A safe “opioid” – is dry needling an efficacious alternative to opioids?

Traditional Chinese medicine has used acupuncture for more than 2,000 years as a method to effectively treat numerous illnesses and diseases. It is in the Western model of medicine that acupuncture is considered ‘alternative’ medicine. The practice of this Western model of acupuncture, known as dry needling (DN), requires a technique that uses a monofilament without an injectate that is inserted into the soft tissue at varying depths–from superficial to deep–triggering a physiological response. Certain physicians and physical therapists have adopted this westernized version of the Chinese medicine modality by using the same technique for acupuncture to perform DN and electric dry needling (EDN). DN and EDN are administered to mediate analgesia peripherally, spinally, and supraspinally via multiple pathways by arousing the hypothalamic-pituitary-adrenal axis, provoking immune cells, and prompting the supraoptic nucleus. Stimulating these sites initiates the opioid interneuron mechanism resulting in opioid-based pain reduction that is mediated by the sympathetic nervous system and endogenous cannabinoids. Although EDN is further correlated with the spinal to supraspinal mechanisms of anti-nociception, both DN and EDN have shown to be components of a comprehensive analgesia pathway that acts like opioids in the human body. When comparing DN and EDN to opioid usage for analgesia, the adverse reactions and the significance of higher adverse reactions in the patient are essential factors to consider; DN and EDN have markedly less adverse effects than opioid use. They show high efficacy for analgesia and operate via similar mechanism of action as opioids. Therefore, the medical community should consider and utilize DN and EDN as an alternative to opioids in certain conditions.