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Dry Needling vs Acupuncture: Which Is Better for Pain Relief?

October 30, 2023

Acupuncture Q & A

What Is Acupuncture Treatment?

Acupuncture is a type of treatment that originated in China more than 3,000 years ago. Acupuncturists use extremely slim needles, placing them in key areas on the body to alleviate pain in a natural way. The needles create a balance in the body’s energy, which allows the body to return to its optimal pain-free state.

There are several types of acupuncture. In moxibustion, moxa taken from dried mugwort warms key areas and helps with smooth qi energy flow. In auricular acupuncture, points on the outer ear are stimulated for healing. In cupping therapy, suction is used to help stimulate blood flow and promote healing.

Imagine this: you wake up and that familiar tight, throbbing pain has wrapped around your shoulders and neck again. 

No matter how much you stretch or massage the area, the tension persists. 

Taking pain medication provides only temporary relief before the intense pressure returns. 

As these issues become more prevalent in today’s day and age, interest in drug-free treatment options like dry needling and acupuncture has surged dramatically.

However, with this growing popularity, many people struggle to grasp the key differences between these two needling therapies and their most appropriate uses. 

In this extensive guide, we’ll walk you through the core contrasts between dry needling and acupuncture in great detail, comparing their origins, needling techniques, benefits, ideal applications, risks, and more. 

With a comprehensive overview of both modalities, you can make a fully informed decision on which treatment method aligns best with your needs and health goals.

Origins and Evolution of Dry Needling and Acupuncture

To start, let’s explore the history and evolution of each therapy.

Acupuncture originated in China over 2,500 years ago and developed as a core component of Traditional Chinese Medicine. According to ancient philosophy, disruptions in the flow of Qi (vital energy) along meridians in the body lead to the manifestation of disease.

Acupuncture needles rebalance Qi to restore health. As acupuncture has spread globally, clinical trials have aimed to validate its mechanisms and effects scientifically.

Dry needling is a modern adaptation of acupuncture principles utilizing a Western anatomical perspective. 

Rather than meridians, dry needling focuses on trigger points - hyperirritable knots in skeletal muscle and fascia. Though studies as early as the 1940s examined trigger point pain patterns, Czech physician Karel Lewit is credited with coining the term ‘dry needling’ in 1979. 

Since then, researchers have worked to further understand trigger points and refine needling techniques.

So while acupuncture has ancient roots as part of Traditional Chinese Medicine, dry needling emerged more recently as a physical therapy grounded in Western medicine concepts. 

But both leverage the healing power of needles applied strategically.

Defining the Two Needling Therapies 

Dry Needling vs Acupuncture

Now that we understand their origins, let’s clearly define what dry needling and acupuncture involve.

Dry needling utilizes thin filiform needles to penetrate trigger points in muscles and connective tissues in order to deactivate dysfunctional firing patterns, alleviate spasms, reduce local ischemia (restriction of blood flow to a body part), and modulate pain signaling. 

Physical therapists, physicians, and other providers with advanced training perform dry needling treatment.

Acupuncture uses ultra-slim solid needles along carefully mapped meridian points on the body to rebalance and regulate the flow of Qi (vital energy), restoring harmony between yin and yang forces according to Traditional Chinese Medicine principles

Licensed acupuncturists, like those at Complete Wellness, deliver acupuncture therapy.

On the surface, both incorporate strategic needle insertion but have distinct perspectives. Next, we’ll break down their shared needling techniques and processes.

Key Differences Between Dry Needling and Acupuncture

dry needling and acupuncture

Dry needling and acupuncture have several core differences:

Factor Dry Needling Acupuncture
Conceptual Basis Anatomical, biomechanical Traditional Chinese medicine theory of meridians & Qi
Goal Temporary pain relief & improved range of motion Holistic wellness & vital energy balance
Terminology Used Anatomical - muscles, nerves, tissues Traditional - Qi, yin/yang, meridians
Training Required Short continuing education courses Extensive master's degree programs
Practitioners Physical therapists, physicians, chiropractors Licensed, nationally certified acupuncturists
Session Duration Brief, 5-30 minutes 45-60 minutes
Needling Approach Repeated trigger point needling Gentle needling along meridians
Sensations Felt Localized twitching & muscle soreness Mild systemic tingling, warmth, heaviness

Now that we understand their differences, let’s examine when each therapy is most effective.

