Although the practice of Dry Needling (DN) began to develop in the US in the 1940s, it was not until acupuncture made its way to North America in the 1970s that significant interest in DN took hold. Dry Needling is defined as the insertion of needles into tender points in the body without the injection of substances. Typically, DN is used to treat musculoskeletal disorders, especially myofascial pain. The technique revolves around the identification of tender points (trigger points) in the body.
The perceived correlation between acupuncture and DN is a source of disagreement, especially in the United States, where the practices of acupuncture and DN rarely converge. While those practicing DN maintain that the practice was developed in isolation from acupuncture, those who practice acupuncture believe that traditional acupuncture encompasses all dry needle insertion techniques. In Canada, however, practitioners have been fortunate to avoid this controversy because of the long history of training and certification of physiotherapists in neuroanatomical acupuncture, as developed by Dr. Joseph Wong. The freedom to practice both techniques opens up important possibilities for treatment that would otherwise be unavailable.
Christene Misener (B. Sc., B. Sc.PT, FCAMPT, CAFCI), practices both techniques. She often uses acupuncture and DN in the same treatment and finds that the two techniques complement each other very well. She explains that with limited health group benefits, patients are often looking for fast results, which is where DN can be especially effective. She uses DN specifically for stiff muscles with trigger points: it helps get rid of the referred pain pattern her patients feel and improves strength and range of motion immediately. In these cases, patients are very pleased with the quick results.
While there are many conditions that DN cannot treat alone, a combination of DN and acupuncture techniques can produce excellent results. Christene finds that DN will not treat nerve issues, widespread inflammation, severe pain, or tendonitis. When she encounters a patient with very acute swelling and pain, she uses acupuncture. She explains that chronic conditions need energy and deeper meridian points, making them more responsive to acupuncture. However, if she has a chronic tendonopathy in the shoulder, for example, she will do dry needling on the trigger points that have developed due to the chronicity, muscle shortening and stiffness, and then do acupuncture for the local and referred pain and for the tendons.
To summarize, Christene uses dry needling specifically to help a muscle that is causing referred pain due to trigger points. This muscle is usually stiff and weak. She stresses that it is a modality:
I always correct the problem with education and exercises to resolve the muscle imbalance. I use acupuncture for systemic work such as swelling, pain and especially for nerve issues. Acupuncture is the best for treating a nerve locally and distally. It treats the entire system, so it is more widespread. This is great for chronic conditions. And not everyone can tolerate the discomfort of dry needling, so if my patients refuse dry needling, they will usually let me do acupuncture to the muscle, nerve and tendon points instead. I still get good results. Acupuncture will not reduce a trigger point, but it can still do everything else and is more comfortable.
It is evident that a combination of both modalities, as well as proper education and exercise, are the best solution. Ultimately, utilizing knowledge from a range of sources is for the betterment of our patients.
Acupuncture Canada’s Dry Needling program is being offered in Halifax, Vancouver and Toronto in spring 2019. You can find details about the courses and schedules on our website.