If you only compared dry needling and acupuncture with a photo, you might be stumped to identify each. Both acupuncture and dry needling use thin, stainless steel needles. For both practices, those needles are inserted into the skin. And both practices also claim to treat pain.

But that’s where the similarities end. Unique qualities help differentiate the two. One practice has been used for thousands of years as an alternative treatment and has some solid research of effectiveness. The other was adopted in the last few decades.

One is designed to relieve pain, discomfort, or issues by opening up a person’s energy flow (or chi). The other is designed to stimulate “trigger points,” or muscles that are irritable. Knowing the differences can help you decide which type of treatment is right for you.

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Dry needling is a modern treatment designed to ease muscular pain. Its popularity is growing. During dry needling, a practitioner inserts several filiform needles into your skin. Filiform needles are fine, short, stainless steel needles that don’t inject fluid into the body. That’s why the term “dry” is used.

Practitioners place the needles in “trigger points” in your muscle or tissue. Dry needling is also sometimes called intramuscular stimulation. The points are areas of knotted or hard muscle.

Dry needling practitioners say the needle helps release the knot and relieve any muscle pain or spasms. The needles will remain in your skin for a short period of time, often between 10 and 30 minutes.

In-and-out techniques

Some forms of dry needling use a technique called pistoning or sparrow pecking. Both of these techniques rely on in-and-out needle insertion. In other words, the needles don’t stay inserted in the skin for a period of time. The needles prick the trigger points and are then removed. However, research does not support this method of dry needling.

Non-trigger point technique

Some dry needling techniques treat a broader landscape of the central nervous system. This is called non-trigger point treatment. Instead of inserting needles only in the area of pain, the practitioner may instead insert needles in areas around but not directly on the point of pain.

This technique relies on the idea that pain is the result of a greater nerve or muscular issue, not a focused one only in the main area of pain.

Dry needling is most often performed by physical and sports injury therapists. Currently, dry needling practitioners don’t need extensive training to perform dry needling. No regulatory agency controls training, licensure, or supervision for this procedure.

Because there’s no credentialing board, there’s also no way to determine if someone’s training is legitimate and satisfactory.

Dry needling may provide relief for some muscular pain and stiffness. In addition, easing the trigger points may improve flexibility and increase range of motion. That’s why this method is often used to treat sports injuries, muscle pain, and even fibromyalgia pain.

Dry needling, unlike acupuncture, does not have guidelines for practice.

Research supporting the use of dry needling is limited. Most of the existing research for dry needling supports the practice for relieving mild to moderate pain.

In some studies, dry needling provided more relief than a placebo treatment. However, one study showed that dry needling is no more effective than stretching alone to relieve muscle pain. In addition, a 2012 study compared platelet-rich plasma injections with dry needling for rotator cuff injuries. The injections provided more relief.

Mild side effects are very common with dry needling, but serious side effects remain rare.

The most common side effects around the injection site include:

  • bruising
  • bleeding
  • temporary soreness

If non-sterile needles are used, you may be at risk for contracting blood-borne illnesses, infection, and diseases. You must ensure your practitioner uses sterile needles and disposes of them after each use.

Because dry-needling does not have formal training, certifications, or state licensure, like acupuncture does, there are more concerns about use.

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Acupuncture is a form of traditional medical treatment that has been used for hundreds, even thousands, of years. Acupuncture originated in Asian medical practices. That’s why many licensure and oversight boards use the term “Oriental Medicine” to classify acupuncture.

Acupuncture is practiced by tens of thousands of licensed acupuncturists. Expert acupuncturists train for three to four years. The training includes both instruction in the use of needles and instruction in diagnosing conditions. Practitioners have direct supervision from another senior or expert practitioner.

In addition to this training, acupuncturists must undergo testing from a national board of examiners and continue to take instructional courses each year to maintain their license.

The American Medical Association accepts acupuncture as a medical treatment, and some insurance companies may cover the cost.

The fundamental belief of acupuncture is that illness is the result of blocked or interrupted “chi.” Chi provides your body with healing energy. Acupuncture seeks to remove these blockages and return your energy flow to a state of balance.

