Understanding the Difference Between Dry Needling and Acupuncture (Through an Acupuncturist’s Lens)
When it comes to this topic, I’m biased. I’m an acupuncturist. I’ve dedicated years of study and practice to understanding how this medicine works.
Last week, a relative in North Carolina called me, upset after what they believed was a terrible acupuncture experience. They’d gone to physical therapy for chronic neck pain and were offered dry needling.
The result? So much pain afterward that they called me to ask, “Is this normal after acupuncture?” (insert eye-roll emoji here)
Except… what they received wasn’t acupuncture! And that distinction matters a lot.
What’s the Difference: Dry Needling Compared to Acupuncture
There’s a misunderstanding that dry needling and acupuncture are the same thing. They’re not. While both use the same type of needles, that’s where the similarity largely ends.
Put simply:
Dry needling
Western pain relief technique
Only 20-80 hours of training required (for physical therapist and other orthopedic providers)
Generally focuses on one localized area
Typically targets trigger points or tight knots in muscles to release tension
Focused on muscular pain and injury recovery
Acupuncture
Rooted in Traditional Chinese Medicine
3-4 years of formal education and medical licensing required
Looks at the entire system, not just your meat suit
Uses muscle and meridian pathways, nerve connections, and fascia networks to treat both the source and symptoms of pain
Also helps with:
Anxiety, stress, and sleep
Digestive issues
Hormonal imbalances
Immune support and chronic fatigue
Acupuncturist’s Take a Whole-Body Approach
One of the things that makes acupuncture so powerful is its systemic approach. When I treat someone with neck pain, I’m not just needling the neck. I’m looking at posture, the spine, connected muscle groups, and even underlying factors like stress, digestion, and sleep.
If you come in with back pain, I might use points along the bladder meridian that trace up the calves and connect through the hamstrings and glutes. Why? Because these pathways are not just energetic, they’re anatomical. Ancient Chinese physicians likely understood how fascia and nerves worked, even thought they didn’t have modern technology.
Many acupuncture points correlate with anatomical landmarks, including fascia junctions, nerve bundles, and muscular trigger zones. This means when we needle a point, we’re not only helping to release muscle tension locally, but also promoting systemic balance.
Dry Needling in Physical Therapy: Helpful, But Limited
Let’s be clear: dry needling is effective. It's a form of acupuncture, whether PTs want to call it that or not. When done well, it can relieve pain, break up muscle tension, and promote healing.
But here’s the catch: most physical therapists are only treating the site of the pain. Shoulder hurts? They needle the shoulder. Neck? Just the neck. Low back pain on the right? They’ll hit trigger points on the right.
The human body doesn’t work in isolated parts.
So what happens next? You feel better (or worse) for a few days, until your neck goes out or your opposite hip flares up. Why? Because treating one isolated area without addressing the whole system can throw the rest of your body off balance.
Your Body is a System, Not a Collection of Parts
Your pelvic girdle, shoulder girdle, and spine are connected by fascia, ligaments, and muscle chains. If you release one area without supporting the others, tension shifts, often to the places that are already vulnerable.
This is where acupuncturists trained in sports medicine and orthopedics have an edge. We’re not just releasing a muscle; we're treating the patterns. We’re addressing the root cause, the compensation, and the systemic ripple effects. And if you're also stressed, constipated, or not sleeping well, we’re equipped to address that too.
Not All Practitioners Are Created Equal
To be fair:
Acupuncturist can dry needle and not all acupuncturists want to dry needle
Not all acupuncturists are adequately trained in sports medicine and orthopedic acupuncture
Not all PTs are under trained when it comes to needling
But if I had to choose? I’d rather be dry needled by an acupuncturist who deeply understands meridian theory, myofascial lines, anatomy, and how all of it connects to my nervous system, organs, and overall well-being.
Final Thoughts
Dry needling works. Acupuncture works. But they are not the same.
If you want lasting results from the needles and a treatment approach that sees you as a whole person (not just a shoulder or a tight hamstring), seek out a licensed acupuncturist trained in orthopedic and/or sports medicine acupuncture.
Your body deserves that level of care.
