Is all acupuncture the same?
No. In fact, there is a world of difference between acupuncture and dry needling.
You should be well educated on what those differences are before making an appointment!
If you haven’t already, make sure you check out my post on a modern understanding of acupuncture. I dispel the weird myths surrounding acupuncture and introduce a modern understanding of the practice. Once you’re finished with that post, come on back here and we’ll start explaining the difference between acupuncture and dry needling.
Today, we do a deep dive into acupuncture vs dry needling. I’ll explain the pros and cons of each. Who you should see. The differences in practitioner training between the two and so much more!
By the end of this post, you’ll view acupuncture and dry needling in a whole new light. Let’s get going!
Acupuncture vs dry needling: Science & voodoo
If you’re seeing a physiotherapist, chiropractor, or medical doctor for acupuncture he’ll likely refer to his style as dry needling or medical acupuncture.
Dry needling is thought to be evidence-based. Acupuncture is thought to be more along the lines of voodoo. At least in the minds of most physios, chiropractors, and medical docs.
I’m inclined to agree that a lot of practices employed by acupuncturists are a bit out there. In their defense, acupuncturists haven’t updated their vocabulary for a few thousand years. So, they still use outdated terms like qi, energy, and meridians. Even when there is a scientific/medical understanding of how acupuncture works.
FYI it’s not via an invisible form of energy!
In an effort to avoid philosophical differences on whether or not there is a human energy system, allow me to summarize the difference between acupuncture and dry needling:
Dry needling focuses on the musculoskeletal system. By needling nerves that innervate specific muscles, practitioners are able to improve muscle tension. The resulting effect is an improvement in musculoskeletal conditions.
Acupuncture focuses on the body as an integrated system. Practitioners will look to identify underlying causes of muscle tension, digestive issues, etc. and focus on treating said underlying condition with needles. They identify these conditions by way of pattern recognition. The effect is brought about by phenomenon known as purinergic signaling.
Both acupuncture and dry needling could help your condition. The ways in which each achieves the beneficial outcome is slightly different.
From a patient perspective, go for dry needling/IMS for muscle aches/pains and not much else. Go for acupuncture if you’re dealing with many different symptoms including but not limited to:
- Headaches/migraines
- Muscle aches/pains
- Low back pain
- Anxiety
- Depression
- Gut issues
- Hot flashes
- Allergies
But before you book an appointment, you should know that there is a chasm of difference in training. The education on needling/acupuncture your physio went through is worlds apart from the education your acupuncturist went through…
Acupuncture vs dry needling: Training
This is what gets my knickers in a bunch. The level of training required to become an acupuncturist vs a dry needle therapist is worlds apart.
In Alberta, the province where I practice, acupuncturists are required to have more than 500 hours of clinical practice and thousands of hours of acupuncture theory before being eligible to become registered. Becoming registered involves taking a 2-3 day provincial exam that tests your competencies in various domains of acupuncture.
If you’re seeing a registered acupuncturist in Canada or the United States, you can rest assured that he/she has completed hundreds of hours of supervised clinical practice. To be clear, that supervised clinical practice is in addition to his or her studies on the topic of acupuncture. All in all, there will be several thousand hours of education required to become an acupuncturist.
The level of training for dry needling doesn’t come close to acupuncture training. In Canada, physiotherapists and/or chiropractors can get certified in performing needling via three different organizations:
There may be more, but these three are the most popular IMS courses I could find for Canadian practitioners. But here’s the kicker:
To achieve certification in dry needling, practitioners must – on average – complete two to three 3-day courses. For a grand total of six to nine days of training. Or, about 60-ish hours of training.
That’s it.
Acupuncturists go to school for 3-5 years to learn how to needle safely and effectively. Physiotherapists and chiropractors get a little more than standard work week’s worth of training.
Dear reader, if you’re a patient, this is information worth knowing. I don’t know about you, but I’d feel a lot more comfortable with a practitioner with several hundred hours of practice compared to sixty.
The acupuncture vs dry needling turf war
As you can well imagine, it can get pretty heated between acupuncturists and physiotherapists. This is most evident in the United States. In the USA, acupuncture and dry needling are legislated at the state level. Meaning that each state has its own laws and legislation around the practice of needling/acupuncture.
Most states operate similar to the provinces here in Canada – physiotherapists and chiropractors have the ability to needle their patients. But there are a few key battleground states where the issue is far more contentious. I feel it’s worth paying close attention to these areas.
In California, Florida, Idaho, New York, Hawaii, Washington, and South Dakota acupuncture can only be practiced by licensed acupuncturists. Physiotherapists and chiropractors operating in these states cannot perform dry needling.
Should physios and chiropractors be able to needle patients?
I don’t think I have the qualifications to answer that question.
In Canada, the legislation in provinces that regulate needling says yes, physios and chiropractors are allowed to needle patients. In the USA, 7 states have said no, physios and chiropractors cannot needle patients. Needling can only be done by licensed acupuncturists and medical docs. The other 43 states have agreed to let physios and chiropractors needle patients.
Who’s right?
I really don’t know the answer. But I do know that even after several hundred hours of acupuncture practice I was awful. Those first few years of practice were rough – I was not very good at acupuncture. I look back now at the way I practiced with shame. And that was even after hundreds of hours of supervised practice!
I can only imagine how wretched a practitioner would be after fifty-ish hours of practice. Certainly worse than I was. And I was quite bad.
Just because you’re allowed to perform an activity does not ensure you’re any good at it. Competency comes with experience. Courses don’t give you the necessary experience. You can well imagine how good I’d be at neck (cervical) adjustments if my only training was a weekend course…
Should you be concerned about safety?
Acupuncture has been shown to be safe time and time again. That impeccable safety record includes acupuncture performed by both acupuncturists and physiotherapists.
As a patient, I don’t think you need to be concerned about the safety of acupuncture. Regardless of who is performing it. Whether it’s a physio, chiro, or acupuncturist, you’re not going to end up in the emergency room afterward. At worst, you’ll experience a slight worsening of pain and a bruise.
But there’s far more to a good treatment than safety. Not only do you want your acupuncture appointment to be safe you want it to be effective. And this is the area where a world of difference exists.
What’s more effective – acupuncture or dry needling?
Either is as effective as the therapist performing the task. There are incredible physiotherapists and there are awful physiotherapists. The same goes for acupuncturists. The efficacy of your treatment has far more to do with your practitioner than whether he’s performing acupuncture or dry needling.
If this is your first visit to a physiotherapist, be sure to ask how long he’s been needling. The longer the better. As his skill will increase the more patients he sees. If he has been needling for less than 3 years, I’d recommend finding a different practitioner!
An acupuncturist with three years experience – assuming he’s seeing patients regularly – will likely be more skilled than a physio with three years experience in needling. So, if you’re booking an appointment for IMS with a physio, just make sure he’s got plenty of experience!
Ok, now you know as much as I do about the differences between acupuncture and dry needling! It’s time for me to hear from you.
What has your experience be with acupuncture and dry needling?
Which do you prefer? Why?
Leave your answers in the comments section below!
