In case you haven't tried dry needling, here is what it looks like...
OUCH!? I would say that dry needling is usually painful and effective. I incorporate both dry needling and traditional acupuncture into my practice. In recent studies it has been suggested that the combination of the two is more effective than dry needling alone. It's been my experience that very few licensed acupuncturist's practice dry needling in their clinic's.
As discovered in previous articles, you the reader can see that the training to become an acupuncturist versus a physical therapist is quite different. The core fundamentals of training for an acupuncture student is to understand the rich history of Chinese medicine, in which, the use of needles is a small portion in the realm of Chinese medicine. Along with the history students learn, different diagnostic methods of disease which include tongue inspection, traditional pulse taking, and inspecting the ear to name a few. During the 2-4 years of training an acupuncture a student is equipped with a wide variety of knowledge in treating musculoskeletal pain and problems, internal medicine conditions such as; hormone imbalances, digestive issues, and emotional problems. In order to be accepted into acupuncture school one does not even need a bachelor's degree! Students can do 2 years at any college and have their basic core curriculum completed which must include basic anatomy and chemistry classes. In general, acupuncture schools tend to accept pretty much everyone who applies.
Physical therapy schooling predominantly consists of the study of the physical body. The curriculum is heavy with anatomy and physiology classes. They learn how to engage with and assist physically disabled patients. PT student's must become expert's with the body and how to help patients in pain regain ability. The requirements for all potential physical therapy students is at minimum a four year bachelor's degree, preferred in pre-med studies or some type of applied human sciences. Colorado has two top ten physical therapy schools and they are extremely picky on their candidates.
The professions of acupuncture and physical therapy are very different. Acupuncture is meant to be a whole system therapy while physical therapy is meant solely to treat musculoskeletal dysfunction. Both therapies excel in their unique attributes. The unfortunate reality is that the musculoskeletal training for acupuncture students is quite minimal. Furthermore, the needling instruction for aggressive, trigger point needling is just not a part of the norm at any school for acupuncture. One might think, because a student has gone to school for 2-4 years in “acupuncture” that their knowledge is the end-all, be-all of anything needles - and that is just not the case. Acupuncture and needling techniques is a small, non-majority portion of the training for one to become a licensed acupuncturist.
I have been on a personal mission throughout my career to find as much training in the needling portion of Chinese medicine as I can. I have personally attended four different schools for acupuncture and Chinese medicine. I have had many, many classmates and colleagues from around the globe. I have seen needling styles from far and wide, I have written many works including my doctoral dissertation on needling techniques and I can say without hesitation that most acupuncturists do not know how to perform dry needling. As expressed previously, I would be furious if another profession was stealing my medicine and calling it their own. Unfortunately that is not the case. Physical therapists have taken a therapy essentially invented by a medical doctor in the 40’s who found that physically breaking apart a tight knot in a muscle could relieve pain - this is called trigger point therapy. Dr. Janet Travell actually used hypodermic needles with procaine (a numbing agent similar to lidocaine and novocaine) to relieve pain. In a future blog, I will discuss why the use of hypodermic trigger point therapy with procaine isn’t used by physical therapists and how dry needling came into fruition.
In regards to the lawsuit of acupuncturists versus physical therapists in Colorado, I have always felt, that instead of suing physical therapists, acupuncturists should have taken it upon themselves to train their licensee's in dry needling and provide this useful therapy to the general public. If the lawsuit is successful, many patients who have been helped by dry needling will no longer have that therapy accessible to them. Overall, that is the key point that is saddening. I am upset about a useful therapy being removed because of a turf war. I always feel that the patient should come first!
Dr. Christina Fick (DAOM)