Talk:Dry needling

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I
I see some tendentious edits being made to this article but no talk here. This won't do so I'm going to be bold and start talking. I am familiar with this matter as a term in UK physiotherapeutic practise and have some understanding of the medical theory behind it. Now we shall examine the sources and start editing the article accordingly. Colonel Warden (talk) 19:04, 10 May 2008 (UTC)

The article was not neutral in its presentation of the controversy. It was clearly slanted to accentuate an argument for distinguishing dry needling from acupuncture. I have attempted to make it more neutral. I am a newbie when it comes to editing wikipedia (as evidenced that I am not even sure that I making this entry correctly) and would prefer help to improve my additions rather than have them removed on purely technical grounds.

In the interests of full disclosure - I am an acupuncturist but coming from the UK I am somewhat more laissez faire in my attitude to professional 'turf wars' that seem to be much more heated in the US. May 30th 2012. — Preceding unsigned comment added by Aaprescott (talk • contribs) 14:44, 30 May 2012 (UTC)

Differences from acupuncture
Fyslee is trying to add a statement like but unlike acupuncture it isn't necessarily associated with a belief in meridians or acupuncture points.. This seems both tendenditious and incorrect. It is not supported by any source and so I shall continue to remove it. Colonel Warden (talk) 14:41, 28 July 2008 (UTC)


 * For a good source on the definition of acupuncture and the diversity of its practise, please see this report which I previously cited in the article. Colonel Warden (talk) 14:47, 28 July 2008 (UTC)


 * You know full well that acupuncture is normally based on a belief in acupuncture points and meridians, while dry needling isn't. What's the problem? Place a citation needed tag, instead of deleting factual and uncontroversial (except to you) information. If you dispute the accuracy of it, then discuss it here instead of edit warring. If you have sources that show that dry needling is usually based on such beliefs, then produce them. We know there are masses of refs that show that acupuncture does so, but that's not the subject here. This is about dry needling, and if it was based on those beliefs, then this would be an improper fork. Then it could just as well be a part of the acupuncture article, but it isn't because of those significant differences.


 * My understanding is that acupuncture is a medical procedure where the skin is pierced with a solid filaform needle in order to stimulate a point. I've also reviewed the research cited in this article that indicates that trigger points and dry needling points correspond with acupuncture points.  It seems that this article is really just an acupuncture stub, or should be included in the acupuncture article.  However, there seems to be some POV editing, filled with weasel words, that is intentionally trying to distance this article from acupuncture.    — Preceding unsigned comment added by CoulterTM (talk • contribs) 21:11, 7 December 2013 (UTC)


 * BTW, I have looked at your source above and wonder what relevance it has to this discussion. It only mentions dry needling once and doesn't address this dispute in any manner. If it does, please point me to the relevant page(s).


 * An interesting comment from a chiropractic source makes my point:


 * "There are similarities, but also very significant differences between the TCM style of acupuncture and dry needling. Acupuncture follows rules and beliefs that have been established since ancient times, whereas dry needling ignores ancient acupuncture philosophy. Most, if not all of TCM, is based on pre-scientific ideas, whereas dry needling is totally based on modern scientific neurophysiology and anatomy. Dry needling is purely for pain relief and based on recent understandings in pain science. There is much less mystique surrounding dry needling for pain abatement." From: When Acupuncture Becomes "Dry Needling"


 * Most sources describe dry needling of trigger points, which are not the same as acupuncture points. I'm improving the article by including this source. -- Fyslee / talk 07:26, 29 July 2008 (UTC)


 * An important source in this discussion, that lays it out convincingly, is Stephen Birch's "On The Impossibility of Trigger Point--Acupoint Equivalence: A Commentary on Peter Dorsher's Ananlysis" in the Journal of Alternative and Complementary Medicine, 14:4 (2008) and his preceding 2003 paper, "Trigger Point--Acupuncture Point Correlations Revisited", vol. 9, no. 1 of the same journal.


 * -- 67.180.51.216 (talk) 10:40, 26 November 2013 (UTC)Jonah Hershowitz


 * Wait, I thought that the whole point of dry needling is that it is based on anatomy rather than meridians? Is the dispute that a practice can still call itself acupuncture without being credulous to all of TCM? - Eldereft (cont.) 09:23, 29 July 2008 (UTC)
 * Something like that. The term acupuncture is certainly used by some therapists who don't follow the Chinese tradition.  We can't be dogmatic or precise about the use of either term because both of them cover a variety of overlapping methods.  The report I cited above, was written to try to make some sense out of the current confusion with a view to guiding regulation and/or self-regulation. YMMV depending upon the jurisdiction as the practise(s) are licensed in some places, I gather.  Colonel Warden (talk) 12:12, 29 July 2008 (UTC)


