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Kohut S.1, Larmer P.1
1Auckland University of Technology, Clinical Sciences, Auckland, New Zealand
Background: The definitions of acupuncture and dry needling are complex, with differing definitions being used worldwide. There is one tool used by all practitioners, the 'dry' acupuncture needle. The clinical reasoning underlying the application differs, whether from traditional Asian medicine, Western medicine or trigger point dry needling.
The origins of Western medical acupuncture originated from traditional Chinese acupuncture, however are fundamentally different philosophically and theoretically, with very different clinical reasoning practices. The name acupuncture originated in late seventeenth century Europe, deriving from the Latin, acus (a needle) and pungere (to puncture). Dry needling as a practice can be traced back to the mid twentieth century where pioneers such as Janet Travell coined the term dry needling to treat myofascial trigger points using a 'dry needle', rather than an injection using a hypodermic needle for the myofascial pain. Yet because they use the same tools and similar needling practices may appear similar to the untrained eye. The difference between acupuncture and dry needling practices is the definition of dry needling being a rapid, short term needling to altered or dysfunctional tissues in order to improve or restore function, rather than the needles being left in situ and stimulated over time. However many research publications utilising dry needling state a treatment time with the needles in situ for five, ten minutes or even longer. This is argued to be acupuncture. It could be questioned that acupuncture is being subjected to the social, political and religious influences which have historically driven medical practice. Thus defined legislated scopes of practice limited practice, for example in the U.S.A. physical therapists are trained in dry needling and not allowed to 'acupuncture'.
The origins of Western medical acupuncture originated from traditional Chinese acupuncture, however are fundamentally different philosophically and theoretically, with very different clinical reasoning practices. The name acupuncture originated in late seventeenth century Europe, deriving from the Latin, acus (a needle) and pungere (to puncture). Dry needling as a practice can be traced back to the mid twentieth century where pioneers such as Janet Travell coined the term dry needling to treat myofascial trigger points using a 'dry needle', rather than an injection using a hypodermic needle for the myofascial pain. Yet because they use the same tools and similar needling practices may appear similar to the untrained eye. The difference between acupuncture and dry needling practices is the definition of dry needling being a rapid, short term needling to altered or dysfunctional tissues in order to improve or restore function, rather than the needles being left in situ and stimulated over time. However many research publications utilising dry needling state a treatment time with the needles in situ for five, ten minutes or even longer. This is argued to be acupuncture. It could be questioned that acupuncture is being subjected to the social, political and religious influences which have historically driven medical practice. Thus defined legislated scopes of practice limited practice, for example in the U.S.A. physical therapists are trained in dry needling and not allowed to 'acupuncture'.
Purpose: This research was undertaken to further understand the origins, theoretical perspectives, complexities, similarities and differences in practices of acupuncture and dry needling practices.
Methods: A qualitative historical methodology was utilised to identify primary and secondary information sources in relation to dry needling origin, development, theories, legislation and future possibilities.
Results: The major finding emerging from this health system analysis was needling practices being camouflaged by a name and terminology. This substantive issue can confound adequacy of patient understanding and informed consent. How does the public discern what treatment is being provided, and the level of competency and qualification of the practitioner providing an invasive technique.
Adequacy of teaching programmes was also highlighted, because needle-based therapies are a postgraduate competency. Some teaching programmes can be as short as two days. Thus safety of the patient and the practitioner is a paramount consideration. How long does it take to learn safe needle therapy practice? This is further confounded because of many countries having limited guidelines towards what constitutes legitimate needling practice in physical therapy.
Conclusion(s): A more inclusive model of needling practice development is required in order that this valuable physical therapy tool can be understood and practiced legitimately, without obfuscation. Legislation and patch protection are the drivers behind this separation.
Implications: Greater clarity of professional acupuncture dry needle related practices are required for the safety of both patients and physical therapists.
Funding acknowledgements: No funding has been sought or secured.
Topic: Professional issues
Ethics approval: Ethics approval was not required.
All authors, affiliations and abstracts have been published as submitted.