1. Primary Uses and Applications

Research and clinical practice guidelines endorse dry needling for:

  • Myofascial pain syndrome involving trigger points
  • Muscle cramps and spasms
  • Joint stiffness restricting the range of motion   
  • Overuse injuries like tendinopathies
  • Post-surgical scar tissue adhesions
  • Tension headaches and migraines
  • Jaw tightness and TMJ dysfunction
  • Neck and shoulder trigger points
  • Low back stiffness and pain

On the other hand, evidence supports acupuncture for:

  • Chronic musculoskeletal pain - back, knee, neck, shoulder
  • Tension headaches and migraines
  • Osteoarthritis and rheumatoid arthritis 
  • Chemotherapy-induced nausea  
  • Post-operative nausea and vomiting
  • Allergies and sinusitis
  • Anxiety, depression, and stress
  • Addiction and substance withdrawal  
  • Headache disorders
  • Digestive complaints - IBS, constipation
  • Fibromyalgia
  • Asthma
  • Hypertension
  • Insomnia
  • Menopause

In summary:

  • Dry needling excels at relieving localized trigger points that generate referred pain patterns. 
  • Acupuncture is better equipped to balance and restore whole-body health across multiple systems through personalized treatment plans.

2. Treatment Experiences and Sensations

There are also pronounced differences in the needling techniques and sensations between dry needling and acupuncture sessions. Here are some of them:

Dry Needling

  • Needle insertion is repeated directly for 1-2 minutes per trigger point.  
  • It can elicit muscle twitching and cramping as trigger points are deactivated.
  • Needling itself is the primary treatment, not retention time.
  • Needle manipulation stops when the local twitch response ceases.
  • It often feels like a muscle knot is slowly releasing as it is needled. 
  • It may cause muscle soreness that peaks 24-48 hours post-treatment and resolves.


  • Needling happens gently along meridian channels and is retained for 15-30 minutes.
  • Needles are lightly stimulated and then sit undisturbed as they balance Qi. 
  • Patients report sensations like tingling, warmth, heaviness, and numbness.
  • The needling creates energetic effects for healing, not the retention time.
  • The overall sensation is mild and comfortable when performed correctly.
  • There is no soreness compared to dry needling’s post-treatment muscle achiness.

While dry needling produces more intense, localized sensations, acupuncture is gentler with mild system-wide effects. Now let’s examine risks and side effects.

3. Safety, Risks, and Side Effect Differences

When performed correctly using proper techniques, both dry needling and acupuncture have very minimal risks.

The most common side effects tend to be minor and temporary, like mild bleeding/bruising at the needle site, moderate soreness after treatment, and brief pain during the needling.

More serious risks like pneumothorax are extremely rare but can occur if needling is too deep. Proper patient screening, practitioner training, and use of single-use disposable needles are crucial to minimize risks.

Overall, acupuncture performed by licensed professionals has an excellent safety record, with mild and infrequent side effects when protocols are followed.

Dry needling can sometimes produce post-treatment muscle soreness. However, both modalities are considered very low-risk when practiced carefully by qualified providers.

Similarities between Dry Needling and Acupuncture

Both dry needling and acupuncture leverage extremely thin monofilament needles, typically just 0.20-0.30 mm wide, about the diameter of a human hair. This allows smooth insertion into the skin and underlying tissues with minimal discomfort.

Needling depth varies based on treatment area, tissue depth, and individual size. But lengths between 5-30 mm are common. This enables sufficient penetration to access trigger points and acupoints without penetrating internal organs or nerves. 