 * The disputed version has been tagged for some time without improvement. I continue to find it poorly sourced and tendentious.  I have reverted to an earlier version which seems better. Colonel Warden (talk) 14:44, 31 October 2008 (UTC)
 * And I reverted it back, since there is absolutely no consensus for you to do so. Just because no one seems to care about this article, doesn't mean that because you do, you can revert it back to your favorite version.   Orange Marlin  Talk• Contributions 17:23, 31 October 2008 (UTC)

There is consent to change this article. I placed a new link to the ashi points wiki page. Ashi needling has been around for thousands of years. Just because someone puts a little science behind it does not change the technique, what it is trying to accomplish, or it's origin. Let's be realistic here. trying to dupe folks into believing that dry needling is somehow different than acupuncture is simply rediculous. the only thing that is really different is that, in many states (in the US), you need >3000 hours of training to be licensed to perform acupuncture, but if you are a chiropractor, you only need a 100hour certification. —Preceding unsigned comment added by Flobmonster (talk • contribs) 07:13, 19 November 2008 (UTC)

Meridians are based on anatomical relationships, as are many acupoints. ashi points are tender points. they can refer or not. your source for dry needling that I removed is unsubstantiated and written by a chiropractor, which is a conflict of interest. If I were a surgeon and decided I wanted to cut hair under my surgeons license, I can call it razoring and use a razor to do it. It is still a haircut. Hairstylists and barbers have been using razors for a long time. Now it is true that they have different training, but it is easy to see that pretty much no matter how I choose to cut hair, it has been done before. the outcome is the same - shorter hair. in the case of acupuncture and dry needling, the outcome is relief of pain, or THERAPY of any kind. the bit of text I cut is in direct contradiction of the definition that orange marlin provided. &#91;&#91;Flobmonster&#93;&#93; (talk) 21:48, 19 November 2008 (UTC)

The idea the two are similar is downright weird. Tattoos and electrolysis are also done with needles- shall we call them acupuncture as well? Having had both, acupuncture barely punctures the skin, while dry needling involves a needle jammed a solid inch into a muscle. It's like the difference between your grandma patting your shoulder gently and getting worked on for deep tissue massage by a dude who looks like a line backer and pounds the crap out of you. It hurts like a mofo. — Preceding unsigned comment added by 72.48.211.120 (talk) 05:13, 18 March 2016 (UTC)

Recent non-neutral editing
I put in a lot of work last year trying to source this page and edit it to make it neutral. I don't much appreciate the recent POV-warring over whether dry needling is the same as acupuncture or not. Please stop asserting personal opinions and start using secondary reliable sources as the basis for your edits. Stop changing sourced text to read differently, that gives the false impression that the new wording derives from the source rather than being the personal opinion of the editor. Fences &amp;  Windows  19:04, 1 October 2011 (UTC)
 * p.s. I have no dog in this fight by the way. Also, the Oregon ruling is interesting, but a single primary source should not dominate a section (WP:UNDUE). If reliable secondary sources have discussed the ruling, please use them. Don't add your own interpretations or opinions on the ruling. Fences  &amp;  Windows  19:10, 1 October 2011 (UTC)

It is actually not personal opinion given the fact that several state PT and Chiropractic Boards have ruled that dry needling is NOT the same thing as acupuncture and that it is under the scope of practice for PTs and Chiropractors. The very "controversy" had to do with accupuncturists trying to stop them from suceeding. And what I wrote was not opinion but a short version of the what the OBCE and thd Oregon Attorney General wrote in their request for reconsideration (which is not personal but offical state legal opinion.) Compchiro (talk) 19:27, 8 October 2011 (UTC)
 * Aha, here's some local press from January on the OBCE considering whether to allow dry needling. Might be able to work it in. Fences  &amp;  Windows  19:05, 10 October 2011 (UTC)

Controversy needs mention in the lead
The acupuncture / dry needling issue is a major issue surrounding this subject. There should be a more accurate statement in the lead rather than the endorsement that "the rationale is different" - Acupuncturists use trigger point and motor point needling as well as "A shi" needling of painful spots in the muscle, so there is nothing PTs and Chiros do that L.Ac's don't do. Acupuncturists spend 3500 hours training to practice, including 165 just on needling technique and hundreds on orthopedic assessment, physical exam, etc. Dry needling is not just "similar" to acupuncture, it is vastly inferior.Herbxue (talk) 16:12, 24 January 2012 (UTC)

It is just a matter of opinion that MTrPDN is "inferior" to acupuncture let alone "vastly inferior". There is no proof to substantiate that claim. And the so-called controversy is not relevant to the entire subject. PTs and Chiros often spend just as much time in training as acupuncturists do (and not all L Acs have 3500 hours of training.) The simple fact is that the assertion that dry needling is the same as or a subset of acupuncture is a falsehood. (Compchiro (talk) 23:51, 24 January 2012 (UTC))


 * I don't mean that the lead needs to imply that Dry Needling is inferior (that would be inappropriate for an encyclopedia) but really, to suggest that dry needling is not acupuncture is ridiculous. Is there a single technique or assessment method used in dry needling that is not used in acupuncture? Even acupuncturists in China use ortho-assessment and needle areas based on anatomy (independent of channels, and points and theory) when appropriate. How is it different? It really is a blatant co-opting of another profession's methods.


