A growing number of Doctors of Chiropractic (DCs) have expanded their practice to include specialized needling techniques to treat musculoskeletal pain. Whether a chiropractor performs acupuncture or dry needling depends entirely on the individual practitioner’s training and geographic location. Chiropractic care centers on the diagnosis and treatment of conditions related to the nervous system and musculoskeletal system, often through manual spinal manipulation. Both acupuncture and dry needling involve inserting fine, sterile needles and function as complementary methods to address muscular and soft tissue components of pain.
Legal and Educational Requirements
The ability of a Doctor of Chiropractic to perform needling is controlled by the licensing board in their state or province. A DC must pursue post-graduate education and attain certification to legally incorporate these procedures into their scope of practice. For a chiropractor to be certified in clinical acupuncture, many jurisdictions mandate the completion of a postgraduate program, often requiring between 100 and 300 hours of specialized training.
This intensive coursework typically covers anatomy, physiology, clean needle technique, and the clinical application of acupuncture principles. Many states also require the chiropractor to pass a rigorous examination, such as the one administered by the National Board of Chiropractic Examiners (NBCE), to demonstrate competency. By contrast, dry needling certification may involve a shorter, more focused curriculum, sometimes requiring as little as 40 to 53 hours of instruction, depending on state regulations.
The variation in requirements means a DC certified in one state may not be legally permitted to practice the same technique in another without further credentialing. Patients should always verify that their chiropractor holds the necessary certifications and that the specific needling procedure falls within the legal scope of practice for their region.
Acupuncture Versus Dry Needling
Although both techniques use the same type of thin, solid filiform needle, the philosophy and application of acupuncture and dry needling are distinct. Traditional Chinese Medicine (TCM) acupuncture is based on balancing the body’s flow of energy, or Qi, by stimulating specific points along energetic pathways known as meridians. The selection of acupuncture points is holistic, based on a comprehensive TCM diagnosis rather than localized anatomical pain.
Dry needling is a Western-based therapeutic procedure rooted in modern neuroanatomy and pain science, focusing solely on the musculoskeletal system. The primary target is the myofascial trigger point, a hyperirritable spot within a taut band of skeletal muscle. The goal is to elicit a “local twitch response,” an involuntary spinal cord reflex that helps decrease muscle contraction and normalize the chemical environment around the trigger point.
Inserting the needle into this taut tissue band reduces elevated levels of pro-inflammatory substances in the muscle. This process aims to restore normal tissue function by decreasing muscle hypertonicity and improving local blood flow. Dry needling is a direct anatomical intervention for muscle dysfunction, whereas acupuncture is a broader energetic and systemic treatment.
Integrating Needling into Chiropractic Treatment
When a chiropractor utilizes a needling technique, it is employed as an adjunct or preparatory therapy within a broader treatment plan. The goal is not to replace the traditional chiropractic adjustment but to enhance its effectiveness by addressing related soft tissue issues. A common application involves using dry needling to relax a tight muscle, such as the piriformis or hamstrings, that may be restricting joint movement.
Releasing this muscle tension before a spinal adjustment can make the manipulation easier to perform and may allow the effects of the adjustment to last longer. By addressing the muscular component of a patient’s pain, chiropractors are better able to restore normal joint motion and alignment. The combined approach of needling for muscular relief and manipulation for joint function offers a synergistic effect, particularly beneficial for managing chronic pain conditions, referred pain patterns, and sports injuries.