Dry Needling

Probably one of the most common questions I get asked is: What do you think of dry needling? Or do you provide dry needling?

It’s a complicated thing to answer because I think there are two valid ways to see it.

The Legal & Scope-of-Practice Angle

As of writing, dry needling is illegal in California, Hawaii, New York, Oregon, and Washington. The essential issue is this: I don’t take a weekend course in chiropractic adjustments and call myself a “dry chiropractor” or “holistic joint manipulator” or something of the sort.

The primary argument against dry needling, as I understand it, is that the requirements for training aren’t stringent enough to ensure safe and effective treatment. Acupuncture licensure includes extensive training for years to make sure we can insert needles into people in ways that are consistently safe and beneficial.

There’s also the financial reality: it’s an encroachment on scope of practice that acupuncturists mostly deal with because they’re under-represented in a lobbying sense in most states.

But That’s Not the Whole Story

All that said, I don’t think the legal debate tells the full truth. I believe it is possible for a physical therapist or chiropractor to put in the time and effort to genuinely perform dry needling in a way that is safe and helpful.

In my clinical opinion, there is something beneficial about specifically targeting muscle tension through trigger points or neuromuscular junctions—without necessarily needing to interpret the more subtle energetic connections that traditional acupuncture focuses on.

Some acupuncturists even take dry needling classes for this reason: to supplement their traditional training with a more Western, physiology-based approach to the body, especially around trigger points and fascial connections. Traditional acupuncture is deeply enmeshed in Chinese herbal theory and an extremely detailed mapping of the energetic body. It’s rich—but it can also be overwhelming when sometimes you just want to get a spasmed muscle to relax.

Do I Do Dry Needling?

When people ask if I do dry needling, I say yes. I’m more than capable of palpating trigger points and treating them. I mainly let people know that I use a more subtle, gentle technique than most dry needlers. I say this based on both my own experience receiving dry needling and the experiences patients share with me.

Dry needling techniques can often be overly aggressive and, at times, can feel re-traumatizing rather than creating a consistently positive healing experience.

My Main Gripe: The “No Pain, No Gain” Mindset

Assuming someone doing dry needling is being safe about it, my real issue is that the intensity of the technique sometimes scares people away from acupuncture altogether. I’ve had many patients tell me they were afraid to try acupuncture because of a previous dry needling experience.

So then I have to educate: while acupuncture can come with some sensation, the intensity is much lower, and many patients feel little to nothing during an effective treatment. It is possible to resolve pain without causing pain.

Where I Land

So that’s my opinion overall. If I had to pick a side, I prefer a generous approach. I’d love to share this practice, and ideally more people would have access to safe, effective treatments to reduce pain.

I’d prefer more training and a shift in perspective—one that considers the nervous system as much as the tissue—so as to avoid treatments that feel like re-injury. But if pressed, I wouldn’t reduce access to acupuncture or to its relatively new Western spin-off: dry needling.

Rethinking Back Pain: The Role of Fascia

Today I want to talk about something I’ve seen as a primary source of pain in countless patients—yet it’s rarely mentioned in medical school or by most doctors. While I’m still exploring the best ways to keep fascia healthy over the long term—through stabilizing exercises, muscle balancing, and movement practices—I’ve consistently found that massage, cupping, and acupuncture can bring meaningful relief.

For now, let’s start with the basics: what fascia is, and more specifically, the type I most often hear patients describe as the exact spot of their pain—the thoracolumbar fascia.

What Is Fascia?

Fascia is a type of connective tissue in your body—it’s kind of like a full-body spiderweb made of collagen that surrounds and supports everything: muscles, bones, nerves, blood vessels, and organs. It’s not just passive packing material—it’s dynamic, sensitive, and deeply involved in how your body moves and feels.

🧠 Key Facts

Structure: Tough but flexible, fascia is made mostly of collagen fibers arranged in a multidirectional web.
Function: It holds things in place, transmits force, reduces friction, and allows structures to slide smoothly over each other.
Layers:
- Superficial fascia: just beneath the skin, often containing fat.
- Deep fascia: wraps around muscles and bones.
- Visceral fascia: encases internal organs.

Fascia can get tight, stuck, or inflamed, contributing to pain and mobility restrictions—even far from the original source. It’s richly innervated, meaning it plays a major role in proprioception and pain perception. Manual therapies (like massage, myofascial release, or acupuncture) often aim to restore its glide and elasticity.

🧱 Thoracolumbar Fascia (TLF)

The thoracolumbar fascia (TLF) is a major fascial structure in your lower back—like a thick, multilayered tension bridge connecting your upper and lower body. It’s central to stability, movement, and force transmission, especially through your core and spine.

