Acupuncture
Dry needling vs traditional acupuncture: what’s the difference?
By Natura Integrative Care Clinic · Updated · 4 min read
The short answer
The word “acupuncture” is an umbrella term that both dry needling (trigger point release) and TCM or “Constitutional” acupuncture fall under. The main difference in dry needling vs traditional acupuncture is the approach, not the needle. Both use the same thin, solid, single-use acupuncture needles. Dry needling places them into tight bands in muscle (trigger points), based on Western anatomy. Acupuncture places them at points chosen through Traditional Chinese Medicine that may be a completely different area of the body than what is being treated. At Natura, Dr. Erin Esau, ND provides both.
When it comes to dry needling vs acupuncture, the tool is identical: a fine, solid, sterile, single-use needle with nothing injected (that’s the “dry” part). What differs is the reasoning behind where the needles go and how the practitioner assesses you.
Several kinds of practitioners offer acupuncture, including naturopathic doctors, physiotherapists, massage therapists, doctors of Chinese Medicine and licensed acupuncturists. Here is how the two techniques differ, what a session feels like, what to ask before you book, and what to tell your practitioner for your safety.
What is dry needling?
Dry needling, also called trigger point release or intramuscular stimulation, aims needles at trigger points: tender, knotted areas in a muscle that can hurt on the spot or send pain elsewhere. The goal is to relieve tension in the muscle, and release the fascia.
The method grew out of Western anatomy and pain research, and was developed separately from traditional acupuncture theory. The practitioner feels for the tight band, inserts the needle and may move it until the muscle gives a brief twitch. Needles may stay in for a couple of seconds or up to about 20 minutes, depending on the technique.
Training is not extensive to be certified in this style of acupuncture, often a few weekends of training for someone who already is a health care provider. This is the type of acupuncture to expect from a RMT, physiotherapist or chiropractor.
What is traditional or constitutional acupuncture?
Acupuncture places fine needles at specific points on the body. It comes from traditional Chinese medicine (TCM), which describes health in terms of balance and the flow of qi (vital energy) along channels called meridians. TCM has been used for many years and more recent studies are focusing on the neurophysiology that can be shifted with acupuncture.
A TCM-based treatment, sometimes called constitutional acupuncture, starts with a wider assessment than one sore spot. Your practitioner may ask about your sleep, digestion, stress, energy and menstrual cycle, and those answers can shape which points are chosen. Tongue and pulse assessment guides point selection.
Training for this type of acupuncture takes years, and is a core modality in naturopathic medicine, trained over the course of 4 years with many exams including licensing exams. Naturopathic doctors, registered or licensed acupuncturists and doctors of Chinese Medicine are trained for this type of acupuncture.
Dry needling vs acupuncture at a glance
| Dry needling | Acupuncture | |
|---|---|---|
| Based on | Western anatomy and trigger point research | Traditional Chinese medicine |
| Assessment | Focused on the muscle or area of concern; the practitioner feels for tight bands | In TCM, full system assessment including tongue and pulse diagnosis |
| Where needles go | Into tight bands and knots in muscle, scar tissue or fascia | At specific points throughout the body, often on arms, torso and legs |
| Needle time | A couple of seconds to about 20 minutes | Usually about 20 minutes |
| What you may feel | A prick, then a deep ache or brief muscle twitch. Sometimes it can be quite painful, with shooting electric-like sensations for a brief moment | A small prick, then a dull ache, heaviness or tingling |
| Afterwards | Muscle soreness for a day or so is common; bruising is possible | Side effects are usually few and mild |
At Natura, both styles of acupuncture are provided by Dr. Erin Esau, ND.
Whoever you see, it’s reasonable to ask:
- What training do you have in this technique, and does your regulatory body authorize you to perform it?
- Which approach are you planning to use, dry needling, acupuncture or both, and why?
- What will the session involve, and how long will the needles stay in?
- What side effects should I watch for afterwards, and who do I contact if I’m concerned?
- How often would you suggest coming, and when will we review the plan together?
