Clinical Kit 102 - Dry Needling: What's in a Name?
One point of view is provided here;
When it comes to the broad family of needling techniques the obvious common element is the use of a thin, solid, metallic needle inserted into tissue to create a desired effect. There are a few needle types but a plethora of needling techniques. Translated acupuncture means needling, needle prick or needle insertion. Dry needling is a name used to describe the insertion of a needle without injection of other substance cf. wet needling. Dry needling has occurred for thousands of years in Asia and China. Apparently, the term dry needling is a folk term to differentiate the needling styles in China, when western hypodermic needle use, first arrived in the late 1800s. So for some, the term dry needling means acupuncture.
There is a growing use of dry needling techniques in western countries by allied health practitioners with extensive anatomy, physiology, pathology and clinical reasoning skills, but who haven't undertaken extensive training in herbs, yin and yang, five element theory or similar like a traditional chinese medicine acupuncturist. They are using the same needles, but for legal reasons these practitioners can't call themselves acupuncturist and have settled on the term dry needling. These practitioners are however using the term dry needling, in a different way to the folk term used in Asia.
Commonly dry needlers, are using their knowledge and applying needling techniques to have an effect directly on local tissues to achieve;
- nociceptor densensitisation
- pain relief
- muscle relaxation
- increased circulation or
- provoked inflammation
Less commonly when applying segmental or mirroring clinical reasoning, they may use needling techniques to influence other tissues indirectly for enhanced effects or possibly to treat areas not amendable to direct needling (immune compromised clients).
Even more infrequently dry needlers maybe treating systemically via non-specific effects or the autonomic nervous system, attempting to influence functions like post op nausea and vomiting, mood and sleep.
As I see it, the key factors to consider in this discussion on nomenclature, relate to a combination of the tool (the needle) and the practitioner's training and skill set. The tool stays constant across the broad family of needling techniques by whatever name (dry needling, acupuncture, Fu needling, IMS). What is more important is the practitioner's training/experience, the clinical reasoning behind the treatment and the client's expectation. Together these three elements make up evidence-based practice and in my mind are more important than demarcation arguments over titling disputes. Seeking ongoing training, listening to your clients expectations and applying your experience will enable you to assist most clients, regardless of what 'name' you call yourself.
AAP Education is proud to be able to offer practitioners a broad range of dry needling (DN) training from an Introductory/Refresher Course right through to a Master Needling Course and assist practitioners to incorporate these skills into day to day practice.
"The Introductory/Refresher Course was Excellent, both in clinical reasoning and in the practical sessions.
The locations of trigger points, the areas of referred pain/sensation and the effects of releasing them have already proven valuable in my diagnosis and treatments.
The differential diagnosis of problem muscles and the associated anatomy would have been useful even without dry needling." Dave James
"Doug was very thorough and clear in his presentation, his speed of speech is good (not too fast). His way of describing how to palpate certain muscles and structures is LEGENDARY." Jade Chan
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