Some say it is bringing an eastern tool into a western medical framework.

Others say it's just acupuncture by another name.

Whatever you call it, Chris West says it works. West, a physical therapist, calls it trigger point dry needling, and he says it straightened out his chronic lower back pain.

West herniated a disc in his back two years ago. He felt so stiff that he could barely stand up in the morning. And no matter how deep a massage he got, it never felt deep enough.

Then he tried a therapy that used an acupuncture needle to penetrate deep into the knots in his back.

He says it felt like, 'Ahh, that's the spot no one could get.'

It sounds like trigger point acupuncture, and if you walked in on it, you couldn't tell the difference. Except dry needling is done in western environments by physical therapists and has different training requirements.

Local dry needlers say it opens up a new way for therapists to treat injured patients. Acupuncturists say it borrows their methods, slaps on a different name and causes division.

Dry needling, as separately distinguished, is not widely known or practiced. In 2005, the Colorado Department of Regulatory Agencies approved dry needling to be practiced by trained physical therapists as a part of their treatments, without the guidance of a physician. The technique is called dry needling to draw a contrast between the use of a solid needle to a hypodermic needle that can inject liquids. Today, at least a half dozen physical therapists in the Boulder area offer it.

Only a handful of states other than Colorado approve it for physical therapy.

Dry needling training is not as extensive, or expensive, as becoming a licensed acupuncturist. In fact, physical therapists can learn how to needle in a several-day course, compared with 3,000 hours for acupuncture, and there is no registry or national standard. And dry needling is often covered by insurance companies that might not pay for acupuncture.

Needless to say, this has some acupuncturists on edge. West, who performs dry needling at Coreance Rehabilitation and Training Center in Boulder, calls it a bit of a 'turf war.' But he says he is more concerned with the best interests of his patients. He says dry needling is separate from acupuncture and not meant to replace it.

'We're using an acupuncture needle, but that's as close as it gets to acupuncture,' West says. 'I don't know anything about chi. I'm not looking at meridians. I'm not trained in eastern philosophy.'

During dry needling treatments, therapists insert a thin acupuncture needle into a muscle knot, also called a trigger point, which is caused by the shortening of a muscle after an injury. The needle desensitizes the area, so the muscle and nerves are no longer irritated and can relax.

It sometimes feels like a twitch or a warmth. Some patients feel the muscle winding or shaking around the needle, followed by a release.

The needle creates a small cramp in the muscle that practitioners say helps reset the dysfunctional pattern and releases the muscle bands. This clears the path for recovery and other forms of physical therapy.

Some people must be needled multiple times before they feel notable improvement. At Coreance, four to six visits is standard. And therapists recommend combining dry needling with other treatments, such as stretching and strength training.

In some cases, therapists also use a machine that sends low waves of electrical stimulation through the needle. The added technology can penetrate even deeper and can artificially stimulate a muscle contraction.

'It feels like a deep electrical massage in the muscle,' West says. 'Some say it feels good. Some not. It can be very nervy.'

Sessions can be followed with two days of increased soreness. Sometimes the needles cause bruising or muscle fatigue.

Lynn McAuliffe, a physical therapist, has been dry needling at the Boulder Community Hospital since February. She says dry needling is popular among athletes.

'I see excellent results,' McAuliffe says. 'I expected it to be good, but the results are better than what I had hoped, faster.'

She says some trigger points refer to other parts of the body. A point in the leg might affect the back.

'It puts the whole body back together,' she says.

Valerie Hobbs, the campus director for Southwest Acupuncture College in Gunbarrel, says she doesn't doubt that.

She says she respects the physical therapists, but is opposed to the educational standards and lack of monitoring for dry needling.

Hobbs, of Longmont, has been an acupuncturist for 13 years. And she says dry needling is acupuncture.

As she sees it, the western practitioners who started calling it dry needling made a 'social and tactical decision that if they wanted this to be accepted by Western medicine, they would describe it in western medical terms, and promote this as a new technique.'

She says improperly trained needlers can cause bruising, soreness or possibly puncture a lung or kidney, or they might not know advanced techniques or the most effective treatment.

'Eventually as more physical therapists do it without regulation, I fear something will happen to the public,' Hobbs says.

Although she admits not knowing about the energy of the body's meridians will probably not cause serious harm to a patient.

Instead of doing acupuncture but calling it something else to be separate and not have to adhere to the acupuncture standards, she says she wishes western medicine would recognize the benefits of the eastern approach and work together.

'This has nothing to do with anyone's private practice; some of my best teachers are physical therapists,' Hobbs says. 'But their profession is promoting this as a separate entity from acupuncture. And those people have created a non integrated picture.'

She says she hopes as the idea of dry needling spreads, it will spark more discussion between practitioners that will lead to better treatments for patients.

By Aimee Heckel Camera

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