Does acupuncture hurt? What a session feels like
You may feel a small prick as each needle goes in. You may then feel a dull ache, heaviness or tingling around the point.
Dry needling tends to feel stronger. You may feel some discomfort while the practitioner locates the trigger point, and when the needle reaches it, the muscle may twitch or briefly cramp. The area can stay sore for 24 to 36 hours, sometimes with a small bruise. You can ask your practitioner to adjust or stop at any point.
What to expect at your visit
- Assessment. Your practitioner will spend some time figuring out what is going on and how to best treat you.
- Consent and positioning. Your practitioner explains the plan and possible side effects, and you agree to it before any needles are placed. You then lie comfortably on the treatment table during the session. No need to worry about dressing for it since we have sheets on the tables for you to change if needed.
- Needling. Sterile, single-use needles are placed.
- Afterwards. Mild soreness is possible, especially after dry needling. Note anything you notice over the next few days and mention it at your next visit.
How many acupuncture sessions do I need?
There’s no set number. As always with naturopathic medicine, each plan is individualized and communicated in the visit.
Is dry needling or acupuncture safe?
In trained hands with sterile, single-use needles, like it is at Natura, it is considered to be a safe therapy. Risks are reviewed for the specific treatment before beginning so you feel comfortable and informed with your plan.
Tell your practitioner before treatment if you:
- are pregnant
- take blood thinners or bruise and bleed easily
- have a weakened immune system, or a skin infection near the treatment area
- have had recent surgery
- feel very anxious or faint around needles
Acupuncture and dry needling at Natura
At Natura Integrative Care Clinic in Steinbach, Dr. Esau, ND provides traditional Chinese medicine (constitutional) acupuncture and dry needling, also called trigger point release. Acupuncture can be booked as a first visit (45 minutes) or as part of a full naturopathic plan.
Acupuncture at Natura is usually a 30-minute visit, for $100; a first visit for new patients is 45 minutes, including the assessment, for $155. Natura doesn’t direct bill: you pay at your visit and submit the receipt to your insurer. Many extended health plans include naturopathic medicine, so check your plan and see fees and insurance.
Common questions
Is dry needling the same as acupuncture?
Not quite. Both use the same thin, solid needles, but the training and approach differ. Dry needling targets trigger points in muscle using Western anatomy, while acupuncture selects points using traditional Chinese medicine. Some practitioners are trained in both techniques.
Can I have dry needling and acupuncture in the same visit?
It depends on the case, and your preferences. At Natura, Dr. Erin Esau, ND provides both traditional Chinese medicine acupuncture and dry needling.
Does dry needling hurt more than acupuncture?
Usually, a little. TCM acupuncture typically feels like a small prick followed by a dull ache or tingling. Dry needling aims at tight, tender muscle, so you may feel a deep ache or a brief twitch or cramp as the needle reaches the trigger point, and soreness can last a day or so. Your practitioner can adjust the intensity, and you can ask them to stop at any time.
Is acupuncture covered by insurance in Manitoba?
It depends on your plan. Many extended health plans include naturopathic medicine, but coverage for acupuncture varies, so ask your insurer whether acupuncture from a naturopathic doctor is covered and how much per year. Natura doesn’t direct bill: you pay at your visit and submit the receipt yourself. Our guide to naturopathy coverage in Manitoba explains what to ask.
How long is an acupuncture appointment at Natura?
Acupuncture visits at Natura are generally booked as 30 or 45 minutes. If you’re a new patient booking only for acupuncture, you may book a 45-minute first visit that includes both the assessment and your first treatment, at the clinic’s discretion; more complex concerns may need a longer first visit. During treatment, needles usually stay in for about 20 minutes.
Sources
- Acupuncture: effectiveness and safety — NCCIH
- Natural therapies — Canadian Association of Naturopathic Doctors
This article is general information, not medical advice for your situation. If you're unwell or worried, talk to your doctor or call Health Links – Info Santé, Manitoba’s free 24-hour nurse line, at 1-888-315-9257. In an emergency, call 911.
