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, needles are inserted into the skin and both also claim to treat pain.

That’s where the similarities end. Unique qualities help differentiate the two. One practice has been used for thousands of years in traditional Chinese medicine and has some solid research supporting its effectiveness. The other’s been adopted in the last couple of decades.

One is believed to relieve pain, discomfort, or other issues by placing needles in specific points in the body. 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.

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. The length of time depends on the practitioner.

Some healthcare professionals, such as physical therapists, receive some training in dry needling. However, the length of training can vary. Keep in mind that there are no official regulations in place to tell you exactly who is qualified to perform dry needling.

Acupuncturist groups like the American Alliance for Professional Acupuncture Safety (AAPAS) say that dry needling is a type of acupuncture.

Because of concerns about about safety, the AAPAS suggests that dry needling practitioners should have the same training and oversight requirements as acupuncturists do.

On the other hand, physical therapists say that dry needling is an entirely different technique, not a form of acupuncture.

These debates are ongoing. Be aware that state laws governing dry needling may change as new legal decisions are released.

In-and-out techniques

Some forms of dry needling use techniques 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 long.

The needles prick the trigger points and are then removed. More research is needed to 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 the point of pain instead of directly on it.

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

Dry needling is most often performed by physical and sports injury therapists. There is no requirement for extensive training. And no regulatory agency controls training, licensing, or supervision for the procedure.

The American Medical Association (AMA) considers dry needling to be an invasive procedure. Only practitioners with specialized training and licensing in safe needle use should perform dry needling, according to the AMA. This includes doctors and acupuncturists.

According to the American Physical Therapy Association (APTA), most U.S. states allow physical therapists to perform dry needling. However, there are a handful of states that do not allow it.

Overall, it’s important to keep in mind that there are no regulations in place to say whether any given practitioner is trained and qualified to perform the procedure.

And because there’s no credentialing board, there’s 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.

Though it doesn’t currently have guidelines for practice, safe dry needling practices are likely to be standardized as more research becomes available.

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 found that platelet-rich plasma injections provided more relief for rotator cuff injuries than dry needling did.

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

The most common side effects around the injection site include:

  • bruising
  • bleeding
  • temporary soreness

If nonsterile needles are used, you may be at risk for contracting bloodborne illnesses, infection, and diseases. Be sure your practitioner uses sterile needles and disposes of them after each use.

Another potential risk is a punctured lung, or pneumothorax. If a needle is misplaced and pokes into your lung, the tiny hole can cause your lung to collapse.

Since dry needling doesn’t have formal training, certifications, or state licensing, there are more concerns about use than with acupuncture.

Acupuncture is a form of medical treatment that’s been used for hundreds — even thousands — of years. Acupuncture originated in traditional Chinese medicine.

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 AMA accepts acupuncture as a medical treatment, and some insurance companies may cover the cost of treatment.

Traditionally, the fundamental belief of acupuncture is that illness is the result of blocked or interrupted qi. Qi provides your body with healing energy. Acupuncture seeks to remove these blockages and return your energy flow to a state of balance.

In the newer practice of Western medical acupuncture, inserting needles is believed to stimulate the nervous system. Research is ongoing to find out more about acupuncture’s potential effects, such as:

  • lowering inflammation
  • increasing blood flow
  • triggering the release of endorphins, to relieve pain

Acupuncture is used to treats hundreds of conditions and symptoms, including:

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

Some people use acupuncture to treat substance use disorders, or to help when quitting smoking.

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 treatments, such as medications or physical therapy.

Knee pain

Pain caused by osteoarthritis in the knee is a leading cause of disability among adults. A 2010 review 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 with traditional care.

Migraines and headaches

A 2012 review of migraine studies found that acupuncture was at least as effective at easing migraine symptoms as other 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, research suggests that regular acupuncture treatments may help people with a history of migraines prevent future episodes.

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. Others point out that acupuncture’s effectiveness during labor is difficult to measure.

Still, acupuncture remains an area of interest for many mothers looking for medication-free 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 with nicotine replacement therapy, acupuncture was less effective.

However, though more research is needed, acupuncture shouldn’t be firmly ruled out as a potential therapy for quitting smoking.


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 site
  • bruising
  • bleeding

In addition, some people may develop complications if nonsterile 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 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 area of muscles and nerves. Trigger point dry needling focuses entirely on the point of 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. Ask if the practitioner has graduate education.

To see if you can pay for the treatment using your health insurance, confirm that your insurance company covers the treatment and that the practitioner is in your network, if needed.

Finding a dry needling therapist can be a bit more difficult. 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 currently has more definitive research 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.

Dry needling is rather new, so research remains limited. Existing research shows very few side effects and potential as a treatment for pain relief. Still, large-scale studies are lacking.

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

Although dry needling is less established, some early results suggest it could be helpful. If you’re open to a less-proven option, you might be willing to try it.