Acupuncture vs Dry Needling
How acupuncture and dry needling are alike and different, who performs each, how training and regulation vary by place, and what to ask before treatment.
Content last updated . This page has not been medically reviewed.
The short version
Dry needling inserts thin acupuncture-type needles, with nothing injected, into muscle, tendon or other tissue, usually to treat musculoskeletal pain. [1] The needles are the same kind used in acupuncture, and the techniques overlap (see what is acupuncture). The main differences are the explanation used, the training, and who is allowed to do it, which vary by jurisdiction. [2]Alike and different
| Acupuncture | Dry needling | |
|---|---|---|
| Needle | Fine solid needle | Same type of thin solid needle [1] |
| Explanation | Traditional (qi and meridians) or biomedical "Western medical acupuncture" [3][2] | Biomedical, often aimed at muscle "trigger points" [1] |
| Typical practitioners | Acupuncturists, plus some doctors and others | Often physical therapists, in places where it is allowed [4] |
| Evidence | See the use pages | Short-term improvements in some studies; no high-quality long-term trials for muscle trigger points, per a 2014 review [1] |
A review of the debate concluded dry needling and acupuncture overlap in technique and in some fundamental theories, and that dry needling is arguably one subcategory of Western medical acupuncture. It called for an accrediting body for dry needling courses and for collaboration. [2] A separate paper reported that myofascial trigger points are significantly correlated with traditional Chinese medicine acupoints. [5]
Training and regulation depend on where you live
- United States. The American Physical Therapy Association says the regulatory landscape is uneven: dry needling is in the physical therapist scope of practice in some states and not in others. [4] Acupuncture is licensed state by state: see licensing and training.
- Australia. The title "acupuncturist" is protected; those not registered or endorsed cannot use it. [6]
- England. NHS wording: complementary therapists other than chiropractors and osteopaths do not need to be registered by law. [7]
Safety and evidence
Dry needling uses the same type of needle, so the same precautions apply: sterile single-use needles and caution with blood thinners and bleeding risk, covered on side effects and precautions. For osteoarthritis, NICE says not to offer acupuncture or dry needling. [8]Frequently asked questions
Is dry needling the same as acupuncture?
They use the same kind of needle and overlap in technique, but differ in explanation, training and regulation. [2]
Who can do dry needling?
It depends on your state or country; in the U.S. some states include it for physical therapists and others do not. [4]
Does dry needling work?
A 2014 review found short-term improvements in some studies but no high-quality long-term evidence for needling muscle trigger points. [1]
References
- Dunning J, et al. Dry needling: a literature review with implications for clinical practice guidelines. Phys Ther Rev. 2014;19(4):252-265. PubMed 25143704 Read 2026-10-22.
- Zhou K, Ma Y, Brogan MS. Dry needling versus acupuncture: the ongoing debate. Acupunct Med. 2015;33(6):485-490. PubMed 26546163 Read 2026-10-22.
- A critical examination of the main premises of Traditional Chinese Medicine. PMC7253514 Read 2026-10-22.
- American Physical Therapy Association, Dry Needling. Read 2026-10-22.
- Liu L, et al. Traditional Chinese Medicine acupuncture and myofascial trigger needling: the same stimulation points? Complement Ther Med. 2016;26:28-32. PubMed 27261978 Read 2026-10-22.
- Chinese Medicine Board of Australia, Protected titles, endorsement and 'holding out'. Read 2026-10-22.
- NHS, Herbal medicines and complementary therapies. Read 2026-10-22.
- NICE, Osteoarthritis in over 16s: diagnosis and management (NG226). Read 2026-10-22.