What’s the difference between acupuncture and dry needling?
One of the most common questions we hear in the clinic is as follows:
“What’s the difference between acupuncture and dry needling?”
It’s an excellent and essential question for anyone looking to try acupuncture and find the right practitioner. Visual comparisons between acupuncture and dry needling may leave you struggling to tell them apart; both practices use fine stainless steel filiform needles (which the practitioner inserts into the skin); both claim to treat pain and relieve musculoskeletal conditions. However, that’s where the similarities end. Unique qualities help differentiate the two. Let’s explore them both.
ACUPUNCTURE (traditional acupuncture):
Traditional Acupuncture or Acupuncture has been used for thousands of years in traditional Chinese medicine. Acupuncture and Chinese medicine take a holistic view of health and the body and are intrinsically rooted in classical Chinese philosophy. As a result, for many people, the language of Chinese medicine can seem confusing or offputting—yin, yang, qi, etc. However, one must remember that this language forms a working template for diagnosis and treatment—albeit one that may seem alien within modern western medicine. In practice, however, it is vital to clarify that this medical doctrine is based on two thousand years of observation and clinical experience, and is one of the longest established forms of healthcare worldwide. According to classical Chinese medicine, acupuncture works to restore the body’s ability to heal and regenerate itself. It does this by stimulating the movement of qi and blood within the body, thereby removing blockages that can lead to illness. A classical Chinese proverb states, “If there is free flow, there is no pain; if there is pain, there is no free flow.” In other words, Chinese medicine proposes that it is the movement and free flow of qi and blood within the body that is necessary for maintaining health.
TONG ZE BU TONG; BU TONG ZE TONG – If there is free flow, there is no pain; if there is pain, there is no free flow.Chinese Proverb
Research on traditional acupuncture:
As an ancient and holistic medicine, it is often difficult to make traditional Chinese medicine and acupuncture fit the mould of modern western medicine research protocols. This is because each treatment will always be bespoke to the individual and will consider their presenting complaint, personal history, constitutional and environmental factors, and more. With this in mind, no two treatments can be the same—even for the same condition. However, this is not to say that solid research doesn’t exist to support traditional acupuncture’s efficacy and effectiveness; quite the contrary. For example, the National Institute for Health and Care Excellence (NICE) endorse acupuncture in treating chronic pain and has stated that it proves more effective in managing chronic primary pain than analgesics (NICE, 2021). As an agency of the NHS, NICE provides national guidance and advice to improve health and social care in the UK as follows:
- by producing evidence-based guidance and advice for health, public health and social care practitioners in the UK.
- by developing quality standards and performance metrics for those providing and commissioning health, public health and social care services.
In addition, you can view the most up-to-date research relating to the efficacy and effectiveness of acupuncture on the British Acupuncture Council and Evidence Based Acupuncture websites. Recent additions and updates are as follows:
- Allergic Rhinitis
- Angina & Heart Disease
- Back Pain
- Bell’s Palsy
- Chronic Fatigue Syndrome
- Diabetes Type II & Gestational
- Dizziness & Vertigo
- Dysmenorrhoea (painful periods)
- Eczema & Psoriasis
- Facial Pain
- Frozen Shoulder
- HIV Infection
- Incontinence (urinary)
- Infertility (IVF)
- Mental Health
- Neck Pain
- Osteoarthritis (knee)
- Plantar Fasciitis
- Post Traumatic Stress Disorder (PTSD)
Regulation of Traditional Acupuncture in the UK:
If you are looking to try traditional acupuncture, it is crucial to find a fully qualified and experienced practitioner. To do this, you must ensure that they are registered with the British Acupuncture Council (BAcC)—the leading governing body and the gold standard for the acupuncture profession in the UK.
- Members belong to an accredited register, regulated and approved by the Professional Standards Authority for Health & Social Care (PSA).
- Regulation ensures a quality mark for the highest training standards, safe practice and professional conduct.
- Members must have completed over 3600 hours of training at degree level—400 of which must be supervised clinical training hours. Training usually comprises a full-time BSc (Hons) university degree in acupuncture (over a minimum of three years). It incorporates Western medical theory (anatomy, physiology and pathology), Chinese medicine philosophy and acupuncture.
