Acupuncture vs. Needling: The Facts and Benefits

Mariah Stump, MD, MPH

While science and medicine are always advancing, there are some health and wellness traditions and practices that have been used for centuries. Some traditional Chinese treatments like acupuncture can have many benefits.

What is acupuncture?

Acupuncture has been used for 3,000 years as a key treatment modality of traditional Chinese medicine. It was used to treat various conditions, including pain. As its benefits became more well known, it is increasingly being used for overall wellness and stress management.

Chinese medicine explains acupuncture as a technique for balancing the flow of energy, or life force, known as chi or qi (pronounced chee). The chi is believed to flow through pathways, or meridians, in your body. Acupuncture involves the insertion of very thin needles through your skin at strategic points along these meridians on your body. By inserting needles into these specific points, your body can better fight inflammation and heal itself.

Also, the stimulation with acupuncture needles can boost your body's natural painkillers, because it works on opioid receptors in the brain. That is, acupuncture stimulates the endogenous (already present in your body) opioid system and works on managing pain at the level of the brain.

In 1996, the U.S. Food and Drug Administration (FDA) gave acupuncture its first United States “seal of approval” when it classified acupuncture needles as medical devices. Over the past two decades, randomized control trials continue to indicate that acupuncture can help conditions such as low back pain, osteoarthritis and migraine headaches.

Acupuncture points can also stimulate and help with muscular tension, fascial (connective tissue) release and decrease inflammation in connective tissue.

What is needling?

Dry needling is also called “trigger point” dry needling or “myofascial trigger point” needling as it is done to relieve muscular tension through treatment of trigger points. The word myofascial is made up of the roots “myo” which refers to muscle and “fascia” which refers to the tissue that connects muscle. Dry needling is done by acupuncturists, some chiropractors, some medical doctors and physical therapists who have received special training.

What is the difference?

Acupuncture and dry needling can be easily confused since the same needles are used for both treatments. The difference is in the point location and goal of the treatment. For acupuncture, various conditions are treated and the whole person is treated with the goal of restoring balance as well as treating a medical condition. With dry needling, it is done specifically for the muscular tension release caused by trigger points (knotted areas) in the muscles.

Both acupuncture needles and dry needling needles are the same needles in terms of length, width and depth of skin penetrated. They are placed through the skin into “trigger points” for myofascial release with dry needling; and to treat various medical conditions with acupuncture, most specifically for pain control.

Is it safe?

Both acupuncture and dry needling are extremely safe. All needles are sterile and individually packaged and are single use and disposable, therefore the risk of infection is extremely low. There are some common side effects that may occur, including soreness and occasionally minor bleeding or bruising where the needles were inserted. It is important to note that this risk increases if you are on blood thinning medications, but this is not a contraindication for treatment. Compared to the many adverse risks associated with some medications, acupuncture has relatively no side effects or adverse effects.

Does it hurt?

Acupuncture should not hurt. Upon insertion, it feels as though the skin is being pinched, or as though someone is gently pulling on the skin. After that initial pinch the minor discomfort should subside.

Acupuncture technique can vary between practitioners. In some traditional Chinese medicine teachings, twisting the needle is common and can sometimes be uncomfortable at first. However, twisting the needle is not a technique used by all practitioners.

The treatment

Acupuncture is an evidence-based practice for the treatment of acute and chronic lower back pain. Patients are usually asked to change into a gown, particularly if their low or mid back is being treated. You need to be able to lie still on a treatment table for at least 20 minutes to receive a treatment.

Acupuncture has been included in the new American College of Physicians guidelines for treatment of chronic low back pain. Other conditions that are often relieved by acupuncture include:

  • osteoarthritis of the knee and hip
  • tension headaches and migraines
  • severe nausea, including nausea and vomiting in pregnancy, or chemotherapy-related nausea
  • irritable bowel syndrome and associated gastrointestinal conditions
  • anxiety, depression, or post-traumatic stress disorder (PTSD)

There are many other studies underway regarding the success of acupuncture for other medical conditions.

Dry needling is safe and effective for the treatment of:
•    muscular tension and myofascial release for low back pain
•    neck pain
•    shoulder conditions
•    fibromyalgia  

Acupuncture is a safe complement to treatment you may be receiving for a variety of medical conditions. Often patients will seek acupuncture as a “last resort.” The fact is, when it is used together with traditional medical care, it may help your recovery and speed healing. Being low-risk with minimal adverse effects, it is often worth a try.

For more information on acupuncture and other alternative medicine practices, visit our Lifestyle Medicine Center website.

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