Is Dry Needling Acupuncture at All?

A Contemporary Scientific Re-Examination of Two Techniques Often Confused — But Rarely Compared

At Neurohealth Wellness on Sydney’s Northern Beaches, we provide both dry needling (performed by our chiropractors and Ana, our massage/myotherapist) and acupuncture (provided by Lucia).

Because both use a fine, solid filiform needle, they are often assumed to be interchangeable.

Modern anatomical, electrophysiological, and pain-science research paints a very different picture.

Despite sharing a tool, dry needling and acupuncture arise from different origins, target different tissues, produce different mechanical effects, and trigger different neuroimmune responses. They sit alongside each other as valuable therapies — but not as variations of the same method.

This review answers a common question:

Is dry needling a form of acupuncture?

Modern evidence says no.

Both therapies, however, have immense therapeutic value when applied appropriately — which is exactly why Neurohealth Wellness offers both.

A Simple Needle, Two Very Different Ideas

To the untrained eye, both practices appear similar:

• A thin needle enters the skin
• A therapeutic response follows

Clinically and biologically, however, they emerge from separate lineages with distinct intentions and mechanisms.

Acupuncture: Systemic Regulation

Rooted in East Asian medicine, acupuncture developed within a framework of meridians, channels, and pattern diagnosis.

Modern biomedical reinterpretations have mapped many acupuncture points to:

• Neurovascular bundles
• Dermatomes
• Connective tissue planes
• Lymphatic intersections
• Autonomic and visceral reflex arcs

Its therapeutic goal is systemic regulation — influencing autonomic balance, central pain modulation, and internal homeostasis.

Dry Needling: Local Structural Reset

Dry needling evolved from Western pain science and the study of myofascial trigger points (MTrPs).

These are not symbolic points. They are:

• Dysfunctional motor endplate zones
• Regions of spontaneous electrical activity (SEA)
• Hypercontracted sarcomeres and taut bands
• Sites of local ischaemia and nociception

Dry needling aims to directly deactivate a dysfunctional structure that perpetuates pain and movement restriction.

The difference is anatomical, physiological, and intentional — not cultural.

What Exactly Do They Target?

Acupuncture Targets: Global Regulatory Points

Acupuncture points are selected based on pattern diagnosis rather than local tissue pathology.

Even when applied locally, acupuncture often produces systemic effects, including:

• Autonomic modulation
• Vagal activation
• Central nervous system regulation

Research shows many points lie along intermuscular septa, connective tissue planes, and neurovascular pathways.

Their purpose is regulation.

Dry Needling Targets: Dysfunctional Myofascial Structures

Dry needling is unapologetically local and anatomical.

It targets:

• A palpable taut band
• A hypercontracted sarcomeric region
• An electrically active motor endplate
• A structure capable of reproducing the patient’s pain

The target is pathological tissue, not a symbolic point.

This is the most significant distinction between the two approaches.

Mechanotransduction: How Tissue Responds to the Needle

Acupuncture: Fascial Signalling

Research led by Helene Langevin and expanded through 2020–2023 shows acupuncture produces:

• Fascial winding
• Fibroblast stretching and remodelling
• Piezoelectric signalling in connective tissue
• Slow, long-range mechanical propagation

These effects help explain acupuncture’s systemic influence.

Dry Needling: Microdisruption & Normalisation

Dry needling behaves more like a precise microsurgical intervention:

• Mechanical disruption of contraction knots
• Restoration of normal sarcomere length
• Normalisation of excessive acetylcholine at the motor endplate
• Ionic shifts reducing spontaneous electrical activity

This often triggers a local twitch response (LTR) — a hallmark of dry needling and a sign of neuromuscular resetting.

Mechanically, the two therapies operate in almost opposite ways.

🔹 Unsure which needle-based therapy is right for your pain?

Dry needling and acupuncture serve different clinical purposes. Choosing the right one depends on whether your pain is being driven by a local dysfunctional structure or a broader nervous system pattern.

A thorough assessment can help determine which approach — or combination — best supports your recovery.

