Dry-Needling; I can’t believe it’s not Acupuncture

Dry-Needling; I can’t believe it’s not Acupuncture

Acupuncture and Dry-Needling are 2 vastly different practices, but to the everyday patient, they seem kind of the same, both involving the insertion of small needles into the skin to relieve an ailment. So what is the difference?

THE BASICS

ACUPUNCTURE; The practice of inserting fine needles into the skin and muscles of the body to benefit health and relieve a variety of ailments.

            Acupuncture works within the framework of Traditional Chinese Medicine (TCM); a whole health system. Acupuncture has been practiced for over 2000 years and has a long history of efficacy. As acupuncture works on a holistic and broad model, it is used to treat a wide variety of illnesses, ranging from pain, to disorders of the digestive, reproductive, psycho-emotional, respiratory system, and more.

            In Australia, Acupuncturists are registered with the Australian Health Practitioner Regulation Agency as Chinese Medicine Practitioners. They are required to have a minimum Bachelor degree, usually taking about 4 years and requiring over 400 hours of clinical practice, or a 3 years graduate-entry Masters qualification (or equivalent).

DRY-NEEDLING (aka myofascial dry-needling, intra-muscular stimulation); involves the insertion of fine needles (acupuncture needles are used) into the skin and muscles to relieve pain.

            Depending on the technique, these needles may be inserted deeply into the muscles, or superficially into the skin above a trigger point (trigger points are those knots your massage therapist tries to beat out of you). The technique began in the 70’s when it was observed that inserting a solid needle into the skin above a trigger point was just as effective at relieving pain as injecting an analgesic into the point, hence ‘dry-needling’ rather than ‘wet-needling’.

            Most often practiced by Physical Therapists such as Chiropractors, Physiotherapists, and Remedial Massage Therapists, the minimum amount of study to become a qualified dry-needler is         2 days, with a pre-requisite physical therapy or medical degree.

Physical Therapists who practice dry-needling (DN) maintain that they aren’t doing acupuncture because DN utilizes the theory of biomedicine (circulation, prostaglandins, inflammation, fascial release, etc) and not of TCM. However the actual mechanism of action of DN, biomedically speaking, is still unclear, and based more on clinical observation than anything else. In fact, most of the research behind DN is actually acupuncture research.

Now to the real point…

THE RISKS:

• An Australian study found that the risk of pneumothorax (piercing the lung) when acupuncture was administered by medical practitioners was twice that of when performed by traditionally trained acupuncturists (Bensoussan, 2000).
• Between 2000-2011 there have been 86 fatalities worldwide related to acupuncture/dry-needling (none in Australia, incidentally). All articles conclude that these deaths could have been avoided with adequate training (Janz, 2011).
• The World Health Organization Guidelines on Acupuncture recommend doing acupressure instead of acupuncture if the practitioner is not prepared to complete a full 2500 hr programme of study because of the high risk associated with a brief training time (WHO GBT 1999). Most DN training courses in Australia fall between 16-36 hours, with little of this being practical. Thus placing them firmly in the ‘high risk’ category.

Since 2012 in Australia, the title ‘Acupuncturist’ is reserved for those who hold the relevant qualifications. However, there are no regulations on those who practice ‘dry-needling’.

Incidentally, the practice of needling trigger points to relieve local pain is well known in TCM. They are called Ah Shi points and have long been used in Acupuncture as part of wider treatment of meridian points and organ pathology.

When asked if they have had acupuncture before, many of my new patients will respond with, “oh yeah my physio does a little bit of acupuncture”. While it’s possible that your physio is also a qualified Chinese Medicine Practitioner, it’s more likely that they actually do ‘a little bit of dry-needling’, and as we can see, the difference in training and risk is vast, while the actual clinical technique is very similar.

As one of my patients so eloquently put it, “Isn’t saying ‘I do a little bit of acupuncture’ like saying ‘I do a little bit of surgery’? You’re either a surgeon or you’re not a surgeon, right?”

….Well yes, quite.

And you’re either an acupuncturist or your not an acupuncturist as far as I and the research is concerned.

It’s important to be educated. Next time you are offered any form of invasive therapy such as needling, enquire as to the practitioner’s qualifications and experience before consenting to the procedure.

Helena Nyssen

Ba. Applied Science (TCM)

Dip. Remedial Massage

Helena is a registered Chinese Medicine Practitioner, and Remedial Massage Therapist at Journey Healthcare in Leichhardt NSW. You can visit Journey Healthcare at www.journeyhealthcare.ntpages.com.au or call on 0404 0505 13. We look forward to hearing from you!

References

Janz, S., Adams, J. (2011). Acupuncture by another name. Australian Journal of Chinese Medicine, 6(2), 3-11.

http://www.chinesemedicineboard.gov.au/Registration-Standards.aspx

World Health Organization. Guidelines on Basic Training and Safety in Acupuncture. 1999 [cited April 9 2011]. Available from: <http://apps.who.int/medicinedocs/en/d/Jwhozip56e/>.

Bensoussan A, Myers SP, Carlton A-L. Risks Associated with the practice of traditional Chinese medicine: An Australian study. Archives of Family Medicine 2000;9(

Introduction to Gua Sha

Gua Sha (aka as ‘spooning’ or ‘scraping’) is another effective method that we use in TCM to treat a variety of disorders. A form of massage, Gua Sha is used at Journey Healthcare Acupuncture and Massage in Leichhardt to treat pain, tension, muscle stiffness, as well as colds and flus, fever, chills, headache, asthma, bronchitis, among many others.

Chinese Medicine theory states that Qi and Blood should flow smoothly in the channels and muscles for proper functioning of the body. When there is stagnation, deficiency, or blockage, there will be pain and dysfunction.

To help understand the concept of Meridians (channels) and the idea of Qi (energy), imagine a river. When there is a good amount of water, the river flows smoothly and easily. Everything thrives. When there is a heavy rain, the river flows too quickly and too rough, causing damage to the river banks. When there is a large amount of debris in the water, the river’s path will be interrupted, causing flooding. If there is not enough water, the life along the river will not be nourished sufficiently.

Your channels are the river’s path, your Qi and Blood the water. Gua Sha and Acupuncture ensures the flow is kept smooth and even. A popular saying in TCM states, “Big Blockage equals Big Pain, Small Blockage equals small pain, no blockage equals no pain”.

Gua Sha is an appropriate form of treatment when you start feeling that neck pain right before you get a cold, or the knows in your shoulders and back start bothering you. Also for chronic chesty coughs, or bronchitis, fevers and sore throats. During treatment the ‘sha’ will appear as a distinctive reddish bruise, lasting 2-3 days. This is the Heat and Stagnation being released from the muscles and channels.

“if there is an illness, Gua Sha treats it, if there is no illness, Gua Sha strengthens the body”

Helena Nyssen is a registered Chinese Medicine practitioner and Remedial Massage Therapist with Journey Healthcare. We specialise in Acupuncture, Remedial Massage, and Pain Management in Leichhardt NSW. Call 0404 0505 13 to make an appointment.