 * Even if I am wrong, the controversy is notable and there is an ongoing fight in several states over this. In IL, PT's are needling people with only 24 hours of training. This is a public safety issue. Therefore, is is an important aspect of the subject that should be mentioned in the lead. Herbxue (talk) 00:22, 25 January 2012 (UTC)


 * The concept that only acupuncture is allowed to or is the sole owner of trigger points is absurd at best. The methodology used was developed exclusive of acupuncture and was tied more to trigger point injections than anything else. Most of the foundational info for dry needling (physiology, trigger points sans needling and the like) are taught as part of the basic and detailed training that PTs and Chiros receive. Dry Needling is simply a tool that a well trained PT or Chiro can learn in 12 to 24 hours if taught by a skilled teacher.  The idea that 12 to 24 hours presents a public safety issue is an invalid one with the proper course.96.231.145.94 (talk) 22:27, 25 January 2012 (UTC)


 * What if I started doing thrusting manipulations of thoracic vertebrae and called it "dural repatterning" and claimed that it was not a chiropractic adjustment because I developed it "exclusive" of chiropractic training and theory?


 * THAT would be absurd, as is pretending that dry needling, which uses acupuncture needles, in use in China for at least 2000 years, is somehow different from acupuncture. It is highly insulting to suggest that acupuncturists are ignorant of trigger points, motor points, and basic muscle physiology. That's their bread and butter, and they are required to do MUCH more training to be allowed to break the skin with needles than 24 hours.


 * I am not suggesting that acupuncturists own trigger points, but needling into muscle to treat pain or other physiological imbalances is the definition of acupuncture.Herbxue (talk) 02:36, 26 January 2012 (UTC)


 * As someone outside the business, I agree about not seeing a meaningful distinction between dry needling and acupuncture. Based on simple human nature, it seems more likely that it's a truthier repackaging of acupuncture to get buy-in from consumers.  We've seen this before, with the repackaging of creationism as intelligent design.  So for me, dry needling has a steep hill to climb, to convince me.  I need to see multiple peer-reviewed double-blind studies showing that it works significantly better than acupuncture/placebo. 24.57.218.21 (talk) 23:02, 14 February 2013 (UTC)

External links modified
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almost all unsourced
The following is almost all unsourced and was moved here per WP:PRESERVE. Per WP:BURDEN please do not restore without finding independent, reliable sources, checking the content against them, and citing them, and ensuring that this content has appropriate WP:WEIGHT in the article overall.


 * Practice ==

Dry needling is taught to and practiced around the world by some Doctors of Medicine and Doctors of Osteopathic Medicine and physical therapists, as well as alternative medicine practitioners such as Acupuncturists, Chiropractors, Naturopathss. When practiced by a scientific medicine practitioner, it is typically part of integrative medicine and is currently not recommended within the standard of care for medical treatment of pain within the United States.

In the United States of America, dry needling and acupuncture are included in the scope of practice of Doctors of Medicine, Doctors of Osteopathic Medicine, acupuncturists, and in some states chiropractors and naturopaths. Most states allow chiropractors to practice dry needling if needle use (including but not limited to acupuncture) was already included their scope of practice in that state. Some of these states and others have a rule specifically in favor of Chiropractic using dry needling techniques. Other states have ruled that chiropractors cannot practice dry needling. Many states allow physical therapists to perform dry needling, but not acupuncture.

The largest growth in practitioners of dry needling, as a specific technique, in recent years has been among physical therapists. When the Physical Therapy Boards of many states declared that dry needling was already included in their scope of practice, many states had no regulation of dry needling as distinct from acupuncture or trigger point injections allowed by Physicians. Many states have reviewed this stance and allowed Physical Therapists to continue the practice, some have prohibited this technique, and some still have no regulation.

Physical therapists practice in many countries, including South Africa, India, Bangladesh, the Netherlands, Spain, Switzerland, Canada, Chile, Ireland, the United Kingdom, Australia and New Zealand.

