Dry Needling actually is Acupuncture, just rebranded: Dry needling involves inserting solid filiform needles into soft tissue, including trigger points and motor points, to relieve pain or improve movement. It is sometimes described as a modern biomedical practice - but it is, in method and effect, acupuncture. Proponents of dry needling often claim that acupuncture is solely based on the movement of qi through energy meridians, implying it lacks western scientific basis. This is a mischaracterization. Acupuncture is supported by a growing body of biomedical research that identifies multiple mechanisms of action, including neuromodulation and local tissue effects. The argument that acupuncture does not also address pain relief and mobility from a myofascial standpoint is outdated and inaccurate.
Furthermore, the World Health Organization (WHO), identified trigger point needling as part of acupuncture practice in 1999, describing it as “a type of acupuncture treatment.” Likewise, the National Center for Complementary and Integrative Health (NCCIH) recognizes dry needling as a “modern adaptation of acupuncture.”
Multiple state regulatory boards, including in New York, California, and Oregon, have also affirmed that dry needling falls under the legal scope of acupuncture and must only be performed by licensed acupuncturists or medical professionals with equivalent training.
Despite attempts to rebrand it, you can perform acupuncture without using dry needling techniques, but you can’t perform dry needling without essentially practicing acupuncture. The difference is in the training, clinical judgment, and standards of care.
This not a safe add-on skill: Unlike massage, taping, or stretching, dry needling is an invasive procedure. It pierces the skin and underlying muscle tissue, carrying risks of:
To safely manage these risks, a practitioner must understand anatomy, clean needle technique, needling depth, and appropriate patient assessment.
As a licensed acupuncturist, I completed over 700 hours of supervised clinical practice and thousands of hours of didactic training, including anatomy, physiology, and pathology alongside traditional diagnostic frameworks - not to mention countless hours of continuing education. In contrast, athletic trainers pursuing dry needling training may only complete a brief course, with little to no hands-on supervision, clinical evaluation, or adequate time to master the skill.
This is a dangerous double standard and it places the public at risk.
Patients are confused, and sometimes harmed: Allowing undertrained practitioners to needle patients diminishes the integrity of the acupuncture profession and creates confusion among the public.
I have treated numerous patients who came to me fearful or skeptical of acupuncture after negative experiences with dry needling. In many cases, they were unaware that their previous provider lacked comprehensive training. They often assumed I had the same minimal instruction, when in fact, I have 5+ years of advanced graduate acupuncture education and supervised clinical experience.
The public should not bear the burden of understanding licensure and scope-of-practice nuances. The responsibility to regulate invasive medical procedures and ensure public safety lies with the state.
Professional Boundaries should be respected: This is not a criticism of Athletic Trainers, who are are highly skilled in injury prevention and rehabilitation. But it is not appropriate for them to perform invasive procedures like dry needling - just as is is not appropriate for acupuncturists to perform joint relocations or prescribe post-operative rehab.
Dry needling should only be performed by those with the appropriate licensure and educational standards: licensed acupuncturists and qualified physicians or physical therapists with needling included in their core curriculum and licensing exams.
Please protect public health, uphold the integrity of professional training standards, and reject the inclusion of dry needling in the scope of practice for athletic trainers.
Thank you for your time and your commitment to safe, evidence-based healthcare.
Sarah Coghlan, DACM, L.Ac.