Dry Needling v. Acupuncture
The short answer is: both use the same tool, but for different purposes, guided by different reasoning, philosophies, and clinical approaches.
The longer answer:
Let’s start with some brief history. Acupuncture is a school of thought and a therapeutic system within the broader framework of Traditional Chinese Medicine (TCM). It has been practiced for over 2,000 years. Dry needling, as we know it today, originates from the work of Karel Lewit, a Czechoslovakian neurologist, in the 1980s. Lewit originally used subcutaneous injection needles, which are much wider than modern dry needles and have a hollow channel for injecting substances. Think of the needles used for shots or childhood vaccines versus something thinner than a sewing needle.
Lewit’s use of needles focused on producing analgesic effects without pharmaceutical analgesics. Combined with the work of Janet Travell, an American physician who mapped trigger points and muscle referral patterns (where pain is felt in an area different from the source), dry needling emerged as a tool for addressing muscle pain. This differs significantly from acupuncture, whose goal is to balance life energy. A 2,000-year gap and the contrast between East Asian culture and Western medical science naturally create substantial differences.
There are two main similarities:
Both use thin, dry (non-injectable) needles.
Both aim to support a person’s health.
However, even the second point gets complicated, because in TCM, “health” encompasses mind, body, and spirit, whereas in Western medicine it refers to physiological function and tissue homeostasis.
The purpose of the intervention determines everything that comes before it, especially the evaluation and assessment. In TCM, the assessment is holistic and non-physiologic, examining mind, body, and spirit to evaluate the quality and balance of life energy (qi). A clinician who uses dry needling performs a physical exam aimed at determining whether a specific muscle or tissue is appropriate to treat with a needle. Dry needling is applied to anatomically defined structures based on dysfunction, neuroanatomy, and the clinician’s physical assessment.
One nuance: acupuncture can include techniques that influence muscles as well. In that sense, dry needling overlaps with only one aspect of acupuncture. But in TCM, muscle needling is rarely the first-line intervention for muscle pain or tension. TCM has many tools, and practitioners generally ask why the body responded a certain way before simply needling the area.
A brief caveat: Acupuncture also relies on the Meridian system, channels through which qi flows. This is what acupuncture seeks to influence. There is no scientific evidence that Meridians exist as physical structures. Some research notes possible overlap with the nervous or lymphatic systems. While science isn’t the sole measure of truth, it’s fair to say acupuncture principles are not empirically validated in the same way Western anatomy is. Some of these ideas may reflect higher-order concepts we cannot currently measure.
We could go much deeper into the differences between the two. Ultimately, both can produce similar effects. The strongest predictor of your outcome is your relationship with the practitioner, whether they are an acupuncturist, chiropractor, physical therapist, or another clinician. After that, it comes down to your personal preferences and which interventions best support your condition. Some people prefer teas, supplements, exercise, technology-based treatments, short visits, longer relaxation-focused sessions, or other styles of care.
