“Dry Needling” vs. Acupuncture

I had a gentleman ask me last week if I had heard of “dry needling” and if I ever did it. I was flabbergasted… Dry needling is what acupuncture is called when non-acupuncturists do it. Wait – that’s not quite right. It’s what using acupuncture needles is called when someone else does it… but that doesn’t make it acupuncture. True acupuncture requires an understanding of a complex system, while most “dry needling” courses are surprisingly brief.

When comparing acupuncturists vs other practitioners as providers of therapeutic needling, some interesting things come to light. I feel very strongly that the various types of medical providers each have their areas of expertise. A bad injury, a serious infection, and organ failure are just a few of the problems that would send me running to “Western” modern medicine. But in some cases – chronic pain, healing after an injury, neurological repair, anxiety, etc. – acupuncture is highly effective. So….Why not just have your doctor do it?

There are some advantages to doctors doing acupuncture. First, they have a more extensive knowledge of anatomy than the average acupuncturist. I was very lucky to get to work with cadavers when I was at chiropractic school – most don’t. Secondly, the procedure is more likely to be covered by health insurance.

Unfortunately, there are also some disadvantages. Doctors are usually MDs first, and have taken a seminar on acupuncture. This course is a few weekends of instruction. They learn a handful of “recipe” points that are based on symptoms. Some people doing “dry needling” are physical therapists or chiropractors. As a comparison, I have a Master’s degree from OCOM, which consisted of 3,344.5 total hours, including 996 clinical hours. I learned about the Zang Fu organs, the channels, and the 1000 points and how they interact.

Doctors usually don’t spend much time getting to know every detail of your medical history. They tend to have 10 minutes for the whole appointment, and focus purely on your “chief complaint” as we call it in medicine: the main reason you came in. Traditional Chinese Medicine (TCM) is holistic. I prefer to take an hour with my patients. We examine the entire body, not just an isolated part, and our diagnosis is dependent upon that global perspective. For example, you may have a headache due to Liver* Yang Rising, or Qi deficiency, or a Wind Invasion. Or look at it from the other direction: A single diagnosis, such as Kidney Yin Deficiency, can cause varied symptoms like menstrual irregularity, anxiety, vertigo, night sweats… you see the problem. This is why I ask all those rude questions (sorry) in a 10 page form when you come in. What your menstrual cycle is like can actually help me determine how to treat your digestive disorder.

When doctors, chiropractors, and physical therapists use dry needling, especially for internal medicine, their results are not as strong as when a TCM trained practitioner wields the needles. I see this in a lot of research studies that “prove” acupuncture “doesn’t work.” It’s roughly equivalent to testing antibiotics for a runny nose, without separating out bacterial infections from viruses and allergies, then claiming that pharmaceutical drugs aren’t effective.

In this article, a doctor writes about needling. The myofascial part is spot on, but he’s missing the energetic component. Some of the points work on areas far away from where the needle goes! LI-4 and LV-3 are beautiful examples of powerful points that don’t really make sense with the Western understanding of anatomy. If distal points like the hands, feet, scalp and ears are neglected, the treatment may be weaker than ideal. It’s something to think about when comparing someone offering dry needling vs a true acupuncturist.

People with only basic anatomy training like massage therapists, and physical therapists doing dry needling? Super bad idea – and the reason there are so many news stories about dry needling pneumothorax (collapsed lung) problems created by physical therapists. Acupuncture needles are controlled as a medical device, because they really shouldn’t be used by amateurs.

Dry needling is a bad idea, m'kay?

Dr. Andrew Weil, M.D., agrees that TCM training should be comprehensive.

*Remember that in Chinese medicine, capitalized organs are energetic concepts and should not be confused with your anatomical organs.

Trusted Referrals & Healthy Shoe Shopping

Here’s a short list of professionals I recommend. Please let me know if you use one of these referrals – I’d love to hear how it goes for you!

Also – the second half is a guide to shopping for healthy shoes.

Medical Doctor:
Dr. Kathy Alvarez
Cedar Hills Office Park 
1815 SW Marlow Suite 206 
Portland, OR 97225
(503) 296-6144

Chinese Herbal Medicine:
Root and Branch
7642 SW Capitol Hwy
Portland, Oregon 97219
(971) 288-5939

Physical Therapy:
New Heights
Locations in Vancouver, SE Portland, and NW Portland

Hand Surgeon:
Dr. Charles Woolley
2311 NW Northrup St, Portland, OR 97210
(503) 274-4865

Podiatrist:
Dr. Ray McClanahan
Northwest Foot & Ankle
2701 NW Vaughn Street, Suite 424
Portland, OR 97209
(503) 243-2699

Personal Trainer:
Brandie Sylfae  (SE Portland)
(503) 422-0402

Rolfers:
Jenny Rock
(503) 345-7660
Body Balance Rolfing & Massage
10700 SW Beaverton Hillsdale Highway
Building 3, Suite 605  (2nd floor, there is an elevator)

Karin Edwards-Wagner
2732 SE 18th Ave Portland, OR 97202
(503) 230-0087

Massage:
CURRENTLY SEEKING AN LMT to rent my spare treatment room!

