing clear images of the body and where the needle is being inserted.

While some practitioners and doctors may have a special ability to locate trigger points without the aid of images, ultrasound-guided dry needling is undoubtedly the better choice to make, as there is no room for mistakes.  

Check dry-needling certifications

There are untrained people performing dry needling throughout the world. Imprecise needling can lead to pneumothorax (lung puncture), nerve damage, vascular damage and visceral (abdominal organ) damage.

To better determine if your practitioner or doctor is an expert at dry needling — ask yourself these questions:

  • Is this practitioner certified in dry needling?
  • Who is this practitioner certified by?
  • Is there evidence of this practitioner’s continuing education in dry needling?

Dry needling can treat tendons

Dry needling for tendons can be done with acupuncture needles, but for the majority of tendons, a hypodermic needle is preferred. The hypodermic dry needle requires local anesthesia because it would be too painful otherwise. Dry needling for tendons is different from dry needling for myofascial pain because it induces local tissue damage to create reparatory reaction from the tissues.

It is just as effective as PRP (plasma injections). Dry needling for tendons also requires ultrasound guidance because the needle is too large to be used without precise guidance.

Dry needling may treat athletic injuries

While more evidence is needed, it is possible that dry needling can help treat acute and chronic injuries in elite sports. Athletes could have less pain and improved muscle function with the aid of dry needling. 

Dry needling works better as monotherapy

Monotherapy involves one type of treatment. It is better to try dry needling without supplementary interventions because there would be no interference to the nervous system in its response to the treatment.

While dry needling has not yet entered the mainstream, its study results are inviting further inquiry into this method of treating muscle pain, myofascial dysfunction or myofascial pain syndrome.

LEV KALIKA, DC, RMSK, is founder of New York Dynamic Neuromuscular Rehabilitation & Physical Therapy and a doctor specializing in chiropractic medicine and sports medicine rehabilitation. He is a speaker and co-author and has been successfully practicing medicine in his midtown New York City clinic since 2011. He can be contacted at


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