Origins of Dry Needling

The needling of hyper-irritable areas or palpable nodules in muscle fascia has existed since at least the era when the very first acupuncture book was written in China sometime between 440 BC- 220 CE. This book, known as the Huangdi Neijing (Yellow Emperor's Inner Classic), describes in detail how to discover and needle into these tender and knotted spots, or ashi points, to eliminate pain. This method has been known and taught to acupuncturist for millennia as the ashi method, and is usually learned within the first year of hands-on training.

The origins of the term "dry needling" can be traced to a much later time that coincides with the arrival of Western Medicine in China during the late 19th Century. For about 2000 years prior, the Chinese had continuously developed their own unique system of therapeutic needling methods known simply as zhen (针), which translates into English as “needling”. When modern Western Medicine was introduced in China, the Chinese word gan (干), or “dry”, was added to zhen (needling) to differentiate it from the hypodermic needling that injects or withdrawals fluid, or "wet" material, into and from the body.1,2

About a century before hypodermic needles were introduced in China, zhen became the inspiration for the invention of the hypodermic needle in Europe.3,4 Basic therapeutic needling techniques had been imported from China and Japan into Europe since as early as the 16th Century and named acupunctura (Latin acus for "needle", and punctura for "to pierce with"). By the 18th and 19th Century, medical books discussing acupuncture's effectiveness in the treatment of pain were widely circulated throughout European medical communities. As word spread around, so did the idea that acupuncture could be even better at alleviating pain if drugs could be injected into the same area through a hollowed needle. Soon after, the hypodermic needle was invented and went on to become one of the most important tools used in modern medical treatment.

By the 20th Century in China, with the rise in use of Western Medicine and "wet needling", the term "dry needling" had become a common folk name used for acupuncture.1 Subsequently, to establish a new theory and practice of acupuncture irrespective of its traditional concepts, "dry needling" began undergoing scientific testing. Because of its simple procedural needling technique, wide applicability, and therapeutic effectiveness in the modern healthcare setting, the ashi method became the most general type of "dry needling" used and studied. As a result the term "dry needling" came to describe the ashi method and the emerging scientific evidence surrounding its use. However, despite decades of research and clinical trials around the world, the emerging scientific theory of therapeutic needling, whether called acupuncture or "dry needling", remains poorly understood and inconclusive.5-13

Mistakenly, there are some resources that attribute the origin of the term "dry needling" to Janet G. Travell, who uses the term in her book, "Myofascial Pain and Dysfunction: Trigger Point Manual" (1983). However Travell uses "dry needling" to differentiate between two hypodermic needle techniques when performing trigger point therapy.14 Additionally, Travell did not elaborate on the techniques of "dry needling", whereas current "dry needling" techniques are largely based on Chinese acupuncturist Yun-Tao Ma's Integrative Systemic Dry Needling (ISDN) protocol that draws from both traditional and Western medical acupuncture.15

 

References
  1. Fan, A.Y., and He, H. (2015). Dry needling is acupuncture. Acupuncture in Medicine, 34(3), 241.
  2. Fan, A. Y., et. al. (2017). Evidence and expert opinions: Dry needling versus acupuncture (I): The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016.” Chinese Journal of Integrative Medicine, 23(1), 3–9.
  3. Omura Y. (1975). Some historical aspects of acupuncture and important problems to be considered. Acupuncture & Electro-Therapeutics Research, 1(3/4):3–44.
  4. Lu, D.P., and Lu, G.P. (2013). An historical review and perspective on the impact of acupuncture on U.S. medicine and society. Medical Acupuncture, 25(5), 311–316.
  5. Cohen M.L., and Quintner J.L. (2008). The horse is dead: let myofascial pain syndrome rest in peace. Pain Medicine, 9(4), 464–465.
  6. Cohen M.L., and Quintner J.L. (1993). Fibromyalgia syndrome, a problem of tautology. The Lancet, 342(8876), 906–909.
  7. Jin G.Y., and Jin, J.X. (2007). Contemporary Medical Acupuncture: Systems approach. Beijing: Higher Education Press.
  8. Perreault, T., Dunning, J., and Butts, R. (2017). The local twitch response during trigger point dry needling: Is it necessary for successful outcomes? Journal of Bodywork and Movement Therapies, 21(4), 940-947.
  9. Quintner J.L., and Cohen M.L. (1999). Fibromyalgia falls foul of a fallacy. The Lancet, 353(9158),1092-1094.
  10. Quintner J.L., Bove, G.M., and Cohen M.L. (2015). A critical evaluation of the trigger point phenomenon. Rheumatology, 54(3), 392-399.
  11. Quintner J.L., Bove, G.M., and Cohen M.L. (2015). Response to Dommerholt and Gerwin: Did we miss the point? Journal of Bodywork and Movement Therapies, 19(3),394-395.
  12. Shah JP, Thaker N, Heimur J, et al. (2015). Myofascial trigger points then and now: a historical and scientific perspective. PM&R, 7(7), 746-761.
  13. Stux, G., and Hammerschlag, R. (Eds.). (2001). Clinical Acupuncture: Scientific basis. Springer.
  14. Travel, J.G., and Simons, D.G. (1983). Myofascial pain dysfunction: The trigger point manual. Lippincott Willimas and Wilkins.
  15. Ma, Y. (2011). Biomedical acupuncture for sports and trauma rehabilitation: Dry needling techniques. Churchill Livingstone.