Dry needling, trigger points or Chinese acupuncture?
This short article is inspired by one of the patients I had this week. He told me that in the past he visited a physiotherapist and that she performed some form of needling called “dry needling”… My patient, seeing that I was needling his hand for shoulder pain, asked me; “what’s the difference between dry needling, and Chinese acupuncture?”
Before giving a direct answer, I think it is worthwhile to take a look at each concept separately:
Dry Needling
According to Cleveland Clinic “Dry needling is a treatment that healthcare providers use for pain and movement issues associated with myofascial trigger points. With this technique, a provider inserts thin needles into or near your trigger points. The needles stimulate your muscles, which causes them to contract or twitch. This helps relieve pain and improve your range of motion. These myofascial trigger points are identified through palpation.”
It is interesting to notice that dry needling and Chinese acupuncture use solid needles that, of course, do not contain any kind of medication. This is why the technique is called “dry”, as nothing is injected into your body. Trigger point injections are different; they do contain a type of medicine and are only performed by medical doctors.
So, you may now wonder, what’s a ‘Trigger Point’? Is this the same as an acupuncture point?
Trigger Point
Well… Yes and no. Trigger points are knotted, tender areas that develop in your muscles. They are highly sensitive and can be painful when touched. Sometimes, a trigger point may be near the location of your pain, but they’re also often the cause of referred pain. Referred pain is pain that affects another part of your body.
Chinese Acupuncture
Acupuncture is a treatment therapy.
It involves the insertion of extremely fine solid needles into the body.
These needles are placed at strategic points for therapeutic purposes. It has been practiced for thousands of years in China and other Asian countries and according to Eastern medicine traditions, acupuncture treatments stimulate the body’s own natural healing processes by balancing and unblocking obstructions in the body and re-establishing the optimal flow of Qi (energy) and blood circulation. Acupuncture is one the main 4 therapies of Chinese Medicine along with herbal therapy, TuiNa massage and QiGong.
So, with each separate definition, we can now say that dry needling or trigger point therapy, as it is sometimes called, is usually performed by physiotherapists or osteopaths and is based on Western medical thinking. The research on the so-called ‘trigger points’, started like 500 years ago and in 1950 Travell and Rinzler coined the term “myofascial trigger point”, reflecting their finding that the nodules can be present and refer pain to both muscle and overlying fascia.
On the other hand, Chinese acupuncture belongs to Traditional Chinese Medicine…
One of the aims of Chinese Medicine is to look at the whole person and bring it back to balance. Acupuncture not only works for musculoskeletal pain, but also for digestive, gynecological, respiratory, cardiovascular issues and more.
We always look at the whole person when making the diagnosis: sleep, digestion, appetite, evacuation, diet, posture, emotions and other signs and symptoms. Based on an in-depth analysis we then come up with a personalized diagnosis and a treatment principle, which is essentially the shift we want to generate for this particular person.
Then, after all this process, we decide the treatment plan and which acupuncture points are best to achieve those results. We may also prescribe certain foods or herbs, lifestyle changes and even specific exercises.
As you can see, Chinese acupuncture is part of a very deep ancient medicine, which is not limited to the treatment of pain. Even though the term Trigger Point can be sometimes elusive, some people agree that those points (and Motor Points as well) were already contained in Chinese Medicine and called “a-shi points”, translated as “that’s the point” or sometimes as another expletive, which indicates pain upon palpation of the tissue.
Chinese Medicine, as a holistic therapy, does not limit the treatment to needling the painful area, but often the treatment can involve needles far from the painful area, improving circulation of blood, fluids, and energy as an attempt to restore whole body balance.
Of course releasing a muscle can be very effective and relaxing, and that’s why Chinese Medicine practitioners often study the location of these particular points and often needle these points as well, but as I said before, this is just a small percentage of what this great medicine can offer.
I really hope you find this article useful and enlightening. As always, I wrote my articles as “patient’s notes”, hopefully bringing some light into these different and similar concepts, to empower you to choose the best options available, and the treatment that suits your needs best.
References:
https://www.mayoclinic.org/diseases-conditions/myofascial-pain-syndrome/symptoms-causes/syc-20375444
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508225/
https://www.pacificcollege.edu/news/blog/2019/07/26/diagnostic-ashi-points-a-focus-on-muscle-motor-points photo credit Katherine Hanlon from Unsplash.com/@tinymountain