Once inserted, the needles may be rotated, manipulated, or stimulated to elicit a localized reaction. They are retained for varying lengths of time before removal. 

This brief needling disrupts dysfunctional patterns to induce physiological effects with minimal side effects when executed properly.

While the outward technique is similar, their approaches differ. 

Deciding Which Treatment Is Right for You  

So how do you determine if dry needling or acupuncture is better suited for your needs? Here are key factors to weigh:

  • Carefully assess your symptoms, complaints, and health goals. What issues trouble you most? This can indicate if isolated versus whole-body treatment is best. Are you seeking temporary relief or to address root causes?
  • Understand if acupuncture, dry needling, or both are covered by your insurance as this greatly affects cost. Many plans cover acupuncture services but dry needling often requires separate rider fees.
  • Thoroughly research practitioner credentials - check for physical therapists with advanced certification in dry needling, and licensed acupuncturists that meet all state licensure requirements.
  • Consider a combined treatment plan that strategically integrates both modalities tailored to your issues for maximum lasting results. Explore integrative options by consulting qualified providers. 

By evaluating your unique health profile and objectives, you can determine if dry needling, acupuncture, or a combined approach is optimal. But always partner with knowledgeable specialists to guide treatment selection. 

Key Takeaways on Dry Needling vs Acupuncture

what is the difference between acupuncture and dry needling

Now that we’ve done an extensive deep dive into comparing these two needling therapies, let’s recap the core contrasts and how to choose between them:

  • Dry needling provides temporary relief by targeting localized trigger points while acupuncture balances whole-body energy flows using meridians. 
  • Dry needling alleviates regional muscle and joint pain while acupuncture treats complex multi-system conditions and restores holistic wellness.
  • Both can successfully reduce pain but suit different symptoms and therapeutic objectives.
  • It is essential to partner with qualified, licensed specialists in either modality to determine which treatment method fits your needs through thorough assessment.
  • A tailored combination approach may provide the greatest lasting benefits for more complex cases. 

Recognizing these key differences allows you to make fully informed decisions when weighing these options.

For those considering acupuncture, Complete Wellness offers a customized integrative program with acupuncture as a centerpiece blended with modern complementary treatments (like physical therapy) based on Traditional Chinese Medicine principles honed over centuries.

Our holistic acupuncture services aim to restore balance, provide soothing yet lasting pain relief, reduce anxiety, enhance sleep, and nurture overall mind/body wellness through personalized care.

Take the first step today by booking an appointment with the experienced acupuncturists at Complete Wellness. 

Frequently Asked Questions

Are the needles different between dry needling and acupuncture?

Both modalities typically use thin monofilament needles, but acupuncture needles are smoother while dry needling uses needles with a rougher surface to better grip muscular tissues.

Can you receive dry needling and acupuncture together in one treatment session?

Yes, many pain specialists are integrating both modalities together in tailored combination plans to target both localized trigger points through dry needling and whole-body issues using acupuncture.

Is the cost of treatment usually different between dry needling vs acupuncture?

Yes, dry needling costs tend to be slightly lower per session than acupuncture since it takes less time. But acupuncture is more likely covered by insurance, reducing out-of-pocket costs.

Do dry needling and acupuncture rely on the same physiological mechanisms?

No, dry needling aims to resolve localized muscle issues while acupuncture activates systemic responses like inflammation modulation, blood flow changes, and neurotransmitter release to restore holistic health.

Which has been practiced longer historically - dry needling or acupuncture?

Acupuncture originated over 2,500 years ago in China while dry needling was developed much more recently, emerging in the late 1970s.

Are the risks and side effects different between dry needling and acupuncture?

Yes, dry needling has higher rates of muscle soreness after treatment while acupuncture shows very low risks, making it extremely safe when performed correctly.

Complete wellness

Medically reviewed by Complete Wellness on Feb 16, 2024

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