If you’re looking into pain relief treatments, chances are you’ve come across dry needling and acupuncture.
Here’s what you should know: Technically, both practices are doing the technique typically called “dry needling”, but the approach used is going to be different depending on what type of practitioner you go to.
Both use thin needles, and both are beneficial for reducing pain and improving function. However, it is important to realize that the type of dry needling treatment you need for your specific issue will dictate which type of dry needling treatment you should seek in that instance (musculoskeletal dry needling vs. acupuncture).
Whether you’re dealing with muscle tightness, chronic pain, or recovery after injury, it’s important to understand what makes one dry needling session different from another, and what practitioner you should see for your particular condition.
What is Dry Needling?
Dry needling performed by a physical therapist uses a filament needle to treat muscle and fascial restrictions, pain, joint stiffness, and inflammation due to mechanical or postural deficits in the body. The name comes from the fact that there’s no medication in the needle—it’s “dry”, as opposed to a trigger point injection, which would be a “wet” technique.
Dry needling often works well for:
- Muscle spasms
- Joint pain
- Limited range of motion
- Sports injuries
- Tension headaches
- Chronic pain
- Tendonitis
- Bursitis
- Arthritis
You might feel a deep ache or twitch when the needle hits a trigger point. That’s completely normal and is usually a sign your muscle is reacting. Unlike acupuncture, dry needling focuses on structures in the muscles and fascia rather than energy flow or meridians.
Dry needling clinicians are trained to address movement deficits in the body that correlate to the mechanical factors that led to your injury or breakdown in the first place. We look for physiologic connections between how the muscles are activating, what nerves might be compressed, and what joints might need opening. Then, we use our application of dry needling to facilitate these changes. We always follow this up with exercises and education on how to reinforce better movement, muscle activation, and function in your body, so your symptoms get resolved for good.
What Is Acupuncture?
Acupuncture, in essence, is a type of dry needling that focuses its approach on a component of Traditional Chinese Medicine (TCM). Practitioners insert very thin needles into specific points on the body to promote balance and improve the body’s energy flow, referred to as “qi” (pronounced “chee”). Acupuncture is often used to address:
- Chronic pain
- Stress and anxiety
- Digestive issues
- Headaches and migraines
- Hormonal imbalances
Acupuncturists do also treat the muscles and fascia in the body; however, their training is not as comprehensive in the mechanical, underlying factors in your body’s biomechanics as it relates to your muscles, bones, joints, and tendons.
One thing to note, however, is that some acupuncturists do have additional training in the Musculoskeletal System, so there are acupuncture practitioners who specialize in sports or athletic injuries. These practitioners will be better suited than the average acupuncturist for treatment of a muscle, tendon, joint, or bone issue, but do not usually have the same extent of training that a physical therapist has on the Musculoskeletal System, especially how it relates to movement and performance.
On the flip side, a physical therapist using dry needling may offer some insight into dietary needs related to healing and recovery (such as eating enough protein and drinking enough water), but they are not usually as well educated as a TCM specialist in the many other factors that can be addressed related to healing, such as incorporating the use of herbal supplements and/or other supplemental support.
As a physical therapist who is not TCM trained, I am limited even in my ability to fully express a TCM specialist’s ability to address many different factors in a patient’s recovery.
How Dry Needling and Acupuncture Compare
While both dry needling and acupuncture use thin needles, they differ in purpose, technique, and training. Here’s a side-by-side look to help you understand how they compare.
| Feature | Dry Needling | Acupuncture |
| Based On | Western Medicine | Traditional Chinese Medicine |
| Primary goal | Release muscle trigger points | Restore energy flow (qi) |
| Practitioners | Physical therapists/chiropractors (with training) | Licensed acupuncturists |
| Focus | Muscle, tendons, nerves, and fascial tissue | Meridians, energy balance |
| Common uses | Musculoskeletal pain and injuries, and performance | Pain, stress, systemic imbalances |
| Sensation during treatment | Muscle twitch or dull ache | Mild tingling or light pressure |
| Treatment approach | Targeted to specific muscles but linked to the entire kinetic chain and holistic from a mechanical perspective | Holistic and energy-focused, but in general less focused on the mechanical points of breakdown in the muscles, joints, tendons. |
| Other components of treatment | Paired with movement testing and exercises to reinforce restored movement within each session. | Paired with herbal supplemental guidance and/or other TCM tools. |
Which One Works Better For You?
