Skip to main content
Log in

Evidence and expert opinions: Dry needling versus acupuncture (II)

The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016

  • Hot Topic
  • Published:
Chinese Journal of Integrative Medicine Aims and scope Submit manuscript


In the United States and other Western countries, dry needling has been a topic in academic and legal fields. This White Paper is to provide the authoritative information of dry needling versus acupuncture to academic scholars, healthcare professionals, administrators, policymakers, and the general public by providing the authoritative evidence and expertise regarding critical issues of dry needling and reaching a consensus. We conclude that Dr. Travell, Dr. Gunn, Dr. Baldry and others who have promoted dry needling by simply rebranding (1) acupuncture as dry needling and (2) acupuncture points as trigger points (dry needling points). Dry needling simply using English biomedical terms (especially using "fascia" hypothesis) in replace of their equivalent Chinese medical terms. Dry needling is an over-simplified version of acupuncture derived from traditional Chinese acupuncture except for emphasis on biomedical language when treating neuromuscularskeletal pain (dry needling promoters redefined it as "myofascial pain"). Trigger points belong to the category of Ashi acupuncture points in traditional Chinese acupuncture, and they are not a new discovery. By applying acupuncture points, dry needling is actually trigger point acupuncture, an invasive therapy (a surgical procedure) instead of manual therapy. Dr. Travell admitted to the general public that dry needling is acupuncture, and acupuncture professionals practice dry needling as acupuncture therapy and there are several criteria in acupuncture profession to locate trigger points as acupuncture points. Among acupuncture schools, dry needling practitioners emphasize acupuncture's local responses while other acupuncturists pay attention to the responses of both local, distal, and whole body responses. For patients' safety, dry needling practitioners should meet standards required for licensed acupuncturists and physicians.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Fan AY, Xu J, Li YM. Evidence and expert opinions: drying needling versus acupuncture (I)—The American Alliance for Professional Acupuncture Safety (AAPAS) White Paper 2016. Chin J Integr Med 2017;23:3–9.

    Article  PubMed  Google Scholar 

  2. Nichols HW. Ancient pain-killing method works, while US scientists don't know why. Albany Democrat-Herald (Albany), March 21, 1947. Available at http://www. Accessed October 3, 2016.

    Google Scholar 

  3. Andersen H, Ge HY, Arendt-Nielsen L, Danneskiold-Samsøe B, Graven-Nielsen T. Increased trapezius pain sensitivity is not associated with increased tissue hardness. J Pain 2010;11:491–499.

    Article  PubMed  Google Scholar 

  4. Melzack R, Stillwell DM, Fox EJ. Trigger points and acupuncture points for pain: correlations and implications. Pain 1977;3:3–23.

    Article  CAS  PubMed  Google Scholar 

  5. Birch S. Trigger point–acupuncture point correlations revisited. J Altern Complem Med 2004;9:91–103.

    Article  Google Scholar 

  6. Dorsher PT, Fleckenstein J. Trigger points and classical acupuncture points: Part 1. Qualitative and quantitative anatomic correspondences. Ger J Acupunct Relat Tech 2008;51:15–24.

    Google Scholar 

  7. Dorsher PT, Fleckenstein J. Trigger points and classical acupuncture points: Part 2. Clinical correspondences in treating pain and somatovisceral disorders. Ger J Acupunct Relat Tech 2008;51:6–11.

    Google Scholar 

  8. Dorsher PT. Can classical acupuncture points and trigger points be compared in the treatment of pain disorders? Birch's analysis revisited. J Altern Complement Med 2008;14:353–359.

    Article  PubMed  Google Scholar 

  9. Fan AY, Yang G, Zheng L. Response to Dommerholt and Stanborough re: ''Evidence that dry needling is the intent to bypass regulation to practice acupuncture in the United States''. J Altern Complem Med 2017. DOI: 10.1089/acm.2016.0394.

    Google Scholar 

  10. Hong CZ. Myofascial trigger points: pathophysiology and correlation with acupuncture points. Acupunct Med 2000;18:41–47.

