acupunture for insomnia

acupuncture vs. dry needling

Many patients ask me the difference between acupuncture and dry needling. Although both therapies involve inserting a stainless steel filiform needle into the skin, there is a vast difference in training and philosophy. Here is how I explain it based on my training in Chinese Medicine. 

To begin, acupuncture therapy programs require years of schooling and training. I attended a 3.5 year program that required over 2,500 hours of clinical  experience. This was the minimum requirement for graduation. State board requirements vary, but typically they require passing 2-4 board examinations to obtain a license to practice. Dry needling certification, on the other hand, can be obtained by a licensed medical professional such as a PT, ATC, or DC in a weekend seminar of 27 hours at a cost of roughly $1,200.00. 

While passing such a weekend course will land you a basic certification to dry needling, this is of the great cause of concern to acupuncturists who spend thousands of hours perfecting the technique of needle insertion with extensive study of the risks associated with deep needling. Needle safety is a primary concern as the risk of causing a pneumothorax (punctured lung) or muscle and nerve damage significantly increases with deep needle insertion. 

Acupuncture and dry needling are both used to treat pain. Pain management is treated by Traditional Chinese medicine using acupuncture for both acute and chronic injuries. Many patients seek relief through acupuncture when all other modes of treatment fail to provide pain relief. In addition to treating specific points along the body’s meridians or mapping, we also use techniques that needle around a point of pain. We call these tender points Ashi (A-she) points. 

Other medical professionals may call them myofascial trigger points.  

Traditional Chinese medicine uses acupuncture to treat acute and chronic injuries

The location of these points is determined by each patient during examination and are needled in addition to specific meridian points. When addressing the treatment regimen for pain and injury through Traditional Chinese Medicine, pain is most definitely accompanied by Qi (Chee) stagnation or the pooling of energy. To move stagnated Qi and restore balance to the affected area, different points are needled, to encourage the movement of Qi. This can give great pain relief and healing to the patient, and it is not addressed with dry needling. The procedure of dry needling involves the insertion of a needle into a myofascial trigger point for release and possible pain relief. 

Another main difference between acupuncture and dry needling is that the latter can be very painful. This can promote tension within the muscles and stress in anticipation of the process. Acupuncture is typically not painful. By contrast, it promotes a heavy sensation around the needle insertion area, indicating Qi’s arrival. We aim to promote relaxation while the benefits of the needles are taking place. Many patients even fall asleep during treatment. 

Dry needling does not address the emotional state and needs of a patient. Note that injury and disease create emotional changes. The philosophy of Traditional Chinese Medicine always takes the emotional health of a patient into consideration. We treat each patient’s mind and body as a whole: the mind affects the body, and the body affects the mind.  Acupuncturists are very strongly against dry needling. As the popularity and widespread awareness of acupuncture’s health benefits grows, other healthcare professionals now have a desire to simulate this healing response. As a profession, we will continue to question the decision to allow dry needling with a weekend seminar’s simple training. Until greater training is required for dry needling, I encourage healthcare professionals to offer pain relief from this technique to explore additional training and education in acupuncture. 


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Karla Knauf
Karla A. Knauf. Nationally Board Certified in Acupuncture (NCCAOM), Licensed Acupuncturist (Lac, WI), Pursuing Diplomate in Acupuncture (NCCAOM). Areas of interest: anxiety/stress management, insomnia, emotional balance in teens and women, Qi Gong, guided meditation, energy healing, crystals, and essential oils. Hobbies include kayaking, paddle boarding, hiking, Qi Gong cooking, and meditation. Lives in Wisconsin with her husband and two children.
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