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Adding dry needling to your therapy practice

Photo: Tim Chow on Unsplash
Jeff Laurence has qualifications in health, fitness, remedial massage and dry needling. Laurence trained in a physiotherapy rehabilitation clinic before starting his own wellness practice in Sydney.

Working with clients in fitness and sport, he has seen for himself the benefits of combining evidence-based practices using client education to assist with the rehabilitation process.

Laurence is quick to point out the difference in dry needling and acupuncture, with the emphasis on dry needling as a method of releasing tension in the affected muscle, to get the healing process started; preceded and followed by kneading and massage. Follow-up appointments to strengthen the muscle are necessary to strengthen the tissue.

“I don’t believe in recommending dry needling over physiotherapy. I think that everything has value. Dry needling is most effective for unlocking tissue, but the body needs exercise therapy, massage, physio, chiro to complete the healing and rehabilitation process. Any of these therapies are incomplete on their own.”
The Australian Physiotherapy Association (APA) has recognised the application of trigger point dry needling in a profession that is based on extensive training in human anatomy and physiology – with some practitioners specialising in sports, chronic illness and rehabilitation.

In a statement to HealthTimes, Chair of APA acupuncture and dry needling group, Rebecca Fagan said, “Dry needling uses a western scientific framework to treat muscle tender points, myofascial trigger points, tendons, ligaments and pathways of the nervous system, as well as to reduce neural sensitivity and pain.”

To view dry needling courses, click here.

“The evidence base for dry needling in various areas of physiotherapy has increased substantially over the past decade. In particular, research has grown to provide evidence-based support in the treatment of acute and chronic back pain, chronic neck pain, tension type and migraine headaches, pelvic girdle pain, knee osteoarthritis, lateral elbow pain and shoulder conditions.”

Laurence firmly believes that dry needling only works when it targets muscles – and that acupuncture is misleading because it is based on the body’s energy lines. Such an esoteric approach leaves little consent for the patient, who must trust the practitioner’s training in Traditional Chinese Medicine (TCM).

However, acupuncture professionals have concerns with the increase in dry needling accreditation, which can be covered in a weekend of theory and practical-based training.

President of the Australian Acupuncture and Chinese Medicine Association (AACMA) Waveney Holland says the 5000-year-old practice of acupuncture should not be compared with dry needling.

A physiotherapy degree and weekend course in dry needling is not the equivalent of a bachelor of acupuncture, she says. While trained physiotherapists do have a knowledge of anatomy, their education is in relation to movement and physical therapy.

“The short dry needling course only tells them where to stick the needle.”

A bachelor of acupuncture is specifically tailored to acupuncture, with nearly two years of practical work in needling application, under the direction of a supervisor or tutor, giving instruction on not just placement but on diagnosis, as well as the angle and depth of the needle insertion.”

Holland gives the example of knowing that a set of needles might need to be placed in positions relative to a person’s size – this is a precise method that takes time to master, and can often cause injury if done incorrectly.

“It can cause a lot of pain and turn the patient of the treatment – which is why we need properly trained practitioners.”

In 2017 the Acupuncture Evidence Project was published (by AACMA), a systematic literature review comparing the effectiveness of acupuncture in treating 122 conditions across 14 clinical areas in Australia and the United States from 2010 to 2016. Only five conditions showed little or no evidence or effect (including alcohol dependence, cocaine addiction, epilepsy) and 71 conditions showing unclear/mixed evidence (conditions such as Alzheimer’s, ADHD, erectile dysfunction, hyperemesis gravidarum, rheumatoid arthritis, uterine fibroids).

Holland notes that although we have been slow to uncover the evidence for acupuncture effectiveness, it is the translation of information that has been the problem, as most of it is in Chinese. An article from the Australian Journal of Acupuncture and Chinese Medicine has collected studies from Chinese databases on the use of acupuncture in the treatment of migraine, which indicated moderate evidence of the effectiveness of frequent acupuncture treatment compared to Western pharmacotherapy.

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Sharon Smith

Sharon Smith writes freelance articles as a medical, science and technology specialist. She is researching health journalism at Griffith University and lives mostly on Twitter @smsmithwriter (and would love to hear from you).