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Dry Needling

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What is Dry Needling

Is Dry Needling, Acupuncture?

 

The short answer is YES, anytime someone inserts acupuncture needles in the body they are performing acupuncture.  Every registered acupuncturist has extensive training in needling methods, that include "Dry Needling" However, the title Dry Needling is a legal loophole that allows non-registered acupuncturists to administer needling with little to zero training.

 

What is the difference between a Registered Acupuncturist, and a Dry Needler?

 

Acupuncturists are registered with the Australian Health Practitioner Agency (AHPRA) and the Chinese Medicine Board of Australia (CMBA). It is actually illegal to claim to be an Acupuncturist or imply that you are an Acupuncturist without being registered. The purpose is to protect the public from negligence, safe needle handling, sanitation, liability insurance, and to ensure continuing education of practitioners. In order to be registered, acupuncturists must undergo 4 years minimum (roughly 3,000 formal education hours) of training and 900 or more hours of supervised clinical practice. 

As part of the rigorous 4 year degree, acupuncturists must study Western Medical Science, such as Anatomy, Physiology, Pathology, Biochemistry, and Western Medical Diagnosis, in addition to Chinese Medical Theory, Channel Location, Point Location, Needling Techniques & Contraindications, and intensive courses of study such as Traumatology, Internal Medicine, Gynecology, Pediatrics, Opthamalogy, Ear, Nose and Throat, etc. 

Dry Needling by contrast is unregistered, therefore anyone can technically perform this with out having to undergo any training at all.  Dry Needling courses require as little as 16 hours of training before a practitioner can be qualified to perform the practice.  

How do I know if I am seeing a qualified and registered acupuncturist for Treatment?

 

All Acupuncturists must be registered with the Chinese Medicine Board of Australia (CMBA), and will have a unique registration number that starts with CMR followed by a series of numbers.  This number ensures you are in safe hands, and receiving services from someone who is highly trained, skilled, and knowledgeable in Acupuncture.

 

Acupuncture consists primarily of two categories:

1). Local needling (meaning at or near the site of pain, inflammation, or imbalance)

2). Distal needling (meaning away from the area of pain, inflammation, or imbalance).

 

All acupuncturists learn both categories while earning their degrees, and most continue to learn more techniques after graduation and most often further their education and training in a certain style or lineage. 

 

Dry Needling falls under the category of local needling. This is often the first thing an acupuncturist learns while in school; to look, and feel for trigger points often called AhShi Points which translates as “AHH YES!” tender areas.  Dr. Janet Travell, the developer of the term ‘Dry Needling’ admitted publicly that dry needling is in fact acupuncture, and registered professional acupuncturists practice dry needling as acupuncture therapy, using many methods and criteria to locate trigger points as acupuncture points.

 

Dry Needling is commonly used for musculo-skeletal issues, such as:

 

Knee pain, Plantar Fasciitis, Sciatica, Carpal Tunnel, Tennis Elbow, Headaches, Migraines, Neck/Shoulder Pain, Back Pain, etc.

 

When dry needling is done, the trigger point must be manipulated to release a twitching response, which can often be quite painful for the patient. This twitching gets the muscles to relax and can give short-term pain relief, but does not address the source of the problem, therefore the pain nearly always returns. 

 

Local needling by an acupuncturist is much more comprehensive than just dry needling trigger points. There are specific acu-points beyond the technique of ‘Dry Needling’ that are used by a registered Acupuncturist to elicit a healing response.  These may or may not be considered trigger points, and are learned as part of the comprehensive training an Acupuncturist must learn as part of their rigorous degree. Acupuncturists almost always choose distal points along with local points to address the cause of the pain, or imbalance.  

 

Distal needling is performed, by choosing specific points away from or distal to the pain or imbalance. Distal acu-points exist on standard acupuncture channels, in between channels, and in many microsystems such as Ear acupuncture, Scalp acupuncture, Hand Acupuncture, and Abdominal Acupuncture. Distal Acupuncture works by sending a message to the central nervous system. It tells the brain to increase blood circulation, increase vasodilation, relax tendons, muscles, and ligaments, regulate hormones, and release natural pain-killers such as endorphins, norepinephrine, and enkephalin. Some of these substances are 10-200 times more potent than morphine.

 

The primary advantage of distal needling is that the patient can have nearly instantaneous pain relief, with out having to further aggravate an area that is inflamed. It also allows the patient to move the painful or injured area and test if the acupuncture has successfully reduced the pain. For the most part, distal needling is painless, when compared to dry needling, and since distal needling is training the brain, it is addressing the source of idiopathic pain.

 

Where did the name Dry Needling come from?

 

Dry Needling was first developed in the 1940’s by Medical Doctors’ Janet Travell and David Simons, when they experimented with a technique using hypodermic needles to stimulate or inject trigger points with drugs and substances such as corticosteroids, anelgesics, and saline solution. Janet Travell started using the term Dry Needling for a technique where no substance was injected, in contrast to Wet Needling (an injection of a substance). However Janet Travell noted that hypodermic needles used for acupuncture techniques (Dry Needling) have been used in China since the 1800’s, and standard filiform acupuncture needles have been used in China for over 2000 years.

 

Western based practitioners such as Janet Travell, C. Chan Gunn, Peter Baldry and others recognizing the effectiveness of needling trigger points for myofascial pain relief, began using the term “Dry-Needling” rather than acupuncture to rebrand it using English biomedical terms, as they deemed Chinese Medicine terminology to be ‘mysterious’ and ‘unscientific’.  In 1976, Gunn proposed that “as a first step toward acceptance of acupuncture by the medical profession, it is suggested that a new system of acupuncture locus nomenclature be introduced.” He then started replacing acupuncture with the term dry needling in his publications in 1980, and is probably the formal beginning of dry needling popularity in the West.

 

While the language used in Chinese Medicine may sound strange to people not familiar with the terminology, it is highly sophisticated, and clinically important. Chinese Medicine is Functionally Medicine based and the terminology is used to find complex physiological relationships and functional imbalances.  Conversely, Western Medicine is Anatomically Medicine based, and tends to focus on parts rather than function

Are you suffering with pain? Book online with Dr. R.J. Singer (Chinese Medicine).

References:

Birch S. Trigger Point–Acupuncture Point Correlations Revisited. J Altern Complem Med. 2004; 9(1): 91-103. doi:10.1089/107555303321222973.

Fan AY, Xu J, Li YM. Evidence and Expert Opinions: Drying Needling versus Acupuncture (I). Chin J Integr Med. 2017; 1(In press)

Fan AY, Yang G, Zheng L. Response to Dommerholt and Stanborough re: ‘‘Evidence That Dry Needling Is the Intent to Bypass Regulation to Practice Acupuncture in the United States’’. J Altern Complem Med.2017 DOI: 10.1089/acm.2016.0394 

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