Dry Needling vs Acupuncture
Western medical acupuncture, as it is practiced in Canada by physiotherapists, is a therapeutic modality that uses the insertion of needles. This practice is also known as dry needling or intramuscular stimulation. This acts by directly stimulating the nervous system utilizing the mechanisms of antidromic reflexes, and neuromodulation, amongst other central effects. Its use in the physiotherapist’s scope of practice is usually limited to treatment of musculoskeletal pain. Less attention is paid to what particular points are used to modulate what traditional Chinese practitioners refer to as yin and yang, but acupuncture points are used to access the nervous system. Through stimulation of the nervous system we can release neuropeptides, increase blood flow, release opioid peptides and seratonin in the brain.
The system of acupuncture practiced by physiotherapists, although derived from traditional acupuncture, has evolved to become part of conventional practice and is no longer thought of as “alternative”. The current scientific concepts of neuroplasticity and neurotransmitters have helped us understand the mechanisms behind how it works; this knowledge wasn’t present thousands of years ago when acupuncture was first developed as part of an entire medical system of knowledge. Our current use of acupuncture does not include the concepts of yin, yang, and qi.
Acupuncture, as practiced by physiotherapists, can vary in technique from needling of trigger points, neurovascular bundles, nerve roots, and may differ in the number of needles used, etc. It is used within the framework of western evidence based medicine, but there still needs to be more controlled trials, and points are sometimes chosen based on clinical experience. Acupuncture in this framework is used to treat pain and not maintain wellness as it is used in the east or by those practicing TCM (traditional Chinese medicine).
There are similarities between Eastern TCM practiced acupuncture, and western medical acupuncture (dry needling, intramuscular stimulation) in terms of the points of access to the nervous system. Trigger points often correspond to what TCM practitioners call “ashi points”. Although they are identified as the same point, the purpose of needling them will be different when done by a physiotherapist vs a practitioner of TCM. Many acupuncture points correspond to the location of a neurovascular bundle or nerve root; thus, may be the desired way of stimulating the nervous system. Again, the aim of which will be different depending on the viewpoint of the practitioner. (calming the nervous system vs. changing a yin/yang balance)