Written by Katherine LaGassie, LAc, MSAOM
If you are struggling with a painful condition, you may have come across both acupuncture and dry needling during your research. Sometimes, dry needling is mentioned in Google search results or recommended through care providers. A frequent question our patients ask “What is dry needling?” That question is often followed by “How is it different from acupuncture?”
Are acupuncture and dry needling the same thing?
Both practices involve the insertion of very thin needles into the body to improve function and, in the case of painful conditions, alleviate pain. However, beyond this basic similarity, they are two different modalities. The key difference is the philosophy/treatment goal, as well as technique, and practitioner training.
Acupuncture is an East Asian medicine treatment modality that is designed to balance the flow of Qi and blood through the body. Thin, single-use, sterile needles are inserted along meridians to affect the flow of Qi and blood. The practice has been housed under the umbrella of East Asian medicine for thousands of years. It offers holistic health benefits, treating both the chief complaint a patient has, as well as treating the whole person. As a result, acupuncture supports physical, emotional, and mental wellbeing. It addresses the underlining ‘dis-ease’ that manifests symptomatically in the body. Musculoskeletal pain and tension are only a portion of what acupuncture can alleviate, treat, and support. Acupuncture treats and supports a wide variety of health conditions due to its holistic approach. Practitioners who use acupuncture and other East Asian medicine modalities, to treat their patients are called acupuncturists.
Dry needling is a contemporary Western medicine term for a treatment technique used to relieve pain through targeting specific muscle knots, called trigger points.1 The goal of dry needling is to facilitate a response, usually in the form of a muscle twitch, to reduce tension, pain, and restriction of movement.1
The advantages of dry needling for people with muscle tension, particularly athletes and those with repetitive strain injury include relief of acute pain on specific muscles, relaxation of tension, and improved muscle performance. 2 Dry needling is usually performed by physical therapists or chiropractors.
The quick view comparison
While both dry needling and acupuncture use very thin needles to provide benefit for patients, the focus and technique are quite different.
Acupuncture
- Takes into account the entire person, their constitution, and their chief complaint to provide a holistic treatment.
- Process is usually gentler, with needles left in place longer to relax the body.
Dry needling
- Focuses only on reducing musculoskeletal pain and improving recovery through manipulation of the needle in or around specific trigger points.
- May cause some discomfort or a twitching feeling in the muscle since it targets tight knots directly. 2
- Needles are usually not left in place for a prolonged period of time during treatment unless combined with electrical stimulation.
Who can practice this procedure?
The qualification of acupuncturists is assured by The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM). NCCAOM National Board-Certified Acupuncturists ™ are highly trained healthcare professionals. They undergo hundreds of hours of specialized training “in the core skills required to correctly perform invasive and potentially dangerous needling techniques, assuring the competencies to insert and manipulate acupuncture needles safely”.3
In order to be NCCAOM Nationally Board-Certified, acupuncturists must complete a minimum of 3 years or 1,905 hours of education, including a minimum of 660 hours of supervised clinical training.3 Acupuncturists must graduate from a Master’s degree or Professional Doctorate degree accredited by Accreditation Commission for Acupuncture and Oriental Medicine (ACAOM).3 They must also pass NCCAOM National Board certification examinations and complete a written and practical Clean Needle Technique course and assessment.3
Currently 46 states plus the District of Columbia require NCCAOM certification and/or NCCAOM certification examinations in order for an acupuncturist to be licensed.3
The official position of the NCCAOM, is that “dry needling” is a newly coined name for an acupuncture technique that involves the insertion of acupuncture needles directly into muscles and “trigger points” for the relief of musculoskeletal pain.3 Your acupuncturist can use these acupuncture techniques to alleviate musculoskeletal pain. However, other healthcare professionals who practice dry needling cannot claim to perform acupuncture, due to the difference in training and treatment strategies.
Unlike acupuncture, there is no required academic standard, validated examination, or program for the training of health care providers who practice dry needling.3 There is no current national standard for academic curriculum, education, or training of dry needling for them.3 “The only training in dry needling for physical therapists are abbreviated continuing education workshops. There are no minimum hours or curriculum standards for these workshops.”3
In 2016, the American Medical Association adopted policies on the safe provision of dry needling. The new policy recognized dry needling as an invasive procedure that should require adequate training for patient safety.4 It stated that “dry needling is indistinguishable from acupuncture, yet physical therapists are using this invasive procedure with as little as 12 hours of training”.4 They believe that the practice of dry needling should, at minimum, “require the standards of training, certification, and continuing education that exist for the practice of acupuncture”.4 As such, for patient safety, the AMA Board stated dry needling should “only be performed by practitioners with standard training and familiarity with routine use of needles in their practice, such as licensed medical physicians and licensed acupuncturists”.4 Currently, there is no standard to ensure this.
Summary
Acupuncture
- Balances the flow of Qi and blood through meridians in the body to support optimal wellness.
- Approaches patient conditions with a holistic philosophy, treating, supporting, and alleviating both musculoskeletal pain and a wide variety of other health conditions.
- Needles are placed on specific locations along meridians. They may be left to rest as well as manipulated gently or stimulated with electrical impulses to enhance therapeutic benefit.
- Performed by licensed acupuncturists who undergo extensive training, board examinations, and have a minimum of 660 hours of clinical training.
Dry needling
- Focuses on the alleviation of musculoskeletal pain through targeting trigger points on muscles to release tension, improve blood flow, and reduce pain.
- Needles are inserted in or around trigger points to elicit a twitch response believe to reset the muscle, release tension, improve muscle performance, and alleviate pain.
- Performed by physical therapists and chiropractors following a continuing education course. Currently, there is no national standardized training requirements, certification, or clinical training hours required for dry needling.
References:
1. Understanding the Differences Between Dry Needling and Acupuncture. Nashville Acupuncture Clinic PLLC. 2025.
2. Dry Needling vs. Acupuncture: Key Differences and Benefits Explained. Buckhead Acupuncture & Herbal Center. 2025.
3. NCCAOM Dry Needling Position Statement. NCCAOM.org. 2019.
4. Physicians Take on Timely Public Health Issues. AMA. 2016.
Additional reading:
https://completelyaligned.com.au/acupuncture-vs-dry-needling-whats-the-difference/
https://www.morningsideacupuncturenyc.com/blog/dry-needling-vs-acupuncture
https://redleafwellness.ca/blog/dry-needling-vs-acupuncture-what-you-need-to-know/
https://griffinacu.com/blog/dry-needling-vs-acupuncture-whats-the-difference-and-why-it-matters