Unraveling the Needle: Dry Needling vs. Acupuncture

A question that continuously comes up in my practice - especially as needle-based therapies have gained immense popularity in recent years for their potential to alleviate pain, improve wellness, and enhance overall health - what is the difference between acupuncture and dry-needling? Two prominent practices that involve the insertion of thin needles into the body are acupuncture and dry-needling and it makes sense that people want to understand how to differentiate between the two. While these therapies may appear similar at first glance, they differ significantly in their origins, principles, techniques, and applications. 

First, it is important to understand what dry-needling actually is. The term “dry-needling” was first used by Janet Travell, MD to differentiate between “wet needling” or hypodermic injections and “dry needling” which is either insertion of a needle into muscle without injection or with the use of a filiform - or solid - needle. So by this definition, acupuncture is dry-needling. However, while the distinction between acupuncture and dry-needling can be complex, there are significant differences in the two practices. To better understand these differences, let's delve deeper into the key distinctions.

Acupuncture is an ancient practice originating in traditional Chinese medicine (TCM), dating back over 2,500 years. Acupuncture has a rich history deeply intertwined with Chinese philosophy and culture. It was initially used to balance the body's vital energy, known as Qi, and has evolved over centuries to treat a wide range of health issues. Whereas, dry-needling is a relatively modern therapy that has its roots in Western medicine. It emerged in the late 1970s with Czech physician, Karel Lewit, when he published his landmark paper ‘‘The Needle Effect in the Relief of Myofascial Pain'’ where he concluded that the insertion of needles into muscles to elicit a trigger effect had a remarkable ability to treat pain in musculoskeletal conditions. 

Acupuncture is rooted in the principles of TCM, focusing on the flow of Qi (or energy) through meridians or channels in the body. Acupuncture aims to balance Qi by inserting needles at specific acupoints along meridians, promoting the body's natural healing processes. Dry-needling is grounded in neuroanatomy and the understanding of trigger points, which are tight bands of muscle tissue that can cause pain and dysfunction. The primary goal of dry-needling is to release muscle knots and reduce pain by targeting specific trigger points.

Acupuncture uses thin, sterile needles, often made of stainless steel.Needles are placed at various acupoints, which may or may not coincide with trigger points, and are typically left in place for a longer duration to balance energy flow. In dry needling, solid, filament needles are used, typically without the addition of substances (hence "dry"). The needles are inserted directly into trigger points or tight muscle bands to elicit a twitch response, which helps release tension and relieve pain.

Acupuncture is employed for a broader range of health issues, including pain, digestive disorders, stress, anxiety, and more. Acupuncture seeks to restore balance in the body's energy flow, addressing both physical and emotional well-being. Dry-needling is commonly employed to treat musculoskeletal conditions such as muscle pain, tension, and myofascial pain syndrome. The primary objective is to reduce pain, improve muscle function, and enhance mobility.

The biggest difference, however, may be in the training. Acupuncturists undergo extensive training in TCM theories, meridian systems, and needle techniques, typically completing formal programs and obtaining licensure. Acupuncture is regulated in many countries, ensuring practitioners meet specific educational and ethical standards. Whereas, practitioners of dry needling, who often include physical therapists, chiropractors, and some medical doctors, have varying degrees of education in needling technique. Regulations regarding dry needling vary by region, and it may not be regulated in some places.

In summary, while acupuncture is highly regulated and dry-needling is mostly regulated, they are distinct practices with different practitioners, training requirements, and scopes of practice. Acupuncture is practiced by licensed acupuncturists, with a broader range of applications based on Traditional Chinese Medicine principles - which means they are able to treat musculoskeletal pain in addition to things such as women’s health, digestive health, autoimmune issues, etc. Dry-needling is primarily performed by physical therapists and focuses on musculoskeletal issues. Patients in Tennessee - or any other state in the US - seeking these therapies should ensure they receive treatment from qualified and licensed practitioners in their respective fields.

Chlorophyll, Chlorella, and the Importance of Blood

As daylight fades on 2021 and we move towards 2022, post-holiday hibernation is beginning.  The temperatures are finally getting cooler and my thoughts turn inward just as the season predicts. I look around and see the leaves have fallen from the trees and I’m reminded of a particularly potent pigment in mother nature: chlorophyll. 

“Chlorophyll is a photosynthetic pigment present in green plants that absorbs light energy and uses it to produce carbohydrates from carbon dioxide and water. Chlorophyll is crucial to the process of photosynthesis, which is responsible for sustaining the life process of green plants.” What I find so fascinating about chlorophyll is its similarity to another vital fluid: blood. 

As famous botanist Donald Peattie found in Tree: A Life Story, "Using spectrum analysis, [I] learned that the constituents of a chlorophyll molecule were eerily familiar. 'To me, a botanist's apprentice, a future naturalist,' he writes, 'there was just one fact to quicken the pulse. That fact is the close similarity between chlorophyll and hemoglobin, the essence of our blood.' This is no fanciful comparison, but a literal, scientific analogy: 'The one significant difference in the two structural formulas is this: that the hub of every hemoglobin molecule is one atom of iron, while in chlorophyll it is one atom of magnesium.' Just as chlorophyll is green because magnesium absorbs all but the green light spectrum, blood is red because iron absorbs all but the red. Chlorophyll is green blood."

What is the importance of this finding? Firstly, it leads us to the conclusion that plants are not as different from us as we may like to believe. Secondly, with such striking biological similarity, it is clear that we may use chlorophyll to nourish our own blood, because in Chinese Medicine (CM) we use “like to treat like”. 

I talk a lot about blood quality in session and the key difference between how CM views blood and how Western Medicine views it is, CM is more interested in the quality of blood rather than the quantity. If the quality is good, you will have enough quantity. Blood is categorized as connective tissue, therefore fresh, healthy, high quality blood is one of the vital fluids that keeps our bodies running and functioning optimally. 

