Acupuncture and Dry Needling – Part 2
On to acupuncture, what is it? Stated simply acupuncture is the insertion, manipulation, retention, and removal of fine filiform (solid) needles to address some health issue. The health issue in question can range from pain to digestive complaint to psychological issues like depression or anxiety. The list of issues acupuncture can treat is long. It’s usually easier to tell people what things you wouldn’t treat with acupuncture because that’s a shorter conversation.
Is there a relationship between dry needling and acupuncture? Yes, dry needling is a sub-set of acupuncture techniques. Like I mentioned in my Facebook post, acupuncturists don’t think of them as two separate things. Trigger and motor point therapy are part of the range of acupuncture techniques. Most of us learn trigger point therapy as part of our degree in Chinese medicine.
Is there overlap between recognized trigger points and acupuncture points? Again, yes. In fact, this rabbit hole goes much deeper than a simple overlap between recognized trigger points and classical acupuncture points. There was a 3-part study done by P.T. Dorscher, MD and J. Fleckenstein, MD. It was published in The German Journal of Acupuncture and Related Techniques (Deutsche Zeitschrift für Akupunkture) starting in March of 2008 with the final installment published in January 2009. Dorscher and Fleckenstein had 3 questions:
1. Do currently recognized myofascial trigger points overlap with classically recognized acupuncture points (1)?
2. Do the corresponding acupuncture points have indications for regional pain (i.e. are those acupuncture points typically thought of or used to treat pain in the area) (2)?
3. Do the pain referral patterns of the acupuncture/trigger point combinations match the hypothetical distribution of the acupuncture channel on which the point sits (3)?
The answer to the first question is, yes. In their study, Dorscher and Fleckenstein found a 93.3% overlap between classical acupuncture points and modern trigger points (1).
The answer to the second question is also, yes. Dorscher and Fleckenstein found that of the overlapping acupuncture points, 94% had an indication for regional pain (2). Another 3% of these acupuncture points had indications for pain along the referral distribution of the trigger point (2).
The answer to the third question surprised even me. Yes, referral patterns tend to follow hypothetical channel pathways. Dorscher and Fleckenstein found 81.5% of the acupuncture point/trigger point pairs had a referral pattern that was a complete or near-complete match to the channel trajectory hypothesized by Chinese medicine (3). 9.5% showed partial correspondence (3). Only 9% showed little to no consistency (3).
Trigger points, for the most part, are acupuncture points (1). Pain referral patterns, for the most part, are a complete or near-complete match to the Chinese channel system (3). I don’t know how else to show that dry needling is acupuncture. Same tool, same location, same indications. Even the AMA agrees, dry needling is acupuncture, is an invasive technique, and should only be performed by licensed acupuncturists or MDs (4).
1. Dorscher, P.T., Fleckenstein, J. (March 2008). Trigger Points and Classical Acupuncture Points. Part 1: Qualitative and Quantitative Anatomic Correspondences. German Journal of Acupuncture & Related Techniques. 51:15-24
2. Dorscher, P.T., Fleckenstein, J. (April 2008). Trigger Points and Classical Acupuncture Points. Part 2: Clinical Correspondences in Treating Pain and Somatovisceral Disorders. German Journal of Acupuncture & Related Techniques. 51:6-11
3. Dorscher, P.T., Fleckenstein, J. (January 2009). Trigger Points and Classical Acupuncture Points. Part 3: Relationships of Myofascial Referred Pain Patterns to Acupuncture Meridians. German Journal of Acupuncture & Related Techniques. 52: 9-14
4. Dry Needling is an Invasive Procedure H-410.949. (2016). Retrieved from https://policysearch.ama-assn.org/policyfinder/detail/dry%20needling?uri=%2FAMADoc%2FHOD-410.949.xml