Acupuncture and Dry Needling: Let’s get to the point!
By Naomi Kazi, BHSc (Acupuncture)
What is the difference between acupuncture and dry needling? It is a commonly posed question, that as an acupuncture student I wanted to explore so I could answer from a more educated standpoint. The main area of focus is on the therapeutic approaches to the musculoskeletal system where both therapies tend to overlap.
Acupuncture has been in existence for over 2500 years as a therapeutic method to support the body’s harmonizing of Yin and Yang. This balance ensures harmony between the Yin/Yang organs; and promotes the smooth flow of Qi and Blood through the meridians and for nourishing the joints, bones, muscles and tendons.
Note: Yin and Yang are the foundations of diagnosis and treatment in Chinese Medicine; they are opposites yet cannot exist without the other such as the internal and anterior (Yin) and external and posterior (Yang) body. Yin organs (Liver, Heart, Pericardium, Lungs, Spleen, and Kidney) are solid and their function is to produce and store the vital substances (Qi, Blood, Essence and Body fluids). The Yang organs (Stomach, Small Intestine, Large Intestine, Bladder, Gall Bladder and San Jiao) are hollow and are in charge of the digestion and excretion of fluids and nutrients.
Disruption of this balance can obstruct the flow of Qi and Blood causing stagnation (blockage) in the affected area resulting in musculoskeletal tension and pain. The stagnation is viewed as a manifestation (Biao) the flare signal alerting the acupuncturist that there is a disharmony which is the root cause (Ben). The causes could be external such as injury or pathogens (relating to climatic changes that can cause injury) such as Wind, Cold and Damp which contribute to musculoskeletal issues. In chronic conditions, there may be an underlying deficiency (not enough of/poor quality) of Qi and Blood, chronic blood stagnation (blockage that has gone untreated) or disharmony of the Yin/Yang organs. The organs can be injured by emotion, diet and exhaustion and the main three that contribute are Spleen (controls the muscles and the four limbs); the Kidney (controls the bones); and the Liver (controls the sinews: tendons, ligaments and cartilage).
Dry Needling was a derivative of Wet Needling (hypodermic injections into myofascial trigger points) which was developed by Janet Travell and David Simons in the early 1940’s. Further development by Dr Chen Gunn in the 1970’s with the adoption of acupuncture techniques (needle manipulation and filament needle) on motor points of the muscle creating ‘intramuscular stimulation’ to relieve myofascial tension and pain. Dry needling is used on both myofascial trigger points and motor points for treatment of neuromuscular pain and myofascial dysfunction.
ACUPUNCTURE POINTS VS TRIGGER AND MOTOR POINTS
Acupuncture points are points on the 12 primary channels belonging to the Yin/Yang organs, extra points that reside in specific areas near to the channels and Ashi points that are of no fixed location but are tender or feel knotted on palpation of the myofascial area known as the ‘Jingjin’.
Myofascial trigger points are areas of tension (knots) that restrict normal muscle function and cause referred pain. Motor points stimulate muscle twitch (contraction) as it’s the location the motor nerve enters the muscle. Contracting the muscle results in the resetting of the nerve, muscle relaxation increased muscle strength and minimising strain on joints and tendons.
….but are they the same?
Essentially yes as research has identified that 70% of motor points are the same locations as named acupuncture points (although this is only a small percentage of overall acupuncture points). An example of this is the motor points along the Spinalis muscle which run along either side of the spine (the spinal nerve enters this muscle); this area is known as the Hua Tuo Jia Ji which is an extra point (this extra point has grouped the points that line the spine bilaterally). Ashi points can be defined as both motor and trigger points and stimulating this point to get de qi (arrival of vital energy) or to unblock the meridian can be seen as activating a twitch response or relieving myofascial knots and tension.