Updated: Apr 15, 2019
Definitions of Acupuncture, Chinese Medicine, Dry Needling
As we work on de-mystifying the practice of Chinese Medicine, we have to start with some simple definitions. As Chinese Medicine has migrated into the Western world, a great deal has been lost in translation and resulted in great confusion. Cultural differences, language, and politics all have important roles in our current view of Acupuncture and Chinese Medicine.
Acupuncture: the insertion of an acupuncture needle into the body.
Chinese Medicine: a system of traditional medicine that includes theory, diagnosis, and treatment methods. Chinese Medicine has been derived over more than 2,000 years of systematic clinical practice, observation, and recording. Acupuncture, herbal medicine, bodywork, exercise, and dietetics are the five primary modalities of Chinese Medicine treatment.
It's amazing how simple this should be, yet how convoluted it has become. It's not surprising, however. If you search these terms in google you will come up with many different definitions. In fact, many states Acupuncture Practice Acts have improperly defined acupuncture. You will find a myriad of over-simplified and erroneous definitions that say things like "Chinese Medicine is a system of medicine based on the concept of Qi." We will touch more on terms like "Qi" in Lost in Translation. First up, let's talk licensing.
Licensed Acupuncturist or Doctor of Oriental Medicine?
To practice acupuncture and Chinese Medicine in the US, the requirements are close to the same across the country. 1. Graduate from 3-4 year Master's program in Acupuncture and Oriental Medicine. 2. Pass 2-4 National Licensing Exams (NCCAOM). 3. Meet individual state board requirements. If you meet these requirements in Texas and New Mexico, you are licensed as a Doctor of Oriental Medicine (DOM). In Washington, you are an East Asian Medicine Practitioner (EAMP). In most other states, you are a Licensed Acupuncturist (LAc). In some states MDs, PTs, and Chiropractors can practice acupuncture with no training or licensure in acupuncture or Chinese Medicine.
This last, and largest category breeds confusion because in these states Acupuncture is defined as the practice of Oriental Medicine - not the other way around, which would be correct. All Licensed Acupuncturists practice Chinese Medicine. The theory, and diagnosis of Chinese Medicine is what guides a Licensed Acupuncturist in how to help a patient. Many times this involves the modality of acupuncture, insertion of acupuncture needles. Sometimes it involves prescribing Chinese herbal formulas. Sometimes it involves prescribed exercise, dietary changes, or specific massage techniques. These are all modalities that come from the system of Chinese Medicine.
Further confusing the situation is the fact that the vast majority of Chinese Medicine practitioners in the US primarily practice the modality of acupuncture. An estimated 90-95% of the practice of Chinese Medicine in the US consists of practitioners primarily using the modality of acupuncture. This puts the remaining 5-10% who practice primarily Chinese herbal medicine in an awkward category, especially if they are in a state where their title is Licensed Acupuncturist. BUT! All of these practitioners are trained in a background of Chinese Medicine diagnosis, theory, and treatment. When LAcs, DOMs, EAMPs practice acupuncture, they are practicing Chinese Medicine. When MDs, PTs, Chiropractors practice acupuncture, they are, by and large, not practicing Chinese Medicine.
To summarize: Acupuncture is a treatment tool derived from the system of Chinese Medicine. The body of knowledge, systematic diagnosis and treatment methods of Chinese Medicine make it possible to utilize acupuncture as an effective treatment for a wide variety of health conditions. When divorced from Chinese Medicine training (in the case of MDs, PTs, Chiropractors, etc) acupuncture can still be an effective tool for muscle tension and pain but it pales in comparison to the efficacy and scope of Chinese Medicine trained acupuncture.
Origins: Chinese, Japanese, East Asian, Oriental
You'll notice that I exclusively use the term "Chinese Medicine", while others will use the above listed terms. Despite it's stamp on many of our Chinese Medicine schools, our practice acts, and our diplomas, the term "oriental" is increasingly considered politically incorrect. The historical use of the term "oriental" referred to a region of Asia and is a geographical term, however it's association with racist and derogatory usage has colored this term inappropriate.
Moving on, the primary reason that I use the term "Chinese Medicine" is that it is most accurate term to describe this system of medicine. While Chinese Medicine spread to Japan, Korea, and other East Asian countries and underwent further development - all of these traditions are widely accepted as originating in China. For example, Japanese herbal medicine is called Kanpo. Kanpo translates to Kan = China/Chinese and Po = Medicine. Japanese acupuncture is a distinct style of acupuncture, but it's core cannot be separated from Chinese Medicine.
DND: the Dry Needling Debacle
Dry Needling: the insertion of an acupuncture needle into the body.
Since we're talking definitions we have to touch on Dry Needling. Dry needling is primarily performed by practitioners who are not trained in Chinese Medicine. Dry needling is derived from Trigger Point acupuncture, an acupuncture method that emphasizes local needling into muscle trigger points. Dry needling practitioners in many states have 0 - 100 hours of workshop training compared to 2-3,000 hours of clinical practice that Licensed Acupuncturists have by the time they are licensed.
A few metaphors to help shed light on the differences:
An acupuncture needle is a tool that has no power or magical significance. It's an object, like a scalpel. The insertion of an acupuncture needle is the act of performing acupuncture=dry needling. A cut made with a scalpel is an incision. In a surgeon's hand a scalpel can be used to save a dying heart, reconstruct damaged joints and muscles, remove a malignant tumor from a cancer patient. In a butcher's hand a scalpel can be used to separate meat from bone, dividing into separate cuts and steaks to be turned into valuable food items. These are both valuable, useful tools, but they are completely different in nature. The difference? The training, knowledge, and education in the provider's hands.
A provider practicing Dry Needling: The insertion of an acupuncture needle can be used to treat muscle tension and pain.
A Chinese Medicine practitioner practicing Acupuncture: The insertion of an acupuncture needle can be used to treat muscle tension and pain, angina, atrial fibrillation, palpitations, arrhythmia, asthma, bronchitis, acid reflux, bell's palsy, migraine headaches, fibromyalgia, infertility, ovarian cysts, irregular menstruation, autoimmune disorders, insomnia, constipation, diarrhea, irritable bowel syndrome, and the list goes on and on and on.
Again, the difference is the training and education in the practice of Chinese Medicine.