If you’ve ever been treated for an injury or chronic body pain over the past couple decades, then there's a good chance you’ve experienced dry needling, or at the very least you’ve heard of it and considered it as a treatment option. Dry needling is the term that refers to therapeutic needling that doesn’t include blood testing, injections and vaccinations - hence the word ‘dry’. Now of the large many who have had dry needling therapy, some have received it from their acupuncturist, some from their physiotherapist, some from their chiropractor, and others from their sports or athletic therapist. So the question often arises, “what is the difference between each of these professions when it comes to (dry) needling?”.
Dry needling is the umbrella term for the therapy as a whole. Inserting dry needles into the body has several different effects and mechanisms by which it can influence the body back into a state of better health. It’s not as simple as “Oh! It’s sore here. Let’s needle here!” Depending upon the location, depth, techniques and point combinations the needle can elicit many different responses. In terms of modern anatomical systems, dry needling directly influences the nervous system, circulatory system, immune system, endocrine system and muscular system. It can also indirectly influence other systems like the digestive, reproductive, excretory/urinary, endocrine, respiratory, cardiovascular and lymphatic. Proper diagnosis skills are also crucial to an effective dry needle treatment.
Whether a physiotherapist, chiropractor or acupuncturist, there are definitely some similarities in the ways each of them dry needle, as each of these professionals are all still ultimately working with the same thing: the human body. But the difference lies in how far each of these therapists go down the rabbit hole of dry needle therapeutic complexity. Typically the physiotherapist, chiropractor and athletic/sports therapist who dry needles will use the IMS (Intramuscular Stimulation) technique and that's about as far as their therapeutic focus goes. IMS needling works by influencing the muscular system via the nervous system to release tight muscles and activating deficient ones. IMS needling will also trigger some other local area side-effects in circulation, immune and endocrine responses to assist in local recovery. This sort of therapist may also use needles to get circulation to affected areas (e.g. threading the IT bands, needling joint spaces, etc.)
The acupuncturist uses IMS but in addition spends much more time and focus in their education and practice of dry needling, extending their therapy to work not only on the muscles but with the many other systems of the body mentioned above. Acupuncturists also work with aspects of the mind-body that do not quite fall under any one particular anatomical system - aka meridian balancing and spirit-points. Think of an acupuncturist as the dry needling specialist! IMS needling is one technique of many in their arsenal. The acupuncturist also may use techniques that influence the central and peripheral nervous system to optimize signalling habits. The nervous system can have dominion over internal organ health, psycho-emotional health and musculoskeletal health. By strategically sending signals along certain pathways or certain nerve roots/plexuses, the acupuncturist can coax the body back into a natural and self-sufficient level of health and eliminate one or many symptoms along the way. Acupuncturists will also perform techniques to regulate the inflammatory response in the body to eliminate pain and amplify thorough healing.
Lastly, and definitely the most elaborate piece to an acupuncturist that separates them from strictly IMS needlists is their thorough understanding of traditional Chinese diagnostics and its integration into meridian/acupoint functionality. This is the area that provides the greatest amount of confusion and mysticism in the western world around acupuncture and traditional Chinese medicine, but is also the area that has capability of unlocking the greatest benefits in our modern medical innovation as it is closely linked with our embryological development. Subscribe to our HPH blog if you’re interested in more detail regarding this. This blog sole purpose is to help shed light on traditional eastern medical techniques and assist their integration into traditional western healthcare. For the sake of this article we will only be dipping our toes into the area.
Traditional Chinese medical diagnosis goes much deeper than simply describing the symptom or condition. Traditional Chinese medical diagnosis also pays close attention to the general tendency of qi flow in the body as well as the holistic differential diagnosis. It looks at disease from a broader perspective to address deeper root causes including deficiency-based disease and dysfunction. A diagnosis is only as good as its ability to achieve a result and so many different therapeutic approaches will often call for many different complementary diagnostic methods. The meridians are pathways of communication and expression that traverse the body. Many meridians follow acupoints in a connect-the-dots kind of way. Other meridians and meridian branches do not contain acupoints but can be influenced via other acupoints along with the proper understanding of meridian expression.
As meridians are communication pathways it would be silly to not recognize their relationship with the nervous system. Some acupoints correspond with IMS-style motor points, others correspond with highly influential nerve points (highly sensitive and conductive), whereas many others are believed to correspond with nerve endings (nociceptive, proprioceptive, enteroceptive) within the connective tissue (fascia, tendons, ligaments and periosteum). Neurology aside, these meridians express the qi and underlying connection between: mind and body (psychosomatics), internal organ health and the periphery, as well as the pathways that express collections of seemingly unrelated symptoms when broader imbalances arise.
Meridians are very closely tied in with posture and sense of self. Meridian imbalances can become obstructed and store disease patterns making it more difficult for the body to achieve recovery on its own. Emotions stored in the posture can hinder the mind in rationalizing and realizing solutions to its troubles. Meridian blockages can also disturb the organ qi and make it difficult for the organ to self-regulate. The acupuncturist is highly trained in analyzing these subtle imbalances that show within the meridians and using dry needling (more specifically acupuncture) to restore a balance that will help coach the entire being back into a grand holistic balance.
Now with all that being said education is one thing, but the development of your professional dry-needler’s clinical skill is something completely different. It is not as simple as considering all acupuncturists to be superior to all physios and chiros when it comes to dry needling. It is not often but there still are cases where chiropractors, physiotherapists and sport therapists delve in deeper beyond IMS techniques to refine their skill. On the other hand we may also find non-acupuncturists who have become extremely talented in advanced IMS techniques that are on par with a skilled acupuncturist. It’s all about your therapist and the quality of his or her clinical skill and dedication. But one thing’s for sure, when in doubt or looking for a place to start, I always advise you begin your search with an acupuncturist due to their advanced education and its ability to open many doors early on in the advanced refinement of the skill and diverse therapeutic efficacy of dry needling.
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