“Dry needling” has created a great deal of confusion in recent years, both among patients and healthcare providers. It is one of many names d that refer to a form of acupuncture utilized by Western medicine clinicians. The term was coined by Janet Travell, MD, and came into prominence during the early 1980s when discussed in her seminal text Myofascial Pain and Dysfunction: The Trigger Point Manual. 30 It was used to distinguish from the implied “wet needling,” which is the injection of a fluid with a hypodermic needle. While a “dry needle” initially referred to an empty syringe, it has evolved to include monofilament/filiform 31 needles routinely used by acupuncturists. The latter of which is utilized in the modern application of “dry needling.” Acupuncture, by default, encompasses “dry needling,” and any suggested distinction, in actuality, exists largely in name.

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The current interpretation of “dry needling” largely refers to an aggressive form of acupuncture entailing a piston-like motion of deep needling into tender areas in muscles known as trigger points. Many “dry needling” adherents, whether due to being genuinely misinformed or otherwise, suggest that it never occurred to ancient Chinese physicians to manipulate a needle in a piston-like motion or treat trigger points, utilizing the equivalent language of their time. In an attempt to distinguish it from “dry needling,” they unfortunately misrepresent acupuncture as being relegated to superficial or “energetic” needling based on a mystical paradigm. Neither the needling method, nor the concept of trigger points, is new or innovative.

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This is recognized by numerous clinicians and researchers, acknowledging the historical precedent set by acupuncture. 32-38 For instance, “The Yellow Emperor’s Inner Classic of Medicine” (Huang Di Nei Jing), dating back to between the 2nd century BC and 2nd century CE (Han Dynasty), describes this. The technique, hegu ci, is still used to treat musculoskeletal conditions. It is characterized by deep needling into muscles accompanied by partial retraction and reinsertion at varying angles, which is currently described as “fanning” or “coning.” 39 With regards to trigger points, in his 7th century CE work, “Prescriptions Worth a Thousand Gold” (Qian Jing Yao Fang), the famous physician, Sun Simiao, described ashi points. Ashi, which translates to “Ah, yes!” or “That’s it!” refers to points that are tender or painful upon local pressure and can produce radiating pain – hallmarks of trigger points. 

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These are just a couple of innumerable examples demonstrating acupuncture’s historicity and development over the course of more than 2000 years. Numerous styles and techniques of needling factor in several variables: depth, angle, intensity, frequency, proximity to the diseased/injured area, etc. 39 Acupuncturists are trained in both traditional and biomedical paradigms, evidenced by their educational requirements. In addition, numerous continuing education courses and certificate programs in orthopedic/sports medicine/trigger point acupuncture have been well established prior the recent emergence of “dry needling.” 

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“FAQ.” Wisconsin Society of Acupuncturists, 1 June 2022, www.acupuncturewisconsin.org/faq/.