Written by Brook Cheng
Dry needling, also known as trigger point dry needling and intramuscular stimulation (Dommerholt J et al, 2006; Zhou K, et al, 2015), a therapeutic technique mainly used for treatment of muscle pain by various healthcare practitioners, including physical therapists, physicians, and chiropractors, among others (Crislip, Mark et al, 2016). The American Physical Therapy Association defines dry needling as a technique used to treat dysfunction of skeletal muscle and connective tissue, minimize pain, and improve or regulate structural or functional damage.
An Evolution From “Wet” to “Dry”
“Dry needling” is a terminology invented in 1940s referring to a hypodermic needle (a thin, hollow tube with a sharp tip) without injection of any liquid substance. The word “dry” was just used in contrast to a “wet” hypodermic needle that is used for intramuscular injections or for drawing blood.
The term ‘‘dry needling’’ was first used in a paper published in the British medical journal the Lancet by Paulett JD (1947), who, in a study of low back pain, concluded that pain relief could be obtained not only from the injection of procaine or saline but even “dry needling’’without injection of any substance.
So “pricking for a cure with a hollow needle without liquid substance injection” is what “dry needling” means from the very beginning.
Another Type of Needles Being Always “Dry”
For the therapeutic purpose, in contrast to the dry injection needle which is hollow, there is another type of needle which is solid. It is the needle used in acupuncture without liquid substance injection involved.
In addition, an acupuncture needle is much thinner than an injection needle. Being thinner is an important advantage of acupuncture needle as thinner needle will produce less pain when a patient is stabbed.
Acupuncture needles have never being used in a “wet” condition. So acupuncture is an out-and-out “dry needling”.
Replace Hollow Needles with Solid Ones
Although dry needling had been suggested as a treatment in late 1940s, no trials had ever been attempted until 1970s when an acupuncture fever hit the Western world. In 1979, Lewit K et al (1979) published a landmark paper in the development of dry needling. He used acupuncture needles as well as hypodermic ones and found that the former produced less bleeding and bruising.
From that point, the thinner and solid acupuncture needles gradually replaced the thicker and hollow hypodermic needles for the treatment of muscular-skeletal conditions with pain as a primary symptom.
Who Invented Dry Needling: The West or The East？
As mentioned earlier, a solid acupuncture needle has never been used in a “wet” condition but always being used “dry” (without any liquid substance involved). This condition has remained unchanged since the very beginning more than 2000 years ago in China.
In this context, the tangible “dry needling” is essentially a technique invented in ancient China, although the Western researchers in 20th century did “linguistically” invent a terminology “dry needling”.
Therefore, when the term ‘‘dry needling’’ first time coined by Paulett JD (1947) after he had relieved his patients’ back pain using a “dry’’ hypodermic needle, he just repeated what the ancient Chinese doctors had already done 2000 years earlier as described in Chinese medicine classics Huangdi Neijing (Suwen 41, On Back Pain Relief by Needles 刺腰痛): Pricking for a cure with a dry needle without any liquid substance injection involved.
Therapeutic “Dry Stone”
More interestingly, the ancient Chinese doctors 2000 years ago not only invented “dry needles”, but also invented “dry stones” – sharp pieces of stone used to cause a bleeding of the skin for a cure.
Tangible Invention vs Linguistic Coining
In short, ancient Chinese doctors in the East invented the tangible “dry needling”. The medical researchers in the West 2000 years later coined the linguistic “dry needling”.
Wet or Dry Not An Issue: What Is The Essence?
In China, there were times or occasions a doctor would stab a patient with a “wet” needle which was just soaked in boiling water for sanitization purpose. That was needed when a needle used on one patient was reused for another patient.
So wet or dry? It is not an issue at all. The essence is “stimulation with a sharp for a therapy”.
References
Brav EA, Sigmond H: The local and regional injection treatment of low back pain and sciatica. Ann Int Med 15: 840–852, 1941.
Crislip, Mark. “Dry needling”. Science-Based Medicine. 2016
Churchill, James Morss, A Treatise on Acupuncturation, 1821
David Legge, A History of Dry Needling, Journal of Musculoskeletal Pain , J. Masculoskeletel pain, 2014.
Dommerholt J, del Moral OM, Grobli C. “Trigger point dry needling” . Journal of Manual & Manipulative Therapy. 2006 14 (4): E70–E87.
Esteban, Michelle, Acupuncturists, physical therapists battling over so-called ‘dry needling’ technique, 2016, https://komonews.com
Huangdi Neijing: Suwen 41, On Back Pain Relief by Needles (刺腰痛), BC 100
John Dwyer, Turf War Over Who Can Claim The Title Of Acupuncturist, The Conversation 2012
Lewit K: The needle effect in the relief of myofascial pain. Pain 6: 83–90, 1979.
Paulett JD: Low back pain. Lancet 2: 272–276, 1947.
Morris, William, Acupuncture and Closure: Turf Wars, Acupuncture Today, 2013
Reno, Jamie, Acupuncturists and Physical Therapists Declare War Over Over ‘Dry Needling’, 2016, www.healthline.com
Stainton, Lilo H, Physical Therapists Win Latest Battle in Turf War… New Jersy Spotlight News 2018.
Zhou K, Ma Y, Brogan MS. Dry needling versus acupuncture: the ongoing debate. 2015. Acupunct Med. 33 (6): 485–490.