📍 Neurohealth Wellness – Allambie Heights (Northern Beaches)
📞 (02) 9905 9099
🔗 Book online: https://www.neurohealthwellness.com.au/booking

At Neurohealth Wellness, both approaches are used intentionally — dry needling to address local muscle and neuromuscular dysfunction, and acupuncture to influence broader nervous system and physiological responses — depending on what the person in front of us actually needs.

Electrophysiology: The Sharpest Scientific Distinction

Acupuncture Influences:

• A-delta and C-fibres
• Descending inhibitory pain pathways
• Limbic and cortical modulation
• Diffuse noxious inhibitory control (DNIC)
• Autonomic and vagal activation

Its effects are central and widespread.

Dry Needling Influences:

• Motor endplates (a domain acupuncture does not target)

Electromyography studies (2020–2024) demonstrate:

• Abolition of spontaneous electrical activity
• Elimination of endplate noise
• Triggered local twitch responses
• Reduced nociceptive input from MTrPs
• Segmental spinal modulation via proprioceptive change

Acupuncture has never been shown to extinguish SEA — because it does not aim for dysfunctional motor endplates.

Dry needling’s electrophysiological signature is unique.

Neuroimmune Effects: Different Chemical Messages

Acupuncture Produces:

• Vagal anti-inflammatory activation
• Endorphin and serotonin release
• Mast-cell mediated vasodilation
• HPA axis modulation

Dry Needling Produces:

• ↑ IL-10 (local anti-inflammatory cytokine)
• ↓ IL-6 and ↓ TNF-α
• Satellite cell activation for myogenic repair
• Improved perfusion of taut bands
• Reduced local C-fibre sensitisation

The immune system responds differently because the target tissue and insult differ.

Clinical Logic: Why Each Technique Is Chosen

Acupuncture is selected when addressing:

• Systemic pain modulation
• Digestive or hormonal patterns
• Stress, sleep, or autonomic imbalance
• Emotional or visceral regulation

Dry Needling is selected when addressing:

• Trigger points
• Muscle guarding
• Movement restriction
• Sports injuries
• Postural overload
• Neck or low back pain

If acupuncture adjusts the orchestra,
dry needling fixes a misfiring instrument.

Both matter — for different reasons.

Why the Confusion? The Thin Needle Problem

The only thing these therapies share is the instrument.

If the tool defined the therapy:

• A lumbar puncture would be acupuncture of CSF
• Joint aspiration would be acupuncture of synovium
• Percutaneous tenotomy would be acupuncture of tendons

Clearly, the target and mechanism define the practice — not the needle.

Where Neurohealth Wellness Stands

At Neurohealth Wellness, we value:

• Clarity
• Science-led care
• Choosing the right tool for the right person at the right time

Dry Needling at Neurohealth

Performed by:

• Steve (Chiropractor)
• Florian (Chiropractor)
• Ana (Massage/Myotherapist)

Acupuncture at Neurohealth

Performed by:

• Lucia (Acupuncture & Traditional Chinese Medicine)

Together, these therapies provide a complete spectrum of care:
local tissue repair + systemic nervous system regulation.

The Scientifically Defensible Conclusion

Dry needling is not acupuncture.

It is a distinct, evidence-based intervention targeting dysfunctional motor endplates and myofascial pathology.

Acupuncture is a system-level neuromodulatory therapy with global regulatory effects.

Both belong in modern healthcare.
Both are essential tools.
And both are integral to the integrative care model at Neurohealth Wellness.

🔹 Guidance matters as much as the technique

If you’re unsure whether dry needling, acupuncture, or a combination is most appropriate for your pain or condition, professional guidance can help clarify the best path forward.

📞 Call (02) 9905 9099
🔗 Book online: https://www.neurohealthwellness.com.au/booking

Scientific References

1. Dommerholt J. Phys Med Rehabil Clin N Am (2023).
2. Shah JP, Thaker N. Curr Pain Headache Rep (2021).
3. Sánchez-Infante J et al. Pain Med (2022).
4. Langevin HM et al. Front Pain Res (2021).
5. Yu S, Wang Y. Neurosci Bull (2020).
6. Liu L et al. Clin Rehabil (2022).
7. Butts R, Dunning J. JMMT (2021).
8. Fernández-de-las-Peñas C. J Clin Med (2023).
9. Zhao ZQ. Pain Reports (2020).
10. Kietrys DM. JOSPT (2024).

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