The Birth & Growth of Dry Needling: The Development of An Apple on An Apple Tree

“Pricking the body or apply a stimulation to the body with sharps for a cure” is the essence of acupuncture. From this “essence”, different types of stimulation techniques could be developed.

You can think acupuncture as an apple tree. From an apple tree will grow numerous apples. “Dry needling” is such an apple.

Fertilization of The Ovule

The fertilization of the ovule which would later develop into a “dry needling” apple happened in 1941. In a study on anesthetic injection, Brav and Sigmond (1941) in the US made a “startling” discovery: the simple needling without injection of any substance worked as good as the novocaine injection.

This is the beginning of “dry needling”, albeit the two discoverers did not name it as such. They did not claim the finding as their own either. Instead, they contributed the idea to acupuncture: ‘‘The origin of the local and regional injection treatment of low back pain and sciatica dates back to the earliest descriptions of acupuncture’’ as they wrote.

They further cited Churchill’s publications on acupuncture in 1821 to support their finding.

Invention of The Term “Dry Needling”

The term ‘‘dry needling’’ was first used by Paulett JD (1947), who, in a study of low back pain, concluded that pain relief could be obtained not only from the injection of procaine or saline but even "dry needling’’.

Turning Point: Acupuncture Fever in 1970s

Although dry needling had been suggested as a treatment, no trials had ever been conducted until 1970s when an acupuncture fever hit the Western world.

Where to Put Needles Does Not Matter

Ghia JN et al. (1976) compared needling at acupoints vs. tender points (dry needling) and found that both were effective but the needling location did not matter. Melzack (1981) identified the locations of acupoints and Travell et all's myofasicial trigger points is highly correlated.

Pricking with A Needle Matters

Lewit K et al (1979) published a landmark paper in the development of dry needling. He used acupuncture needles as well as hypodermic ones and found that the former produced less bleeding and bruising. He described the pain relief as ‘‘the needle effect” instead of “trigger point” effect.

Gunn CC (1980) conducted dry needling trials on motor points but not trigger points to treat back pain. Evidently, the key issue is “pricking”, but not "where to prick".

All Ideas Came from Acupuncture

Both Lewit and Gunn were clearly influenced by acupuncture. Gunn was president of the American Society of Acupuncture. Lewit freely admits to having borrowed the acupuncture needles.

MacDonald et al. (1983) showed that superficial needling of trigger points was superior to placebo but he called the treatment acupuncture, but not “dry needling”.

No one had ever considered separating dry needling from acupuncture (until 1990s).

Dry Needling: An Apple

Without inspiration by acupuncture and the use of acupuncture needles, dry needling would never have become an established modality, Osteopath doctor. David Legge concluded (2015).

An apple can not develop from an ovule to a mature fruit outside an apple tree.

References

Brav EA, Sigmond H: The local and regional injection treatment of low back pain and sciatica. Ann Int Med 15: 840–852, 1941.

Churchill, James Morss, 1821, A Treatise on Acupuncturation

David Legge, A History of Dry Needling, Journal of Musculoskeletal Pain , May 2014.

Ghia JN, Mao W, Toomey TC, Gregg JM: Acupuncture and chronic pain mechanisms. Pain 2: 285–299, 1976.

Gunn CC, Milbrandt WE, Little AS, Mason KE: Dry needling of muscle motor points for chronic low-back pain: A randomized clinical trial with long-term follow-up. Spine (Phila Pa 1976) 5: 279–291, 1980.

Lewit K: The needle effect in the relief of myofascial pain. Pain 6: 83–90, 1979.

MacDonald AJ, et al, : Superficial acupuncture in the relief of chronic low back pain. Ann Royal Coll Surg Engl 65: 44–46, 1983

Melzack R: Myofascial trigger points: Relation to acupuncture and mechanisms of pain. Arch Phys Med Rehabil 62: 114–117, 1981.

Paulett JD: Low back pain. Lancet 2: 272–276, 1947.

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