dry needling vs acupuncture

Dry Needling vs. Acupuncture


Medically reviewed by Grace Mollohan

To many people, dry needling and acupuncture look similar, but the techniques are different. While both treatments involve the insertion of thin needles into the body to alleviate pain and muscle tension, they have unique treatment principles and goals.

In this article, we will explain the difference between dry needling vs. acupuncture, the conditions they treat, and how to determine which is right for you.

What Is Dry Needling?

Human muscles are comprised of fibers that are bundled together. These fibers can become sensitive or taut from emotional stress, injuries, and sustained postures.

Over time, chemical changes in the body due to stress can cause muscles to become more sensitive and even and form tight muscle knots, or myofascial trigger points.  These taut bands within the muscles can cause pain and limit movement. Trigger points are generally tender to the touch and send pain signals to other areas of the body.

Dry needling is the insertion of thin, sterile, solid needles (monofilaments) directly into trigger points or another sensitive area of muscle throughout the body.  The goal of inserting these needles is to increase blood flow and decrease the pain-causing chemicals in the tissues, therefore relieving pain and tension.

The therapist may move the needle gently or leave it in place for up to 10-15 minutes.  In some cases, electrical stimulation may also be applied to the needles to enhance the pain-relieving properties of the treatment.

Although some patients experience a pin-prick sensation, mild cramping or muscle twitching, the discomfort of dry needling is typically minimal.  Most people feel immediate relief from their symptoms following this treatment.

How Does Dry Needling Work?

Dry needling works by causing a natural chemical release within the body that helps the muscles and nerves in the area to function more normally.

Research indicates that dry needling triggers the release of endorphins that help to relieve pain and improve range of motion. As the needles enter the muscle, micro-lesions are created, stimulating an increase of nutrient-rich blood to the area and activating the body’s healing response.

Dry needling offers an immediate result that can last hours to weeks.  These improvements are sustained or even further improved when paired with exercise and other physical therapy treatments prescribed by the therapist. Commonly, the dry needling treatment may be repeated over the course of several physical therapy visits to achieve the desired effect.

Conditions Treated With Dry Needling

Dry needling is beneficial to treat a wide range of musculoskeletal and neural conditions causing pain:

Dry needling practitioners include licensed physical therapists or chiropractors that have completed specific training beyond their professional degree. Because guidelines governing dry needling vary, check the laws and regulations to ensure your provider can perform dry needling in your state.

What Are the Benefits of Dry Needling?

As mentioned above, the primary benefits of dry needling are:

What Is Acupuncture?

Acupuncture is a Traditional Chinese Medicine practice dating back 3,000 years, making it just slightly older than dry needling which was developed in the 1940’s. In recent decades, acupuncture has become one of the most widely used forms of complementary medicine in the United States.

Like dry needling, acupuncture is the insertion of thin, sterile needles (monofilament) into strategic points on the body, but with a vastly different purpose.

Acupuncture is based on the idea of restoring and balancing energy (qi or chi) that flows along pathways (meridians) throughout the body. Practitioners believe that illness occurs when chi is blocked, and by accessing certain areas on these pathways, this energy can frow freely.

How Does Acupuncture Work?

We understand the physiology behind how dry needling works, but the hows and whys of acupuncture aren’t quite as clear.  Yet there is a body of research that confirms what many already know: acupuncture is effective, especially for pain relief.

One study of patients with chronic pain found that not only did acupuncture relieve symptoms, but those results lasted upwards of 12 months or more post-treatment.

A scientific measurement of “balancing energy” isn’t well understood.  However, due to the similar nature of inserting tiny needles into the body, the same mechanisms that make dry needling effective are likely at play during acupuncture treatment too.

Conditions Treated With Acupuncture

Acupuncture is commonly used to treat acute and chronic pain across the body, along with an extensive list of mental, emotional, and physical conditions.

In addition to the list of musculoskeletal and neural conditions listed for dry needling, acupuncturists also treat the following conditions:

  • Anxiety
  • Cancer pain
  • Depression
  • Infertility
  • Menstrual cramps
  • Nausea

Nonphysician acupuncturists must complete an accredited acupuncture program and a master’s degree to practice. Many work within the traditional medical care setting alongside nurses, PAs, and physicians. Some chiropractic and physical therapy clinics offer acupuncture as well.

What Are the Risks of Dry Needling and Acupuncture?

Both dry needling and acupuncture may commonly cause soreness at the treatment area, bleeding at insertion points, and mild bruising.  However, these effects are typically very mild and ease very quickly.  For most people, the benefits far outweigh the side effects.

Very rarely, infection is one possible complication of both dry needling and acupuncture.  However, this can be avoided with the use of sterile, single-use monofilament needles which is common practice for both. Also, in rare cases, nerve or organ damage is possible if a needle punctures a major organ.

Although there are few risks associated with both treatments, these minimally invasive therapies are not recommended for everyone. Individuals who are taking certain medications or have complicated health issues should consider other options.

Which Treatment is Right for Me?

As you can see, there is some overlap among the conditions that can be treated with dry needling and acupuncture. But that doesn’t make the treatments interchangeable.

Both are shown to alleviate chronic pain. However, during dry needling, the needle is inserted more specifically into the area of the tissue that may be the cause of pain, which makes it most effective for localized muscle pain and stiffness.

If you have widespread pain, you may find either dry needling or acupuncture helpful, possibly with the addition of electrical stimulation.

Other conditions that are not neural or musculoskeletal in nature (mood disorders, infertility, etc.) are most suited to acupuncture as a complementary therapy to traditional Western medicine.

In any case, pairing a form of needling treatment with exercise has been shown to be the most effective strategy for long term benefits.  Be sure to consult your primary care provider, physical therapist, or acupuncturist to ensure everyone is on the same page and working together to achieve common goals for your health and well-being.

To learn more about try needling and other innovative therapies, find a physical therapy clinic near you.

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Medically reviewed by

Grace Mollohan

Director of Orthopaedic Residency

Dr. Grace Mollohan has been a practicing physical therapist in Atlanta, GA since 2011 when she obtained her Doctor of Physical Therapy degree from Emory University. Dr. Mollohan completed an Orthopaedic Residency and Dry Needling Certification in 2013. She later went on to complete an OMPT Fellowship in 2018 where she discovered a passion for teaching and mentoring orthopedic physical therapists. Since 2019, her primary role has been the Director of Orthopaedic Residency for Upstream Rehab Institute. However, she also severs as a Senior Instructor for the Institute of Advanced Musculoskeletal Treatments (IAMT) and as an Adjunct Professor in Emory University’s DPT program. Outside of work, she enjoys traveling with her husband and two kids, wine, and exercise to maintain balance.

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