📍 Location

The TLF spans from the thoracic spine to the sacrum, stretching laterally to the ribs and hips, and includes three layers:

Posterior layer: Just under the skin and superficial muscles like the latissimus dorsi.
Middle layer: Between the deep back muscles (e.g., multifidus) and quadratus lumborum.
Anterior layer: Deepest, lying in front of quadratus lumborum and connecting to the psoas.

🏋️‍♂️ Function and Importance

Core Stability:
Acts like a natural weightlifting belt by anchoring key muscles:
- Latissimus dorsi
- Gluteus maximus
- Transversus abdominis
- Internal obliques
  These muscles create tension through the fascia to stabilize the spine.
Force Transmission:
Transfers power between upper and lower body—especially important in walking, running, lifting, and rotation.
Back Pain:
Adhesions or tension in the TLF can reduce mobility and contribute to chronic or mechanical low back pain.
Sensory Function:
Fascia is packed with sensory nerves. Dysfunction here doesn’t just feel tight—it can generate real pain and disrupt body awareness.

🔧 Clinical Implications

Manual therapies (massage, cupping, acupuncture) can reduce tension and improve glide between fascial layers.
Engaging muscles like the transversus abdominis through exercises (planks, dead bugs, etc.) strengthens the fascial tensioning system.
Dysfunction in the glutes, lats, or obliques can create asymmetrical pulls, affecting spinal mechanics via the TLF.

🧩 Summary

The thoracolumbar fascia acts as a central tension system for the torso, tying together posture, movement, stability, and sensation. If something’s off in your core, hips, or back, chances are the TLF is part of the story.

PTSD, Healing & Happy Tears

Crying at the Happy Ending

“Crying at the Happy Ending” is an article by psychoanalyst Joseph Weiss (1952), popularized in Michael Bader’s 2014 article on Psychology Today. Its a powerful piece that explores why, even in the context of watching a movie, we often wait until a resolution to let ourselves feel—and cry.

The core idea is:

During the tension or crisis, our nervous system is in survival mode—fight, flight, freeze—so we suppress emotions to stay focused and safe.
Once the conflict resolves, we subconsciously perceive safety, and emotions we’ve been holding back—sadness, relief—can finally surface. That release often comes as tears at the happy ending.

Studies and later commentary support this “safety-signal” theory. A neuroscientific review explains that safety signals—learned cues predicting the absence of threat—actively inhibit fear and stress responses in humans and animals. In conditions like PTSD, this safety learning is often impaired, making it difficult to shift out of fear mode (Hamm & Jentsch, 2012).

This idea of emotional release being tied to a sense of safety? It’s not just emotional—it’s physiological. Let’s talk nervous system…

The Body Keeps the Score

As Bessel van der Kolk wrote in The Body Keeps the Score, trauma and chronic stress don’t just live in the mind. They live in the body.

Muscles clench. Breathing gets shallow. The gut stops working smoothly.
We might “move on” intellectually, but the body hasn’t gotten the memo.
Why? Because safety isn’t an idea. It’s a felt experience.

And until the body believes it’s safe, it won’t let go—of tension, pain, or emotion.

This Is the Core of My Work

In my opinion, my #1 priority in the clinic is to create space for my patients to experience a parasympathetic, relaxed sense of safety.

I will often tell my patients, “I take all snoring and drooling as compliments”. And many patients do fall asleep during massage, acupuncture, or cupping treatments.

Sometimes my patients feel more comfortable talking about their lives rather than hitting snooze, and I think that can be helpful as well. The combination of nervous system ease, physical comfort, and open conversation creates a potent cocktail for healing—one that includes both mind and body.

When things get complicated, I return to what I believe is most essential in healing—and in both my personal and professional experience, safety is key.

All Are Welcome Here: A Safe Space for LGBTQ+ Clients

“Be grateful for whoever comes,
because each has been sent
as a guide from beyond.”
—Rumi, The Guest House

I’ve been surprised—and honestly, really touched—to hear how many of my new patients say they’ve read my blog posts. It makes me happy to know I can start connecting and helping even before someone walks through the door.

I can be a fairly introverted guy myself, and I get how reassuring it is to get a feel for the person you’ll be trusting with your care before ever stepping into the room.

That’s especially true for folks in the LGBTQ+ community. Nearly everyone I’ve met from that community has, in some way, experienced moments of unsafety and bias. So it makes sense that there’s an extra layer of challenge when taking that vulnerable first step toward care.

It might seem like a surprising connection, but many of the veterans I work with have confided in me that they’ve felt pre-judged as well. They’ve felt like people were responding more to preconceived notions of a veteran—or to their tattoos, or something surface-level rather than seeing them for who they really are as people.

