DRY NEEDLING- What is it?

Acupuncture vs Dry Needling:

Travell and Simons define a trigger point as a focus of hyperirritability in a tissue that, when compressed, is locally tender. If it is sufficiently sensitive, such a trigger point may give rise to referral pain, tenderness and sometimes, autonomic manifestations as well as proprioceptive changes.

When making a comparison between dry needling and acupuncture it is important to note that they are two different modalities. Many patients will arrive in your practice claiming they have had acupuncture whereas they have only had dry needling and vice versa** (Amaro).

Acupuncture is traditionally explained as modifying the flow of energy (known as Qi or Chi) throughout the body through different meridians or energy channels. Dry needling is the insertion of a needle into a localized trigger point to eradicate myofascial pain at the specific point or within the referred pain pattern. Acupuncturists go through a very intense and different schooling to practitioners who practice dry needling and it would be incorrect to call dry needling acupuncture in any circumstance.

Trigger point and acupuncture point correlation

As discussed above an a-shi point is found in traditional Chinese acupuncture and is defined as any point that, when palpated causes the patient to cry out or cause discomfort. These points are generally treated by needle technique, moxibustion, cupping, acupressure, Tei shin or gua sha. **(Wu; Xinnong)**(Nielson)

In Japanese acupuncture, KORI is used to describe an area of the body that has stiffness and constriction with discomfort. Kori is defined as a tight myofascial constriction that may or may not elicit pain when palpated, but can be felt as a constriction by the practitioner when palpating. In Japanese acupuncture these points are released by needling into the dense muscular resistance that signals the presence of kori. **Kikko Matsumoto describes this dense myofascial resistance as a gummy feel. A needle is inserted until the gummy feeling is felt and then left there for 10-20 minutes.

Modern Japanese acupuncture believes that when kori is present in the muscles or the fascia, they block the area, therefore affecting the lymphatic drainage, circulatory-venous and arterial system and nervous conduction of the body. When these systems get blocked, not only will there be pain and discomfort, but immune function and internal regulation of the body will be interfered with.

Travell and Simons have this to say regarding the relationship between classical acupuncture points and myofascial trigger points: “Unlike the classical acupuncture points, we do not think of the published trigger point sites as immutable locations, but as a guide for where to start looking. Every muscle can develop trigger points, many muscles have multiple trigger point locations. Only the most common trigger point locations are shown in the published illustrations, individual muscles may have trigger points in other locations. The trigger point sites in a given muscle may vary from person to person, no two people are exactly alike”. The myofascial phenomena described by the ancient acupuncturists correlates directly with the referral patterns seen by Travell and Simons.

In summation, traditional Chinese and Japanese acupuncture draws a parallel correlation to Trigger point therapy. Not only when looking at the original meridian charts, but also based on the description of the pain that those specific points elicited. These painful points (a-shi, kori, etc.) are essentially trigger points and are eliminated most effectively by needle insertion.

** Amaro, John A. When the student is ready the teacher shall appear. Dynamic Chiropractic 1992.

**Amaro, John A. Meridian therapy Pain Management. Dynamic Chiropractic January 15th,1993.

** Lingshu, Jing. Classic of the Miraculous Pivot. Shi Song of the Southern Song Dynasty. 1155.

**Maciocia, Giovanni The foundations of Chinese Medicine. Edinburgh/London: Churchill Livingston 1989.

**Maashing, Ni. The Yellow Emperors Inner Classic. Shambhala. 1995.

**Matsumoto, Kiiko; Euler David. Kiiko Matsumotos Clinical Strategies. In the Spirit of Master Nagano. Volume 1.Kiiko Matsumoto International 2002.

**Matsumoto, Kiiko. Kiiko Matsumotos Clinical Strategies. In the Spirit of Master Nagano. Volume 2.Kiiko Matsumoto International 2008.

** Nielson, Arya Gua Sha: A traditional Technique for modern practice.New York: Churchill Livingstone 1995.

** Travell, Janet and David Simons. Myofascial Pain and Dysfunction: The trigger point manual Vol1. Baltimore: Williams and Wilkins , 1983.

**Travell, Janet and David Simons. Myofascial Pain and Dysfunction: The trigger point manual Vol2.. Baltimore: Williams and Wilkins , 1992.

**Van Nghi, Nguyen. Medecine Traditionnelle Clinoise. Acupuncture-moxibusion and massages. Marseille, edition NVN. 1984.

**Wu, Jing Nuan. Lingshu or the Spiritual Pivot. University of Hawaii Press.. 2002.

**Xinnong, Cheng. Chinese Acupuncture and Moxibustion. Foreign Language Press Beijing.1999.

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Myofascial pain is a term that has been bantered around for many years. It is often unclear to people exactly what this means or how to fix it. Medical doctors, Physical therapists, Occupational therapists, Chiropractors and other practitioners are starting to acknowledge the importance of myofascial pain syndromes and collaborate to figure out how to treat it.

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