In the United States of America, physical therapists in most states perform the technique. Physical therapists are prohibited from penetrating the skin or specifically from practicing dry needling in California, Hawaii, New York, and Florida, though many states have no regulations on dry needling. The Oregon Board of Appeals ruled in January 2014 that the Oregon Board of Chiropractic Examiners did not have the statutory right to determine this in their scope of practice. But the Court made no ruling that chiropractors do not have the training needed to perform dry needling. Additionally, chiropractors are legally allowed to practice dry needling in many US states, as well as in many countries. There are however no established guidelines for the frequency a patient can receive dry needling for a specific location. Therefore, more research is needed to develop a set of safety guidelines.

-- Jytdog (talk) 02:12, 4 January 2018 (UTC)


 * I'm adding the last paragraph of the lead to this section. Frankly I'm not sure it belongs in the article at all, at least not written as an unsourced piece that reads like an opinion.
 * "Chinese style tendinomuscular acupuncture relies on careful palpation of what are called "Ah Shi" points, which often correspond to both trigger points and/or motor points in the myofascial tissue. Chinese style tendinomuscular acupuncture tends to use lower gauge (thicker) needles necessary for puncturing contraction knots with a high degree of precision. On the other hand, lighter styles of acupuncture, such as Japanese style, and many American styles, may tend towards very shallow insertions of higher gauge (thinner) needles. Most acupuncture styles, especially those with lighter techniques, require a detailed knowledge, not only of anatomy but also of the channel networks and connections. Thus, while some forms of acupuncture are not at all the same as dry needling, the term dry needling can refer quite specifically to what is now called Myofascial Acupuncture, Tendinomuscular Acupuncture, or some version of Sports Acupuncture."
 * Rap Chart Mike (talk) 13:29, 3 August 2018 (UTC)

False references
Several of the references - since removed - were to pages of the Federal Register dealing with regulation of medical devices, having nothing to do with the text supposedly being supported by those references. Text left intact, but now needs valid references. David notMD (talk) 11:28, 23 March 2019 (UTC)

Text not matching ref
This paragraph was removed from the Efficacy section because the ref - a 2014 review - did not match the text content, which identified a 2017 systematic revuew. Consider returning to article in some form if correct ref can be located. David notMD (talk) 13:34, 21 March 2019 (UTC)

A 2017 systematic review on dry needling effectiveness over a wide range of body regions reported positive impacts from dry needling on a wide array of body regions. The aim of this review was to determine how effective trigger point dry needling was based on high-quality randomized control trials for all body areas rather than a specific location. After quality control, the researchers collated 19 studies that met inclusion criteria for this review. This systematic review concluded trigger point dry needling to be an effective treatment for pain associated with trigger points along the whole body; the method is claimed by Boyles et al. that more effective than electrical nerve stimulation and stretching, and trigger point dry needling to be at least as effective as manual trigger point release. Trigger point dry needling was deemed effective in the temporomandibular joint, cervical spine and shoulder, lumbar spine, and lower extremities. The systematic review concludes that future studies should isolate and test specific interest variables.

Origin of “dry needling”
The opening statement under ‘origin’ is confusing since other documented sources contradicts published wiki information. I’ve attempted to update however I have been asked to open a discussion first since it is a major change to what’s currently written. Changing this section would very likely require more editing throughout this section.

This is what I wrote:

“Dry needling” (干针, gan zhen in Chinese pin yin) has been used interchangeably with the term acupuncture (针 zhen in Chinese pin yin) since at least as early as the 19th Century when Western medicine and the hypodermic needle were introduced in China, and the term was created to differentiate acupuncture methods from the use of hypodermic needles in Chinese hospitals. Subsequently the use of the term “dry needling” amongst acupuncturists, particularly in China, has a broader scope of indications and is not limited to treating only musculoskeletal disorders such as myofascial pain.

I also added a quote from Travell’s book to the second paragraph of the section attributing the recent revival of “dry needling” to Travell. In the quote Travell states acupuncture as performed by acupuncturists is in fact dry needling of trigger points (TrPs). With the added quote from Travell, this paragraph would read as:

More recently, “dry needling” is attributed to Janet G. Travell. In her book, Myofascial Pain and Dysfunction: Trigger Point Manual, Travell uses the term "dry needling" to differentiate between two hypodermic needle techniques when performing trigger point therapy. However, Travell did not elaborate on the details on the techniques of dry needling; the current techniques of dry needling were based on the traditional and western medical acupuncture. Travell states, “Many practitioners of acupuncture use TrP [trigger point] criteria to locate pain acupuncture points and, in fact, are successfully performing dry needling of TrPs [trigger points] that they speak of as acupuncture therapy.”

Let’s discuss! Thanks R.L. Mendez (talk) 16:01, 1 August 2019 (UTC)