Sometimes patients, referring doctors and even state boards of physical therapy wonder whether TrP-DN is a form of traditional acupuncture. While there are similarities between the two treatment approaches, there are probably many more differences. Physical therapists are legally allowed to practice dry needling in many countries, including Canada, Spain, South Africa, the Netherlands, Ireland, Australia, Switzerland, the UK,etc. In the US, State boards of physical therapy in eight States have determimed that TrP-DN falls within the scope of physical therapy practice. States where physical therapists can practice TrP-DN are NewHampshire, Maryland, Virginia, South Carolina, Georgia, New Mexico, Kentucky, and Colorado. In other States, such as New York, Hawaii, California, and Tennessee, physical therapists are not allowed to use dry needling. Most other state boards have not considered the issue. In some states the physical therapy statutes are quite confusing. For example, according to the Florida statutes, physical therapists are allowed to practice acupuncture “when no penetration of the skin occurs.”
The practice of traditional acupuncture has its roots in ancient China and is based on a presumed flow of energy through acupuncture meridians. The objective of acupuncture is to restore the energy balance in the meridians which is seen as a prerequisite to restore a person’s health. Acupuncturists insert thin needles in specific points throughout the body. Acupuncture has been recognized by the World Health Organization and is practiced around the world. In the US, the training of an acupuncturist requires completion of a master’s degree from an accredited school of acupuncture.
TP-DN requires the completion of an accredited post-graduate continuing education program. In the US, Myopain Seminars directed by Jan Dommerholt and Dr. Robert Gerwin, is the premier company to study TP-DN.
In Canada, many physical therapists have completed the training program from Dr.Chan Gunn, also known as “intramuscular stimulation ”. Dr.Gunn is one of the early pioneers of TP-DN. Although many patients assume that dry needling originated from traditional acupuncture, Dr.Gunn based his thinking on Western medicine and neurology. Another pioneer of dry needling is Dr. Karel Lewit from the Czech Republic, who was strongly influenced by Dr. Janet Travell and her focus on myofascial trigger points.
In TrP-DN, we use the same needles as acupuncturists even though the technique is very different. The objective if TrP-DN is to elicit so-called local twitch responses, which require the needle to be placed directly into myofascial trigger points.
While a few researches have suggested that acupuncture points overlap with myofascial trigger points, it remains difficult to compare an ancient metaphysical concept with a more modern neurophysiologic scientific concept. There are several scientific studies that support both dry needling and acupuncture, although the mechanisms of each remain somewhat elusive. It is interesting to see the similarities between the well-described referred pain patterns of myofascial trigger points and the course of acupuncture meridians. However, from a physical therapy perspective the objective of TP-DN has nothing to do with the control of presumed energy flows.
Three recent studies confirmed that acupuncture does not have unique effects on the central nervous system or on pain and pain modulation, which implies that the discussion whether TrP-DN is a form of acupuncture becomes irrelevant. In these studies, there were no significant differences between acupuncture and sham acupuncture.
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