Acupuncture is used to treats hundreds of conditions with symptoms including:

  • pain
  • nausea
  • vomiting
  • headache
  • menstrual cramps
  • allergies

Some people use acupuncture to treat addiction and chemical dependency.

Acupuncture is used to treat several types of pain. Here’s what the research says.

Low back pain

A 2015 review of studies found that acupuncture could provide short-term relief from low back pain. This is true if acupuncture is used alone or with other more traditional treatments, like medications or physical therapy.

Knee pain

Pain caused by osteoarthritis in the knee is a leading cause of disability among adults. A 2010 review of 10 studies found that acupuncture is an effective treatment for knee pain and physical symptoms of osteoarthritis.

Neck pain

Acupuncture can significantly reduce neck pain, according to one 2015 study. When acupuncture is used with other techniques to ease neck strain and reduce muscle tension, the symptom relief was significant when compared to traditional care.

Migraines and headaches

A 2012 review of migraine studies found that acupuncture was at least as effective at easing migraine symptoms as classic treatments, including medication. It also has some benefits over those classic treatments, including longer lasting effects, lower medication use, and fewer serious complications or side effects.

Additionally, one 2017 study suggests that regular acupuncture treatments may help people with a history of migraines prevent future episodes.

Learn more: Stimulating pressure points for migraine relief »

Labor pains

Researchers are mixed on the use of acupuncture to reduce labor pains during childbirth. Some studies show a statistically significant reduction in pain experience. Other studies point out that accurate measure of acupuncture’s effectiveness during labor is difficult to measure.

Still, acupuncture remains an area of interest for many mothers looking for non-medication options.

Smoking cessation

Acupuncture is sometimes used for the treatment of conditions other than physical pain. Research has yet to establish acupuncture as an effective smoking cessation therapy. When compared to nicotine replacement therapy, acupuncture was less effective.

However, the same research does not firmly rule out acupuncture as a therapy for quitting smoking. More research is needed.


One study looked at the use of acupuncture and antidepressant medication to ease signs of depression. It suggests that medication and acupuncture together may be effective. It’s also well tolerated and presents few complications.

But a review of studies could not declare acupuncture as a reliable treatment for depression. The author concluded the findings were enough to justify additional research.

Overall, the World Health Organization recognizes acupuncture as effective in treating hundreds of diseases and symptoms.

If performed by a trained and licensed acupuncturist, side effects and risks are very rare. Occasionally, someone may experience pain at injection, bruising, and bleeding during the procedure. In addition, some people may develop issues if non-sterile needles are used.

Both acupuncture and dry needling are used to treat osteoarthritis. In particular, research shows acupuncture and dry needling are particularly useful for the treatment of knee pain caused by the arthritis condition.

For the treatment of knee and hip osteoarthritis, non-trigger point dry needling is more effective than traditional dry needling alone. A 2014 review of studies found that dry needling in muscles and tissues around the pain point reduces pain and sensitivity more than needling just in the pain point.

This dry needling strategy is more similar to acupuncture in that it treats a larger swath of muscles and nerves. Trigger point dry needling focuses entirely on the point of pain.

Learn more about natural relief from arthritis pain. »

National licensing groups for acupuncture therapists maintain lists of certified and licensed practitioners.

To find an acupuncture practitioner, start with these options:

Before you confirm your appointment, verify that their license is current. If you’d like to pay for the treatment using your health insurance, confirm that your insurance company covers the treatment and that the practitioner is in your network.

Finding a dry needling therapist can be a bit more difficult. A national accrediting body or commission doesn’t exist.

If you’re interested in dry needling, start with these resources:

If you’re weighing acupuncture or dry needling as a treatment option, the choice may come down to a matter of preference.

Acupuncture is better studied, and practitioners are regulated in training and practice. If you prefer a well-established alternative treatment option from a highly-trained therapist, acupuncture may be more beneficial for you.

However, if you’re willing to try something that is less established with fewer governing principles but promising results, you may be willing to try dry needling.

Dry needling is rather new, so research remains limited. Existing research shows very few side effects but good promise as a pain reliever. Still, large-scale studies are lacking.

Additionally, there isn’t any consistency in training, certification, or licensure at this time. This can lead to unsafe needle practices.