    Article  Google Scholar 

  11. Liu L, Skinner MA, McDonough SM, Baxter GD. Traditional Chinese medicine acupuncture and myofascial trigger needling: the same stimulation points? Complement Ther Med 2016;26:28–32.

    Article  PubMed  Google Scholar 

  12. Hao JK, ed. Atlas of Extro-meridian acupuncture points. Revised Ed. Beijing: People's Military Medicine Press; 2011.

    Google Scholar 

  13. Molsberger AF, Manickavasagan J, Abholz HH, Maixner WB, Endres HG. Acupuncture points are large fields: the fuzziness of acupuncture point localization by doctors in practice. Eur J Pain 2012;16:1264–1270.

    Article  CAS  PubMed  Google Scholar 

  14. Chen Q, Bensamoun S, Basford JR, Thompson JM, An KN. Identification and quantification of myofascial taut bands with magnetic resonance elastography. Arch Phys Med Rehabil 2007;88:1658–1661.

    Article  PubMed  Google Scholar 

  15. Chen Q, Wang HJ, Gay RE, Thompson JM, Manduca A, An KN, et al. Quantification of myofascial taut bands. Arch Phys Med Rehabil 2016;97:67–73.

    Article  PubMed  Google Scholar 

  16. Shah JP, Danoff JV, Desai MJ, Parikh S, Nakamura LY, Phillips TM, et al. Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points. Arch Phys Med Rehabil 2008;89:16–23.

    Article  PubMed  Google Scholar 

  17. Federation of State Boards of Physical Therapy. FSBPT dry needling resource paper (Intramuscular Manual Therapy). 4th ed. Available at: lingresourcepaper_4thedition.pdf Accessed Dec 10, 2016.

    Google Scholar 

  18. Kinetacare. Intramuscular manual therapy (AKA Trigger Point Needling). Available at: Accessed Dec 10. 2016.

  19. Sportscare Physical Therapy. What is intramuscular manual therapy? Available at: http://www.sportscarephysicaltherapy. com/intramuscular-manual-therapy/ Accessed Dec 10, 2016.

  20. Attorney General of Washington, Ferguson RW. Scope of practice of physical therapy: the practice of dry needling does not fall within the scope of practice of a licensed physical therapist. Available at: 7a8bc85ea/1470722293467/Washington+Attorney+General%E2%80%99s+Opinion.pdf Accessed Dec 10, 2016.

  21. National Center for Acupuncture Safety and Integrity. Thirteen facts you need to know about dry needling. Available at: Accessed Dec 10, 2016.

  22. International Veterinary Acupuncture Society. What is veterinary acupuncture? Available at: about-ivas/what-is-veterinary-acupuncture/. Accessed Dec 19, 2016.

  23. California medical association. AMA Policy states H-475.983 definition of surgery. In: 2012 AMA Interim Meeting Highlights (as of 11/13/12). Available at: http://www.cmanet. org/files/assets/news/2012/11/ama-highlights-111312.pdf. Accessed Dec 19, 2016.

  24. The American Academy of Physical Medicine and Rehabilitation. AAPM&R position on dry needling. Available at: Position-Statements/aapmr-position-on-dryneedling. pdf?sfvrsn=2. Accessed Dec 19, 2016.

  25. American Medical Association. Physicians take on timely public health issues. AMA Wire. Jun 15, 2016. Available at Accessed Dec 19, 2016.

Download references


This White Paper reflects the official view of AAPAS. The authors would like to thank Drs. JIN Guan-yuan, Jerome Jiang, YANG Guan-hu, WANG Shao-bai and WANG Xiao-ping for the valuable discussions and assistance during the drafting process.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Arthur Yin Fan.

Additional information

The references 1–35 are available in Chin J Integr Med 2017;23:3-9. The White Paper (II) will be continued in next issue of this journal

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fan, A.Y., Xu, J. & Li, Ym. Evidence and expert opinions: Dry needling versus acupuncture (II). Chin. J. Integr. Med. 23, 83–90 (2017).

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: