“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.

GYN:

Natalie Mohler, WHNP

Evergreen Women’s Health, PC.
1207 Washington St., Suite #145
Vancouver, WA 98660
Phone: 360-964-3060

EMDR Therapist:

Arin A. Wallington, MA, LPC, NCC
Arin Wallington Counseling, LLC
EMDR Certified Clinician/ Trauma Therapist
P: 503-404-EMDR(3637)
F: 503-974-0907

Naturopath:

Dr. Karma Denmark
Sachi Wellness
503-607-0018
2008 Willamette Falls Drive #200
West Linn, OR 97068

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

Physical Therapy:
Dr. Foster Adams King
IPA Physio
(503) 616-0313
7412 SW Beaverton Hillsdale Hwy #110
Portland, OR 97225

Foster@ipa.physio

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
7412 SW Beaverton Hillsdale Hwy #106
Portland, OR 97225

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

JOYN videos on YouTube: Exercises for larger / physically challenged / recovering bodies.

Caregiver Help Desk 1-855-227-3640. You can also chat with them on caregiveraction.org 

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 MerrellNaturalista, 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 rigid, narrow version (skip these!) and the wider, flexible one I like as a transition shoe.  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 Footwear in the Alberta district – they teach classes now, too!
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
REI (surely you know where REI is)
Switch at Multnomah Village. Israeli made. Not minimal but good transition shoes and boots.
Clogs N More – note – don’t buy clogs! :) Locations on Hawthorne and downtown Portland.

The Northwest Foot & Ankle Clinic has a small showroom with a variety of wider toebox shoes.

And don’t forget the toe socks (or tabi 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. Vegan materials.
Altra  Wide toebox running shoes, everyday shoes, and boots.

Aqua Socks: This is a category, not a brand! Very thin, light synthetic slippers with rubber soles so thin and flexible that I can feel the carpet at work, especially after I pull out the unnecessary insole. They *can* be a little sweaty. Search Google or Amazon – they usually run $10-15!
Baer Shoes high-end European boots & shoes

Bearfoot casual & boots
Belleville Military & law enforcement-type boots
The Drifter Leather Sleek, stylish shoes and boots.

Feelgrounds sandals, laceups, boots

Freet UK company with a sporty line
Glerups Wool felt clogs, shoes, boots

Groundz slip-ins and sandals DISCOUNT CODE: RCAhappyfeet
Hot Chocolate Designs Mary Janes with fun prints
JoeNimble athletic / running shoes

Joomra trail running shoes, by Amazon. VERY affordable! I have these in multiple colors. NOTE: The different colors at the link above vary in style: Look closely at the one(s) you’re choosing!
Leguano barefoot shoes
Lems ugly but comfortable

Magical Shoes In Poland. leather and vegan options, wider footbed available
Oesh Variety of women’s styles from professional to casual.

Saguaro inexpensive casual, barefoot, and water shoes
Shoes for Crews Steeltoes, work shoes & boots

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. I love their Ballerine and RunAmoc styles. Based in Philomath, OR!

Taos Their wool line is nice – most others are not foot-healthy.
Tadeevo casual laceups
Topo Athletic runners
Unshoes sandals, mocs, dress flats
Vibram FiveFingers and wrap shoes
Vivobarefoot Lightweight, minimal shoes and boots

Whitin – Amazon brand. Be sure to get the “minimal, barefoot” ones.
Wildling Kids and adults (Re-Wild), based in Germany
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. Zappos is great for easy returns and free shipping both ways.