That being said, I frequently recommend chlorella whenever a patient presents with any blood quality issues. Blood quality issues run the gamut and can be anything from pain to insomnia and everything in between. “Chlorella is a single-celled green algae found in bodies of freshwater and contains high concentrations of nutrients such as vitamin C, carotenoids, vitamin B complex and iron. The algae also contains a high amount of protein and can produce healthy oils high in polyunsaturated fats.” 

Why chlorella over chlorophyll? Though they are related, there are some key differences between chlorella and chlorophyll. Chlorella is a type of algae and chlorophyll is the substance plants use, along with sunlight, to make their own food. While straight chlorophyll is an excellent supplement, taking chlorella has added benefits such as:

• Delivers a high amount of nutrients to the body: Chlorella is packed with good-for-you stuff like vitamins B12 and C, iron, fiber, protein, antioxidants, and fatty acids.

• Helps the body process heavy metals and detox: One of chlorella's best-known benefits is that it's a great ingredient for helping rid your body of all the toxins that come from processed foods, the environment, and life in general which can disrupt our hormonal balance. It binds to heavy metals to assist with detox.

• Provides protective benefits to the body: While studies are mixed, this edible algae may also help strengthen the immune system, as well as possibly lower cholesterol, blood pressure, and manage blood sugars.

• Promotes weight loss:A 2008 study published in the Journal of Medicinal Food discovered that regular chlorella intake over a 16-week period resulted in a lower body fat percentage for the participants, along with lower cholesterol and blood glucose levels.

While supplements are not a cure-all, they are certainly part of the process of healing. Feel free to reach out directly with any questions and I look forward to seeing you in the clinic!

https://www.livestrong.com/article/470008-chlorella-vs-chlorophyll/

https://healthyeating.sfgate.com/chlorella-vs-chlorophyll-10702.html 

https://www.byrdie.com/chlorella-benefits

The (Long Overdue) Normalization of Menstruation

The normalization of women's menstruation is long overdue. For centuries women’s cycles have been shrouded in mysticism and secrecy with the overarching belief being that during the time of the month when a woman bleeds, she is “impure” and must be kept out of the public eye. The menstrual rituals of different cultures run the gamut from the use of menstrual huts to “cleansing” baths once a woman ceases bleeding.

What this broad belief of “menstrual uncleanliness”  has done is create a culture around menstruation where bleeding is considered bad or unclean and therefore, as with most bad or unclean things, it does not get discussed; this lack of openness on the subject ensures serious and honest conversations about our cycles, including what is “normal”, do not occur. Too often, women believe that if their mother suffered from it (whatever “it” is…), then that is also their fate and if their mother did not, then they are just the unlucky one to have to deal with this problem now.

For this reason, so many women have no understanding about what a normal cycle is, what a period should feel like and further, what measures can be taken if they experience something pathological with their period. So having said that, I would like to shed some light on what a normal cycle is, what a normal period is and what can be done if you experience pain or discomfort. 

A normal cycle (with a cycle being defined as the first day of bleeding to the next first day of bleeding) can be anywhere from 26-35 days with the sweet spot really being 28-30 days. Some patients' cycles are slightly longer or shorter than this, and what I say regarding that is: if you are in good health and your cycle is regular, then that is what is normal for you, and what is normal for you is not pathological. A typical period from start to finish, will last anywhere from 3 to 6 days. Shorter or longer bleeding is atypical and would need to be explored further. As for pain with one's cycle, that is pathological, meaning it is not “normal” and not something that one must learn to just “power through” or “suffer with”. The same goes for pain with ovulation, or Mittelshmirz. Premenstrual syndrome is something many women struggle with, and is comprised of any number of uncomfortable symptoms, such as bloating, irritability, cramping and fatigue, experienced prior to a woman beginning her monthly bleed. There are many different reasons one might experience PMS or feel pain with their cycle or with ovulation, and in addition to speaking with a gynecologist, one can also seek out alternative remedies such as acupuncture and Chinese herbal medicine to help alleviate any unusual symptoms. The usual course of treatment for a gynecologist when a women comes in with these complaints is to put the woman on birth control, which comes with its own set of issues. I am all for women having ownership of their bodies, it is another thing for me when I see doctors covering up pathology with a pill that does nothing to address the root of the problem.

Consider how many women you know who have had painful or irregular cycles. Think about how many women you know who may have had trouble conceiving. And now think about how most of those women struggled through the pain and how the ones trying to conceive had to see a number of doctors to get pregnant, if they were lucky enough to get pregnant at all. Think about all the women out there that don’t talk about it at all. This is what a lack of conversation does, it breeds a paucity of education about ourselves. If education is power, then the mainstreaming of women’s health is imperative to our work towards equality in healthcare. 

A Case of Extreme Bloating: Before and After

Another before/after transformation ✨😁✨
Patient came in with a chief complaint of extreme bloating (she is NOT pregnant). She had modified her diet on the advice of her dietician. Multiple functional tests reported nothing out of the ordinary. These cases are always the most frustrating for patients - they don’t feel good, but there is no pathological reason for it!
In her first treatment I opened her Dai Mai, the “girdling” channel, and worked on moving Qi of the Middle Jiao.
Next I prescribed a modified Fu Zi Li Zhong Wan for cold in the middle, to warm and move in an attempt to jumpstart movement in the middle.
The 1st pic is after her first treatment, where she said she already noticed a decrease in bloating. The 2nd pic is from today, after 6 days of herbs. Big difference!! There is still some bloating, but you can see her waist now and more importantly, she feels SO much better.
Next steps are to continue warming Yang and work on nourishing Spleen Qi so she can work on her next big project: getting pregnant.