Clark Original on the left. The Jafe on the right is too stiff to be ideal for regular wear, but a rare find for fancy dress-up occasions.

Clark’s Original “Faraway Field” on the left, grey with mint stitching, also available in red, black, and brown. The Jafe on the right is too stiff to be ideal for regular wear, but works as a rare heel-less find for fancy dress-up occasions. Edited to add: The Jafe’s softened up with use, and the Clark’s model comes in more colors now! I just got myself some blue suede shoes!

Buying bio-mechanically correct shoes:
First, read this article about foot function and how to assess a shoe. Then, look for brands like Born, Clark’s, Keen, Lems, Jambu & J-41 (sexy sandals!), Vivo, Altra, Jafe, Xero, TOPO, Vivobarefoot, and Merrell. Naot and Reiker make wide-toebox shoes that are super cute but stiffer / more supportive in the sole, so they are appropriate for transitioning or if you are going to do major mileage on concrete. FiveFinger and Fila make minimal, separated toe shoes (personally, my short toes like the Filas much better – and they were a mere $30 at Big 5 sports!). Please note that I am NOT endorsing every model shoe the above brands make. For example, Keen has two footbeds, a stiff, narrow version (skip these!) and the one I like with the wide toebox.  In all brands, some models may be great, but others are too pointy-toed, too stiff, or have a heel. Shop carefully. When trying shoes on, you need to step on the liner and examine other factors discussed here. Try not to get carried away with something cute or a pair that feels “good enough” – your feet will get pickier as they adapt to having room to move! They will also spread out, so if you are between sizes, go up. REMEMBER: Most people gain a half to a full size as their toes spread out, and they build muscle in their feet.  It’s best not to buy too many until you know your new size. Winter boot guide here.

Here’s a guide to adapting to your new kicks. 

A happy surprise for the Pacific NW Fall weather - Bogs rainboots have no heel and give plenty of room for the front of the foot. I got my pair at Clogs & More on Hawthorne.

A happy surprise for the Pacific NW weather – Bogs rainboots have no heel and give plenty of room for the front of the foot. I got my pair at Clogs & More on Hawthorne. Update: 2017, and I just bought another shorter pair of waterproof, fabric pull-ons from Bogs. LOVE THEM!

Places to get biomechanically-correct footwear locally:

Pie in the Alberta district
Cobbler Bill’s near 82nd & Foster
Shoe Mill and The Walking Company at big malls (NOTE – most of the shoes in the mall stores are aimed at symptom relief instead of true health and are too stiff! Be careful!)
FleetFeet (formerly FitRightNW) off NW 23rd
Footwise on Broadway
Imelda’s on Hawthorne
REI (surely you know where REI is)
Clogs N More – note – don’t buy clogs! :) Hawthorne and downtown

 

And don’t forget the toe socks so you can move freely inside your spiffy new shoes. Sock Dreams has a store in Sellwood, or you can order online. They carry unique, high quality stuff, including the elusive toesock with formed heels. I love that Sock Dreams thoroughly describe their stock on the website, including measurement info like calf size, and they ship for free.

Places to get biomechanically-correct footwear online:

Hot Chocolate Designs is making cute Mary Janes with a wide variety of prints! These aren’t quite minimal, but have pretty flexible soles.

Ahinsa Casual style, fabric shoes
Altra  Wide toebox running shoes, everyday shoes, and boots.
Baer Shoes high-end European boots & shoes
Belleville Military & law enforcement-type boots.
The Drifter Leather Sleek, stylish shoes and boots.
Glerups Wool felt clogs, shoes, boots
Hot Chocolate Designs Mary Janes with fun prints
JoeNimble athletic / running shoes for men and women
Lems ugly but comfortable
Oesh Variety of women’s styles from professional to casual.

Shoes for Crews Steeltoes, other serious work shoes & boots
Skidbusters Nursing, etc.

soft-star-products

Part of the Soft Star shoe line. You can custom order your color choices!

Soft Star Shoes Minimal, basically leather socks. Rubber soles available. Based in Corvallis
Tadeevo casual laceups
Topo Athletic runners
Tune Men’s penny loafers
Unshoes sandals, mocs
Vibram FiveFingers and wrap shoes
Vivobarefoot Lightweight, minimal shoes and boots
Xero shoes and sandals, including DYI

Again, not everything these places sell will be good for your feet. Double check the shopping guide. I recommend wearing your new shoes inside for a while on a trial run (so they are returnable) before venturing out.