- Members must be fully insured.
- Members must engage in a minimum of 30 hours of annual CPD (continuous professional development) per year and carry out regular risk assessments.
- Members are bound by the BAcC Standards of Practice for Acupuncture, Code of Professional Conduct and Code of Safe Practice.
The easiest way to confirm that your chosen acupuncturist is a member of the BAcC is to search the BAcC directory.
DRY NEEDLING (Western or Medical Acupuncture):
In contrast, dry needling (also known as medical or western acupuncture) has only been adopted over the last few decades. Dry needling is generally used by practitioners with western medical training and solely within the context of modern medicine; for example, GPs, midwives, physiotherapists, osteopaths, chiropractors, etc. It has no connection to classical Chinese medicine or its holistic view of the body. In contrast, western medicine explains acupuncture’s effects due to the release of endogenous opioids and oxytocin following the stimulation of acupuncture points with needles. With this in mind, dry needling adheres to modern western medicine’s reductionist view of the body and its microsystems. It is said to treat a small number of conditions, mainly covering musculoskeletal issues. Each treatment uses standardised protocols, just like medical prescriptions, and is based primarily on addressing signs and symptoms. Alternatively, needles are inserted into ‘trigger points’—areas of compromised muscle tissue, to release surrounding soft tissues. Generally, treatment doesn’t consider a patient’s medical history, constitution or the root of the underlying problem. Training ranges from a two-day course to six months in duration. It is important to note that dry needling or medical acupuncture is not necessarily less effective in treating these types of conditions. However, the practice is poorly regulated in the UK, so finding a fully qualified and experienced practitioner is crucial. Regarding medical acupuncture, the British Medical Acupuncture Society (BMAS) is the leading governing body for the Western Medical Acupuncture (WMA) profession in the UK.
- Membership is open to most UK-based health professionals who are subject to statutory regulation and have “an interest in acupuncture”. This includes doctors, dentists, physiotherapists, nurses, midwives, osteopaths, chiropractors, and podiatrists. It is also open to health professionals who are subject to voluntary regulation that is overseen by the Professional Standards Authority for Health & Social Care (PSA), and have completed the BMAS Foundation Course (24-36 training hours); and to members of the British Acupuncture Council (BAcC).
- Depending on the type of membership, practising members must have completed between 30 and 100 hours of training, of which supervised clinical training hours are not clearly specified. Training ranges from a two-day course to six months in duration.
- Members must engage in 6 hours of annual CPD (continuous professional development) or 30 hours every five years to remain accredited.
- Members must agree to be bound by the BMAS Code of Practice.
Other regulatory bodies in regards to acupuncture and dry needling are as follows. Each have their own membership requirements:
- The Acupuncture Association of Chartered Physiotherapists (AACP) requires its members to undergo a minimum of 300 hours of acupuncture training and has an additional strict Code of Practice. Members must engage in a minimum of 10 hours of CPD every two years.
- The Acupuncture Society represents many practitioners, most particularly those who trained in China. To view their membership requirements, please click here. Members’ experience ranges significantly from short two-day courses (certificate or CPD level) to degree level (5+ years). Additionally, members must engage in a minimum of 20 hours of annual CPD and are bound by their Code of Ethics and Code of Safe Practice.
If you’re weighing acupuncture versus dry needling as a treatment option, the choice may be a matter of preference. What are you looking to achieve, and what practitioner feels like the right choice for you? However, with the field being poorly regulated in the UK, your safety should always be paramount. Be sure to select a fully qualified and experienced practitioner, and, if you’re not sure, don’t be afraid to ask questions. At Acupuncture West London, we are registered with the British Acupuncture Council (BAcC) and the British Medical Acupuncture Society (BMAS), so you can be confident that you’re in the very best hands, whatever your choice may be.
Can acupuncture help me?
For the most up-to-date research and evidence on the efficacy of acupuncture, please visit the British Acupuncture Council (BAcC) website.
If you would like to learn more about how acupuncture may be able to help you, please contact us today.