1. Difference between dry needling and acupuncture
Dry needling (or trigger point needling) is a western approach to treating myofascial pain syndrome, or pain triggered by pressure on sensitive points (muscle-induced problem). Needles are inserted to trigger points (a taut band over the muscles and usually hypersensitive), to elicit a “twitched” response. Needles are removed once this local “twitched response” is achieved.
Aim: Releasing trigger points to relieve pain, improve range of motion and reduce muscle tension
Acupuncture is a method used in traditional Chinese medicine to balance the flow of energy “chi” along the meridians, to balance the body function and improve the body’s well-being. Sometimes needles are put bilaterally and stay on for 10 to 20 minutes.
2. Which is preferred amongst patients in Hong Kong?
In fact, clients are not able to really tell the difference while receiving dry needling or acupuncture treatments. Most patients in Hong Kong received acupuncture (from TCM).
Dry needling is used more so for myofascial pain, chronic tension or knot over the muscles, and overuse injuries. Rotator cuff injuries, neck and back pain, chronic tension over neck and back (due to poor posture), hip and knee pain, Achilles or heel pain, overuse injuries to hip and knee (e.g. runners or basketball players).
Acupuncture treatments can be used for overall well-being, such as to quit smoking, control weight gain, address infertility problems, blood pressure, musculoskeletal problems etc. However, as a physiotherapist, we use acupuncture for musculoskeletal-related conditions, versus other general medical conditions.
3. Is there any specific type of injuries that acupuncture and dry needling is most suited for, as part of an overall therapy plan?
Recurrent strain or overuse injuries due to muscle inflexibility, the taut band within the muscles, and chronic spasm of the muscle because of failed self-recovery.
For example, if a runner has persistent knee pain (either due to biomechanical fault or tendinopathy) and the pain is not resolved by stretches and deep tissue massage then dry needling or acupuncture is appropriate (if not contraindicated to the patient). These treatments are effective to reduce muscle tension and pain, to speed up recovery and facilitate the patient to continue a customised home exercise prescription programme.
4. What are some of the benefits of using dry needling or acupuncture as opposed to the more Western forms of physiotherapy, such as Joint Mobilisation?
This method is part of the overall physiotherapy treatment plan. It facilitates recovery by allowing the continuation of the rest of treatment plan (e.g. deeper soft tissue massage, performing certain rehabilitation exercises) after reducing muscle tension or pain.
Needles are invasive and target deeper structures inside the body. It works very well to treat chronic tension, which restricts the body to function in an optimal way or to achieve full range of movements.
5. How did you get involved in this specialisation? Where did you train?
I completed a Diploma in Acupuncture, conducted by the Physiotherapist Association. As part of the diploma course, theory lessons were completed in Hong Kong and then I had to do clinical placements in Guangzhou, China. After that, I did further training and studies with a trigger point needling course in Hong Kong.
6. Are people aware that physiotherapists are trained to do acupuncture and dry needling?
Not many people know that certified physiotherapists can conduct dry needling or acupuncture. They usually go to Traditional Chinese physicians or specialists.
7. Have these fields changed over time? If so, how do you keep up with the changes?
Techniques and theory of dry needling and acupuncture have not changed much over time. For the most effective treatments, to find the exact trigger points comes mainly from experience.
Photos are close-ups of dry needling by ProHealth Sports and Spinal Physiotherapist, Leo Choi