Physical Therapy

Dry Needling vs Acupuncture

Published October 26, 2020
By Health Loft

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What is the Difference Between Dry Needling and Acupuncture?

Chances are you have heard about acupuncture and dry needling. These two techniques are often thought to be similar, however, each one is distinctly different. In fact, they have more differences than similarities.

What is acupuncture?

Acupuncture is a traditional Chinese medicine, based on the meridian theory that involves inserting thin needles into specific areas of the body. According to meridian theory, there are acupoints in the body to stimulate and activate different organ systems. Researchers have tried to determine the anatomical source of these acupoints but have not come to an agreement. Despite the lack of understanding of how acupuncture works, it has been shown to be effective for treating multiple conditions.2

What is dry needling?

Dry needling, applied by physical therapists uses a thin needle inserted into trigger points “for the management of neuromusculoskeletal pain and movement impairments”.3 Trigger points are commonly known as muscle knots which can cause pain and limit a muscle’s ability to function properly. Dry needling is performed as part of a comprehensive physical therapy treatment plan that is developed following a thorough examination based on human anatomy and how the musculoskeletal system works.

Differences Between the Two

  1. Acupuncture and dry needling have different theories.

As mentioned above, acupuncture is based on meridian theory. Dry needling, on the other hand, is based on a hands-on musculoskeletal exam and the understanding that a muscle can refer pain to multiple locations (grounded on the work of Travell, Simons and Simons). An active trigger point in the muscle can be palpated to determine if it is a source of the person’s pain. In acupuncture, the acupoints are based on meridian lines and may not change the person’s symptoms upon palpation.

  • Acupuncture and dry needling treat different conditions. 

While both acupuncture and dry needling can be used to treat pain, acupuncture can also be used to treat fertility, hot flashes, and anxiety, among other conditions. Additionally, dry needling can be used to increase a person’s range of motion.

  • Training and certification are different.

In the United States, acupuncturists are licensed and board-certified with the National Certification Commission for Acupuncture and Oriental Medicine. To become certified, an acupuncturist must complete a master’s level degree in acupuncture or oriental medicine. For a physical therapist to dry needle, they must first have a physical therapy license and have completed postgraduate training in dry needling. To be eligible for a physical therapy license, they must obtain a doctorate in physical therapy from a certified physical therapy program and pass the National Physical Therapy Exam.

  • Treatment plans for acupuncture and dry needling differ.

Acupuncture is frequently thought of as a stand-alone treatment (you get acupuncture and acupuncture alone) developed and implemented by an acupuncturist. Dry needling is a component of a larger treatment plan developed and implemented by a physical therapist. Physical therapy treatment plans may also include strengthening, stretching, joint mobilizations, patient education, manual therapy (ex. Active release techniques), and aerobic exercise and are individualized to a patient’s needs.

Benefits of Dry Needling

Reduction in pain is the main benefit of dry needling. Studies have shown that the effects of dry needling on pain relief can be immediate and can last up to 12 months. There has also been research to show that dry needling decreases a person’s pain pressure threshold, meaning it can decrease how sensitive a person is to feeling pain when pressure is applied to the skin.4 Dry needling can be effective for treating pain related to multiple diagnosis, including radiculopathies, disc pathologies, tendonitis, carpal tunnel syndrome, headaches, pelvic pain and many others.3 In addition, dry needling can improve range of motion that is restricted due to tight muscles or scar tissue.

Different Dry Needling Techniques

Dry needling involves a thin needle penetrating the skin and muscle tissue to reduce pain or increase range of motion. However, there are different techniques for a physical therapist to choose from in order to best treat their patient.

  1. Deep Dry Needling.

This technique involves the needle going into the trigger point of the muscle with the goal of making the muscle twitch. The needle can be manipulated while it is inserted to elicit multiple muscle twitches. This technique is normally continued in one treatment session until the muscle no longer has twitch responses, there is a noticeable decrease in muscle tension, or the patient’s tolerance to the technique changes.

  1. Superficial Dry Needling.

With superficial dry needling, the needle is placed in the same muscle as the trigger point but not directly in the trigger point. The needle is typically left in the muscle for 30 seconds to 2 minutes then removed and the trigger point is reassessed for tenderness. This technique can be repeated in the same muscle or surrounding muscles within the same treatment session.

  1. Dry Needling with Electrical Stimulation.

Two needles, one on each side of the trigger point, are used simultaneously during this technique with electrodes hooked up to each needle. Different electrical frequencies can be used to prompt the release of certain endorphins and chemicals within the body.

How many sessions of dry needling do you need?

Dry needling can be performed on multiple muscles and repeated in the same muscle within one treatment session. However, it may be necessary for dry needling to be performed over multiple sessions. While it is impossible to determine the exact number of sessions an individual will need without a thorough examination by a physiotherapist, benefits of dry needling should be noticed within 1-2 sessions.  Note, it is uncommon a person will need more than 5-6 sessions of dry needling in the same muscle group.

As mentioned above, dry needling is only a component of a comprehensive physical therapy treatment plan. The first step to determine if you are a good candidate for dry needling is to schedule a physical therapy examination with a licensed physical therapist.

If you’re looking for dry needling in Chicago, consult with one of our physical therapists (virtually via our telehealth platform or in person) by calling us at (312) 374-5399 or by scheduling an appointment online. If you have further questions regarding dry needling, we would also be happy to answer them.  Remember to also check out our Facebook, Instagram, and Twitter pages for more fun facts and articles on nutrition, physical therapy, and exercise!

Submitted by Kellie Stickler 
Edited by Alexander Franz 
Reviewed by James Caginalp PT, DPT, CSCS, CES, PES


  1. Zhou, W. & Benharash, P. (2014). Effects and mechanisms of acupuncture based on the principle of meridians. Journal of Acupuncture and Meridian Studies, 7(4): 190-193. doi: 10.1016/j.jams.2014.02.007.
  2. Mallory, M.J., Do, A., Bublitz, S.E., Veleber, S.J., Bauer, B.A. & Bhagra, A. (2016). Puncturing the myths of acupuncture. Journal of Integrative Medicine, 14(5):311-314. doi: 10.1016/S2095-4964(16)60269-8.
  3. American Physical Therapy Association. (2013). Description of dry needling in clinical practice: An educational resource paper. http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/
  4. Gattie, E., Cleland, J.A. & Snodgrass, S. (2017). The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: A systematic review and meta-analysis. Journal of Orthopedic and Sports Physical Therapy, 47(3): 133-149. doi: 10.2519/jospt.2017.7096.


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