Acupuncture vs. Dry Needling

Same Needles, Very Different Approaches: Acupuncture vs. Dry Needling

You've probably heard of dry needling and acupuncture and may have wondered—aren't they basically the same thing? After all, both involve inserting fine, sterile needles into the skin. But while they may share tools, the intent, technique, and philosophy behind each practice are profoundly different.

Let’s break it down.

What Is Dry Needling?

Dry needling is a technique primarily used by physiotherapists or other musculoskeletal practitioners. It focuses on inserting needles directly into tight bands of muscle known as "trigger points" to relieve localized pain and improve mobility. The aim is to provoke a twitch response in the muscle, which can help it relax.

Dry needling is usually used for short-term symptom relief. Its focus is mechanical and local—think of it as "releasing a knot" in a specific muscle. While effective for some types of pain, it doesn't necessarily take into account the broader systemic or energetic context of your health.

What Is Acupuncture?

Acupuncture is a complete medical system grounded in Traditional Chinese Medicine (TCM). While it can also treat local pain, its aim is much more holistic: it works to restore balance in the body and mind. Acupuncturists assess your overall health, not just your pain points. Treatments are often designed to regulate your nervous system, support hormonal health, improve digestion, boost immunity, and address emotional well-being.

Needles are placed at strategic points along meridians (pathways of energy), including both local and distal points, to influence the body’s internal systems.

The Science Behind Acupuncture’s Broad Impact

1. Activating Your Brain's Natural Painkillers [1,2,3]

Did you know your body has its own internal pharmacy? Acupuncture helps tap into it.

When you experience pain, your brain can release natural chemicals that help reduce it—no medication needed. Acupuncture activates specific regions in the brain, which not only dampen pain but actually change how your brain processes it over time.

• Endorphin and Enkephalin Release: Acupuncture stimulates the release of these powerful natural painkillers. Endorphins and enkephalins are your body’s own opioids—substances that reduce pain and promote a sense of well-being. They're the same chemicals responsible for the “runner’s high.” [1,2]

• Neurotransmitter Modulation: It also helps regulate important brain chemicals like serotonin and norepinephrine. These affect not just pain, but also your mood, stress levels, and sleep quality. That’s why many people feel more relaxed or sleep better after a session.

• Descending Pain Modulation: Acupuncture triggers a communication pathway from the brainstem (especially a region called the periaqueductal gray or PAG) down through the spinal cord, instructing your body to block incoming pain signals. This system acts like your body’s own pain-dampening circuit. [1,2]

Functional MRI (fMRI) studies confirm that acupuncture affects the brain areas involved in sensory, emotional, and cognitive aspects of pain—such as the thalamus, anterior cingulate cortex, and prefrontal cortex. [3]

2. Reducing Inflammation [5,6,7]

Inflammation is a root cause of many chronic conditions—from arthritis to cardiovascular disease. Acupuncture offers a powerful tool for calming this fire within.

• Balancing Cytokines: Cytokines are signaling proteins that control inflammation. Acupuncture has been shown to decrease pro-inflammatory cytokines while increasing anti-inflammatory ones, helping your body return to balance.

• Regulating Immune Cells: It can modulate the activity of key immune cells, like macrophages and T-cells, reducing excessive immune responses that drive inflammation.

• Vagal Pathway Activation: Acupuncture can stimulate the vagus nerve, which plays a key role in the body’s anti-inflammatory reflex—called the “cholinergic anti-inflammatory pathway.” This pathway calms immune overactivity and reduces systemic inflammation.

3. Promoting Deep Relaxation: The Autonomic Nervous System [8,9,10,11]

Feeling constantly stressed, anxious, or unable to unwind? Acupuncture helps regulate your autonomic nervous system—the part of your body that governs stress and relaxation.

• Vagal Nerve Stimulation: Acupuncture points like Stomach 36 and Pericardium 6 are known to activate the vagus nerve. This encourages your body to move out of “fight-or-flight” mode and into a “rest-and-digest” state, where healing and recovery happen.

• Needle Retention Time: Unlike dry needling, which typically uses fast, in-and-out techniques, acupuncture involves gently inserting the needles and leaving them in place for 20–40 minutes. This longer, sustained input sends a calming signal to your brain, allowing your nervous system to truly settle.

People often report feeling deeply relaxed, even drowsy, during and after a treatment—clear signs that the parasympathetic nervous system has been activated.

Beyond Local Points: Acupuncture’s Holistic View

Even when acupuncture uses a point near your pain, it doesn't stop there. Acupuncturists often include distal points to work along the body’s meridians. Interestingly, these meridian pathways often line up with modern understandings of fascia chains, nerve pathways, and circulatory routes.

This holistic strategy allows acupuncture to address the root cause of an issue—not just the symptom. For example, chronic shoulder pain might be linked to digestion or emotional stress. Acupuncture integrates these factors into one comprehensive treatment.

Both acupuncture and dry needling have their place. If you're looking for short-term relief from a tight muscle, dry needling might help. But if you’re seeking a more comprehensive approach that treats the whole person—body, mind, and nervous system—acupuncture offers a deeper and more lasting path to healing.

References

1. Eshkevari, L., et al. (2015). The Effect of Acupuncture on Stress in College Students: A Pilot Study. Journal of Acupuncture and Meridian Studies, 8(1), 22-26.

2. Theysohn, N., et al. (2014). Acupuncture-Related Modulation of Pain-Associated Brain Networks During Electrical Pain Stimulation. Evidence-Based Complementary and Alternative Medicine.

3. Musial, F., et al. (2014). Acupuncture and the Brain: A Review of Functional MRI Studies. Complementary Therapies in Medicine.

4. Nagasaki, M., et al. (2024). Neural circuit mechanisms of acupuncture effect. Frontiers in Neurology.

5. Kavoussi, B., & Ross, B. E. (2007). The neuroimmune basis of anti-inflammatory acupuncture. Integrative Cancer Therapies.

6. Li, A., et al. (2009). Acupuncture and inflammation: mechanisms and applications. Frontiers in Bioscience.

7. Sun, K., et al. (2022). Effects of Acupuncture on Inflammatory Factors and Pain. Pain Research and Management.

8. Ahn, B., et al. (2024). Needle sensation and autonomic nervous system activity. Frontiers in Neuroscience.

9. Luo, C., et al. (2018). Acupuncture and Central Autonomic Regulation. Frontiers in Neuroscience.

10. Yue, S., et al. (2022). Acupuncture on ANS and Prefrontal Cortex Activity. ResearchGate.

11. Hamvas, M., et al. (2023). Acupuncture for autonomic nervous system regulation: A systematic review. Journal of Clinical Acupuncture and Moxibustion.