That depends on what you’re dealing with.
If your issue really is a “musculoskeletal” injury, dry needling with a physical therapist might be your first stopping point. If you have tight, knotted muscles, pain after physical activity, or limited movement, treatment with a physical therapist will help release the specific areas causing the problem and address the underlying mechanical deficits contributing to the breakdown in your body. Think of it as a focused approach. A physical therapist will look for the exact source of pain and treat it directly.
If your pain seems linked to stress, sleep issues, digestive concerns, or more generalized symptoms, acupuncture can potentially address these issues more directly.
Most people can benefit from both simultaneously. Most of us who have muscle, joint, nerve ,and tendon symptoms ALSO have underlying inflammatory and systemic issues that are contributing to the mechanical breakdown. So if you work with both, you’ll likely get better even faster.
Is Dry Needling Legal in PA, and Who Can Perform It?
Here’s the bottom line with practice act laws in PA related to dry needling by a physical therapist.
Dry Needling is within our scope of practice. In Pennsylvania, it is not formally written in the practice act (yet), just as cupping, Instrumented Assisted Soft Tissue Mobilization (scraping), and many other manual techniques are not formally written in the practice act.
Dry Needling is formally written in 38 out of the 50 states in the US. The legal landscape of performing a skill like dry needling in a state that does not have any formal language in it to approve or deny its inclusion is as follows:
- It is up to the physical therapist to interpret if their dry needling practice is in accordance with their state’s practice act, ensuring they are following the outlined standards related to their scope of practice (treating the Neuromusculoskeletal System).
- The physical therapist must be able to prove they are formally and officially trained on all the techniques they are using (certifications and advanced training in dry needling, for instance).
Essentially, a physical therapist performing dry needling should be sure they are using the tool in the scope of their physical therapy education and training.
In a similar vein, an acupuncturist performing dry needling should do so within their “scope” of training.
One Last thing to note is that I personally have reviewed all of this information with the State Board of Physical Therapists in PA, and have been specifically approved to continue with dry needling in my practice. The Board reviewed my education and training and how they related to how I utilize dry needling with my patients (within my scope).
Acupuncturists, on the other hand, follow a very different regulatory system. An acupuncturist’s scope is governed by the Acupuncture Board. Their standards for how they are legally allowed to practice differ from a physical therapist’s because our governing bodies are different.
They must hold a license in acupuncture through the Pennsylvania State Board of Medicine and meet certification standards.
So while both disciplines use thin needles, the intention, method, and who you should seek for your particular issue will vary depending on the type of injury/symptom you are having and the desired outcome or goal you have.
What to Expect from Dry Needling at a Physical Therapy Clinic
If it’s your first time considering dry needling, you might not know what to expect. Here’s a quick look:
- Your physical therapist will assess your movement to see how it relates to your pain.
- They’ll identify tight muscles or muscles that are not activating properly to support your body and its posture.
- Sterile, single-use filament needles are inserted at the targeted areas to stimulate a change in your body
- You may feel a brief muscle twitch or dull ache
- Your therapist will recheck your range of motion to make sure they got the intended response.
- We will usually see movement changes right away, but you should expect on average 4-6 sessions to see the carryover and retention of gains between sessions.
Remember, Dry needling is often just one part of a broader treatment plan. Your physical therapist will combine it with stretching, strengthening, and other manual therapy to give you the best chance at long-term relief.
Still Not Sure? Let’s Talk!
Muscle pain and injuries can be frustrating and sometimes feel like they’re running your life. Whether you lean toward dry needling, acupuncture, or aren’t sure yet, the most important next step is talking to someone who listens and who knows what they’re doing.
At Primal Physical Therapy, our founder and top physical therapist, Dr. JJ Thomas DPT, CMTPT, FDNS, not only specializes in dry needling, she literally “wrote the book” of standards for practice for physical therapists. She and the rest of our team will take the time to understand your symptoms, your goals, and what’s keeping you from living comfortably. We’re here to help you move better and feel like yourself again.
If you’re curious whether dry needling is right for you, reach out to schedule a conversation.
