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What is dry needling?

Dry needling is a type of acupuncture

I am certified in Dry Needling. If you have experienced good outcomes from dry needling or heard good things about it, please call me. But we need to be honest about terms: dry needling is a form of acupuncture. While acupuncture originated in China, it has now traveled into the present across millennia and cultures, and each change in time and space has seen it morph superficially into different approaches, though it remains essentially the same.


“Dry needles” are acupuncture needles. So-called “dry needles” are identical in every way to acupuncture needles; both are implements with a handle and a thin, solid, flexible shaft that ends in a sharp point. Among and within brands of acupuncture needles are to be found many variations of these features, akin to the different models and trims for motor vehicles. Years ago I bought what I thought was the first brand of “dry needles”. They were excellent, indeed, just perfect for people with little acupuncture training who needed to easily employ them without causing discomfort.

Dry needlers claim they’re doing something new and different because their strategies have no reference to Chinese medicine. But there’s no technique in the history of acupuncture that dry needling does not replicate.

In its essentials, my own practice of acupuncture, which sees the body’s interconnections as lying primarily within the nervous system, is congruent with dry needling but extends past it. The physical therapists, chiropractors and others who have extended their scope of practice to include using acupuncture needles aka dry needles split their attention between needling and other modalities. I spend all of my professional life focused on the effective placement of needles. New York State has not extended the scope of practice of PT’s and chiropractors to include dry needling. This is why you don’t see much New York State marketing around it.


I welcome your call so we can discuss this. I invite you to my office for treatment. For a deeper dive into the topic, please see below.



Why should you care that dry needling is a form of acupuncture?

While the word acupuncture has become increasingly familiar to most people, dry needling is not yet a well-known term. I'm going to describe what it is, and how it is both like and different from acupuncture. In the paragraphs below, you will also learn who provides dry needling and why you should care.

I first heard the term “dry needling” while attending Tri-State College of Acupuncture (1999 to 2002). Mark Seem, the school’s founder and CEO, used it several times during lectures, contrasting it to the use of a syringe. I’ve never heard the term “wet needling,” but the distinction is simple: if you use a syringe to deliver a substance subcutaneously or intramuscularly, the needling is “wet”; an acupuncture needle is solid—it lacks a lumen through which to push a liquid— hence, it’s dry. Thus, the term “dry needling” is one that predates the rise of the current dry-needling movement.


The term “dry needling” as it is now offered to healthcare providers—mostly physicians, physical therapists and chiropractors—is a sleight of hand. Those who go to workshops to receive certificates seek to practice acupuncture without receiving the extensive training found in acupuncture colleges. The people who have trained them tell them it’s not acupuncture because it has no reference point to Chinese medicine: meridians, the Five Elements, qi, listening to the radial pulse, or practicing tongue diagnosis, to name a few essentials of “traditional” acupuncture as it has been handed down across millennia. I imagine that many, if not most, believe it’s not acupuncture. After all, the dry needling experts tell them it’s not. Or they make themselves believe it’s not, for both noble and less-than-noble reasons. They may have contempt for the metaphysics underlying acupuncture as it is often presented to the public and are happy to get a quick-and-easy way to practice a technique that holds out promise for their patients; but they don't want to pay for the time required for acupuncture training. Acupuncture is fascinating. No wonder people want to practice it and to receive it.

Safety: Dry Needling Is Not a Licensed Category


There is no actual licensure in the US for dry needling. Some states explicitly extend the scope of practice for physical therapists to include dry needling, some prohibit it, and some leave it a gray area. I don’t know how this plays out for physicians and chiropractors. But, let’s be honest, there are no laws licensing practitioners in the use of syringes, either. (I suppose that would be a license in wet needling.) You’re entitled to use a syringe if you’re a doctor, nurse or dentist. I don’t know whether any states include injection therapy within the chiropractic scope of practice.


On the other hand, when I attended a weekend dry needling training in 2013, the 45 physical therapists who attended, who received the same diploma-looking certificate I did, were told that the three days of training, much of which was theory, with hands-on practice reserved for the afternoon of the third day, qualified them to place needles in people. Contrast this with the hundreds of hours of actual clinical practice that acupuncturists receive and you’ll understand some of the cynicism acupuncturists hold toward dry needling. Patient safety is always emphasized to acupuncture students. Acupuncturists are taught how to place needles safely, a critical concern when needling the back, chest and abdomen. (It’s relatively safer when needling the arms and legs.) Safety is paramount. Can safety be in the foreground during a weekend training?


The Same Soup in a Different Pot


The man whose signature is on my dry needling certificate wrote the two most enlightening and exciting books on acupuncture I came across in the years immediately after my graduation from acupuncture college. They were about a biomedical approach to acupuncture; the term biomedical acupuncture was in their titles. Among other things, the books reaffirmed my growing interest in a palpation-based approach to the placement of needles. They were also motivating because while they honored the two-millennia history of acupuncture, they were free from meridian theory and other concepts explicitly related to East Asian medicine that I was in the process of jettisoning. What I learned in the dry needling workshop was essentially the same soup in a different pot.


What are the targets for dry needling? Primarily areas of tenderness, which in Mandarin are called ashi points. Where does one find ashi points? Almost everywhere. So, how many locations on the body equate to everywhere? As a thought experiment, consider subdividing the body into quarter-inch-square regions. How many of these “body tiles” would there be? The number is practically infinite, given the variation in size and shape of a population of human beings. How many ways are there to insert a needle? To name three: lifting and thrusting, twirling, inserting neutrally. This, too, is subject to many variations, given the difference in size, strength and adroitness of a population of providers’ hands, and the physical dimensions of the needles. Over the course of millennia, all variations on needle insertion have been employed at virtually every place on the body, with the exception of a handful of places that are forbidden. (I imagine the dry needling world acknowledges these places of trespass: nipples, genitals, navel.) What I’m trying to say that there is nothing a dry needler does that is different in any way from what an acupuncturist does. Dry needling is the subset. The mechanics are identical. It’s the underlying theory that’s different. What’s clear is that the body responds physiologically to needles in the same way no matter the theoretical framework. All acupuncture works, and has worked, across time and culture, on account of the same physiological mechanisms.


Here's the critical piece: Acupuncturists’ in-depth clinical training provides them with a broader set of needling and other hands-on techniques. Acupuncturists have both more skill and more skills. Acupuncture is the full set. Dry needling is the subset.


Acupuncture Evolves


As implied above, an ashi point is part of the long acupuncture tradition. Dry needling is merely a modern, newly named subset of acupuncture, just as there have been many subsets and variations across its long and gloried history. One does not need to embrace the concepts of acupuncture channels and allied, traditional principles to practice excellent acupuncture. The nervous system extends everywhere in the body. The nervous system is the primary unifier of the body as an entity.


I’m proud to be a New York State licensed acupuncturist. I welcome your call so we can discuss any of the above. I invite you to my office for treatment.


© William Weinstein 2024

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