Acupuncture and dry needling are hot topics in the media these days. The attention is warranted with the results that both techniques boast regarding pain relief and overall health. If you're confused about what the difference is and when you should seek out these treatments, keep reading and you will get all the information you need!
What is the Difference Between Dry Needling and Acupuncture?
Dry needling is called that because needles are put into the muscle, but they do not inject anything, so it is considered dry.
Dry needling uses the same style of needles as acupuncture, but there is a strong stimulation to the muscle to try to get it to relax and release the tension which is usually causing pain for the patient.
This strong stimulation can be painful but not always. Needles are inserted through the skin to touch the myofascial trigger points under the skin as well as the muscle and connective tissues like ligaments and tendons. Without getting too technical, the needle elicits a pain response from the tissues and essentially shuts down the pain pathway after treatment.
Adverse reactions to dry needling can include bleeding, bruising and pain. However, per a study done by the International Journal of Sports Physical Therapy, there is less than a 0.1% chance of adverse reactions to this treatment.
Acupuncture is gentler with less stimulation to the muscle. Generally, it is not a painful procedure. Acupuncture is a traditional eastern medicine intervention.
It uses the same type of needles as dry needling but are inserted only into the skin. Those needles are placed in certain areas and locations on the body as guided by traditional Chinese medicine.
This is based on the concept of "qi" which addresses pain and other issues with energy housed within the body. This technique is usually used to treat pain but has always been used for mental health and infertility as well.
Adverse reactions to acupuncture include pain, bleeding, bruising as well as dizziness or skin rash. These are similar to the adverse reactions from dry needling.
Both techniques come with more severe risks including damage to nerves and blood vessels, but these are quite rare, and your medical provider would brief you on all the risks prior to any treatment. And before you consider either of these interventions, you should speak to your primary care provider.
Who Can Perform Dry Needling?
The training required varies from state to state. Usually, a physical therapist or a chiropractor will do continuing education classes to obtain a certification to be able to provide dry needling to patients.
There are less classroom and clinical training hours required as compared to becoming an acupuncturist. However, studies will show that the level of education and experience with dry needling does not impact the rate of adverse outcomes, which again, are very minimal.
What Kind of Certifications Do You Have to Have to Do Acupuncture?
Training to become an acupuncturist takes quite a bit of time. The requirements vary from state to state, but often a certification is needed from an accredited program and there is a high requirement for class and clinical training hours. According to the American Institute of Alternative Medicine, it can up to 3 years to obtain your certification.
Are Dry Needling and/or Acupuncture Covered by Insurance?
Most major health insurance plans will pay for acupuncture and dry needling for chronic low back pain specifically. Per Medicare.gov, Medical will pay for 12 visits in 90 days for chronic low back pain and will cover more if the person continues to show improvement. As far the financial impact, for Medicare recipients, they would be responsible for 20% of the visit after they meet their yearly deductible.
If you are seeking out treatment for something other than low back pain like knee pain, TMJ or shoulder pain, you may have to pay out of pocket. Perhaps you could use your FSA or HSA funds to cover the cost.
Other insurance payors like commercial Anthem or Aetna plans may vary by policy so you would need to contact them directly to know what you plan covers.
Which One is Better?
It really depends on what you want to accomplish with the treatment. If you're looking for relaxing and gentle approach, acupuncture is for you. If you're looking for deeper treatment that works on your pressure points, dry needling is for you.
It also depends on your appreciation for or understanding of the principles of the treatment. Dry needling is more based in science and human anatomy while acupuncture is based on traditional Chinese medicine.
Do They Feel the Same?
Overall, no. They use the same type and size of needles, but the administration is different. Acupuncture is more superficial and minimal to no pain. Dry needling is a deeper treatment that might cause pain during the session.
Is Dry Needling Illegal?
In a nutshell, no it is not illegal according to the American Physical Therapy Association. There are five states that do not allow physical therapists to perform dry needling and those are California, Hawaii, New York, Oregon and Washington. Thirty-seven states plus Washington D.C. allow it without restriction and eight states do not have laws in place one way or the other.
Reaching out to your local physical therapy or chiropractic clinic will give you the most up to date information and availability in your area.
What is the Cost Difference?
As we have discussed, this might change based on the insurance plan and carrier that you have.
But if you are paying out of pocket, acupuncture will run around $150-$100 for the initial visit and around $75 for follow up visits.
If you are paying out of pocket for dry needling, it might depend on other services you receive at the same time. For instance, if you are getting physical therapy interventions for your shoulder pain, those might be covered by insurance, but the portion of the visit that is dry needling wouldn't be covered and you would pay out pocket. This could range from $20-$75 depending on the time and complexity.
Which is Better for Sciatica?
There is not clinical evidence one way or another to answer this question and fans of each treatment would boast that theirs is the most effective.
If one looks at the mechanism of treatment, there might be a stronger case for dry needling as compared to acupuncture. This would be because the sciatic nerve is deeper inside the body and below the larger gluteal muscles.
If that is the source of the pain, dry needling is more invasive and thus, more likely to access the problem area. But again, there is no clear evidence one way or another.
Which is Better for Low Back Pain?
Unfortunately, there is not clear evidence which technique would be better for low back pain. Medicare pays for both options so that leads us to believe there could be validity in both treatment options.
If the back pain is related to stress, perhaps the principles around acupuncture would be most beneficial for the patient. But if the back pain is related to chronic muscle tightness due to a lingering injury, perhaps dry needling is the way to go. It should be noted that both techniques work best in conjunction with other interventions to address back pain.
In the end, both acupuncture and dry needling are great options to address pain, especially low back and/or sciatic pain. The decision on which should include many factors like cost, availability in your area, pain tolerance, cause of pain and goal of the treatment.
Asking your medical provider for a referral to a physical therapist or acupuncturist is a great start to getting the help you need.