What is the Difference Between Acupuncture and Dry Needling?

In my Sandton practice, I often get asked about the difference between acupuncture and dry needling.

It’s a fair question, and a common one. Both techniques use the same sterile, single-use needles. Both involve inserting them into the body to relieve pain. And to someone observing from the outside, the two practices can look nearly identical. But the philosophy, application, and outcomes can differ significantly.

The key distinction lies not in the tool, but in the theories underpinning the treatments.

Acupuncture is rooted in Traditional Chinese Medicine (TCM), a system over 2,000 years old that views health as a balance of internal energies. Dry needling, by contrast, is a relatively recent technique grounded in Western musculoskeletal anatomy. While both approaches have merit, understanding their differences helps clarify why acupuncture can treat much more than just tight or painful muscles and why these two treatments are completely different. Check out a detailed explanation of acupuncture in the article What is Acupuncture?

Let’s compare these two techniques.

What Guides Acupuncture?

Acupuncture is guided by a philosophical and diagnostic framework unique to TCM. At its core is the concept of qi (vital energy), which flows through meridians (channels) across the body. Symptoms are seen not as isolated events but as signals of imbalance within a larger system (our body).

Treatment involves identifying this imbalance and selecting specific acupoints to restore balance. The location of these points has been mapped over centuries, refined through practice and clinical experience. This means the acupoints can be near the problem but they don’t have to be.

In contrast, dry needling does not follow a systemic diagnostic framework. It typically targets trigger points in muscles—hyperirritable spots often palpable as tight knots. The needles are inserted directly into these trigger points to provoke a twitch response or release tension. Focus on stimulating the muscle to release tension or alleviate pain.

Similar Tools, Different Goals

The same needle may be used, but the purpose behind its use is where things diverge:

• Acupuncture: targets specific acupoints based on imbalances

• Dry needling: targets muscular trigger points to relieve localised pain

  
  

Interestingly, there is an overlap. A technique in acupuncture known as “Ah Shi” needling involves inserting needles into tender or reactive points—essentially, trigger points. But Ah Shi points are just one subset of a much broader system. Dry needling essentially extracted that technique and made it the whole method.

This is where the scope widens and further clarifies that these two techniques are different. Check out my article for more details (What Can Acupuncture Treat?), but acupuncture can treat a much larger variety of conditions when compared to dry needling. Including digestive issues, emotional issues, Infertility, headaches and much more.

The Philosophical Divide

To appreciate the difference more deeply, one must consider the mindset behind the treatment.

Dry needling treats the body as a biomechanical system. Muscles, fascia, and nerves are the focal points. Pain is a localised issue, and treatment is aimed at releasing tension in that area.

Acupuncture views the body as an integrated whole. A headache may be due to an imbalance, which in turn stems from stress, a poor diet, and unexpressed emotion. Treatment might include points on the feet, wrists, or even the ears. The aim isn’t just to relieve symptoms but to harmonise the entire body to bring about health.

Which One Should You Choose?

It depends on what you're looking for.

• If you have an acute muscle spasm or a sports-related injury, dry needling might help. It’s quick, localised, and often part of a broader physical therapy program.

• If you're dealing with a recurring pattern, such as anxiety-related tension, hormonal imbalance, digestive irregularity, or even emotional burnout, acupuncture offers a more holistic, systems-level approach.

• Or if you're just looking for a more holistic treatment for your condition, whether acute or chronic, try acupuncture.

And of course, both can be complementary. Some physiotherapists and acupuncturists now collaborate to offer integrative care.

Conclusion: Beyond the Muscle

In the end, the question “What can acupuncture treat?” opens up a deeper reflection. Acupuncture is not just a pain-relief technique—it is a framework for understanding the interconnectedness of mind, body, and our environment. While dry needling plays an important role in modern manual therapy, acupuncture's broader diagnostic scope and rich philosophical background give it a unique capacity to address complex, multi-system conditions.

If you're seeking relief that goes beyond the muscle, if you're interested in restoring balance rather than just removing tension, then acupuncture may be worth exploring.

Curious whether acupuncture could help your specific condition? Visit my contact page to book a consultation or explore more resources on my blog here. Otherwise, contact your nearest acupuncturist to find out more!

— Dr Darren Carpenter, Doctor of Chinese Medicine and Acupuncture