Acupuncture Vs. Dry Needling

What is the difference between Acupuncture vs. Dry Needling, is it the fascia?

The most common question we get is “What is the difference between Acupuncture and Dry Needling”? We also field frequent aversion to the idea of needles. Even our biggest fans, still often have questions about how the needles work. At Structural Elements®, we focus on balancing the structures of the body.  We believe that the site of pain is often the result of a structural imbalance or Wobble”.  In past articles we have talked about the concept of Neutral Horizon”, eyes and ears level. If a patient has a “Wobble” they must compensate to achieve “Neutral Horizon”. It is this compensation that causes change to the connective tissue. The change occurs between muscle layers along the intramuscular septa. The change is a thickening of the connective tissue by adding more collagen, forming a “Focal Adhesion”. At Structural Elements®, we use needles to release “Focal Adhesions” found between muscle layers that formed as a compensation to a structural imbalance in efforts to achieve “Neutral Horizon”.

There is much controversy between Licensed Acupuncturists, who do Acupuncture and Physical Therapists who do Dry Needling. In both professions therapists are using “Dry Needles”, opposed to a hypodermic needle that is used to inject liquid. In both professions these “Dry Needles” are “Acupuncture Needles”. The reason for using needles to puncture the skin can vary greatly. Most Physical Therapists use needles to facilitate a contraction/ relaxation response from a muscle in spasm. They do so by needling at the neuro-muscular junction, where the nerve enters the muscle body.  Many Acupuncturists will needle these same points for musculo-skeletal pain. It is our opinion that Acupuncture and Dry Needling are the exact same. It is also our opinion that it should be included in the scope of practice for both Licensed Acupuncturists and Physical Therapists. Where we feel that this debate has gotten off track, is that Acupuncture is not synonymous with the practice of Traditional Chinese Medicine. Acupuncture, regardless of the reason, is simply the use of small, solid, dry needles to puncture the skin. At Structural Elements®, we treat structural imbalances and part of that treatment is the use of needles. The same process is used regardless of the license of the therapist. Our Physical Therapists offer the same treatment as our Licensed Acupuncturist. Our Physical Therapists are not practicing Traditional Chinese Medicine, nor is our Acupuncturist. They both are treating structural imbalances, and part of that treatment is the use of needles.

There is another major difference! Seldom are we using these needles to release tight muscles by achieving this contraction/ relaxation response from needling at the neuro-muscular junction. We place the needles at the site of “Focal Adhesions”, where the connective tissue has thickened to correct a “Wobble”. It’s not the poke of the needle that makes the difference, it’s the twist. Think of a fork in a plate of spaghetti, when the needle is rotated the fibers of collagen wind around the shaft of the needle. It is this mechanical coupling of the connective tissue to the shaft of the needle that has a therapeutic effect. Suspended in this connective tissue are small connective tissue cells called Fibroblasts. These cells like to be nice and round with equal pressure on the cell membrane. When the connective tissue is wound around the needle and the fibroblast gets stretched, it responds with a chemical secretion. It is this chemical reaction that causes the connective tissue to relax, and literally dissolve the “Focal Adhesion”. Many patients who have had traditional dry needling have experienced it as a painful process. Our patients have a different experience, because we are treating “Focal Adhesions” vs. needling at the neuro-muscular junction. Once these adhesions are released, the body is far more relaxed and achieving structural balance can be done using less force. Also, because these adhesions have been released, the changes to a patient’s structure will hold much longer. The process is quite simple and relaxing.  

Douglas Bertram, L.Ac.


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