I’m tearing up just writing this because I think in regards to either community, its a really important part of the work that I try to do. I want to always seek to set aside my own potential biases, my own knee-jerk reactions, and instead be present with and get to know whoever shows up to my practice.

As a healer, that matters. It matters that I take the time to understand and really connect with each person that comes in. It matters that I come to understand the context of their lives rather than simply focus on their diagnosis. While I’m not a licensed therapist (and I’m always transparent about that), I do believe that emotional safety is as essential to healing as physical safety.

I’m not perfect, but I take this safety as a sacred duty. Every person who comes into my practice deserves to be cared for as a whole person, and if nothing else, I do my best to make space for whatever that entails.

If you’ve ever felt nervous about trying acupuncture, massage, or just showing up somewhere new, I hope this helps. I promise that, whoever you are, I’ll do my best to meet you with patience, presence, and care. Everyone is welcome.

From Needle to Nervous System: How Acupuncture Reduces Pain

I really enjoyed working on this post—it’s been a while since I sat down and revisited all the specific ways acupuncture helps the body heal. One of my first thoughts was:
“Oh! Look at all these great things I do at work each day. Nice!”

In the clinic, I usually keep things broad when explaining how acupuncture works. That’s partly to keep it relatable for my patients, but if I’m honest, sometimes I also forget the specifics—I’m focused on the work itself, not the mechanisms underneath.

Before we get into what the research says, I want to share a metaphor I often use to explain how acupuncture helps reduce pain.

🏋️‍♂️ Acupuncture as Exercise

Strength training is a hobby of mine, and so I’ve learned that when you do a bicep curl, you’re not immediately growing your biceps brachii muscle. You’re causing micro-tears, triggering a release of endorphins, and setting off a healing cascade: increased circulation, immune activation, growth hormone, tissue repair. Most of that “magic” happens later—especially during sleep—when the body adapts to the stress you just gave it.

Acupuncture works similarly. When a needle enters the tissue, it’s a gentle, targeted disruption—a stimulus that the body responds to with a series of healing actions. As you’ll see below, that response includes everything from increased blood flow to reduced inflammation to the release of your own natural painkillers.

So what we’re doing is twofold:

Immediate relief – Downregulating pain signaling in the nervous system.
Long-term healing – Supporting circulation, reducing inflammation, and easing tension so real progress can happen over time.

Acupuncture can support many different conditions, but for today—and for the primary focus of my clinic—we’re talking pain.

📊 Summary: How Acupuncture Helps Reduce Pain

Effect	Mechanism	What Research Shows
⬆️ Local blood flow	Vasodilation via neuropeptides (like CGRP, Substance P) and nitric oxide	Increased circulation at needled sites; enhanced healing response
🌿 Muscle/fascia release	Mechanical stimulation of connective tissue and myofascial modulation	Needles create local tissue stretch and relaxation, reducing muscle tone and tightness
😊 Pain relief	Release of endogenous opioids (endorphins, enkephalins, etc.)	Natural painkillers released; pain pathways inhibited in brain and spinal cord
🔥 Inflammation reduction	Suppression of pro-inflammatory cytokines; immune system modulation	Lower levels of IL-6, TNF-α, and other inflammatory markers after acupuncture
🧠 Nervous system shift	Activation of parasympathetic system; modulation of brain pain perception	Changes in limbic system and somatosensory cortex; improved nerve conduction (e.g., CTS)

🧠 Digging Into the Research

1. Nerve Stimulation & Circulation

Inserting a needle activates local sensory nerves, triggering neuropeptide release (e.g., Substance P, CGRP), which leads to vasodilation and increased blood flow around the point.
At the Zusanli point (ST36), stimulation increases cerebral blood flow via nitric‑oxide–mediated vasodilation and reduces inflammatory markers like IL‑6.

2. Muscle Relaxation & Connective Tissue Response

Research indicates that needle insertion mechanically deforms tissues—including fascia—which may relax tight muscle fibers and reset tension via connective‑tissue modulation.

3. Endorphin & Opioid Peptide Release

Acupuncture—especially electro-acupuncture—stimulates the release of endogenous opioids like enkephalins, β‑endorphin, endomorphin, and dynorphin. Different stimulation frequencies affect which peptides are released. These peptides block pain signals in both the central and peripheral nervous systems, similar to morphine, but naturally produced by your body.

4. Anti-Inflammatory Effects

Acupuncture exerts strong anti-inflammatory effects by reducing cytokine release, suppressing inflammatory cell activity, and recruiting neutrophils that help resolve local inflammation.
In stroke patients, it has even been shown to improve neurological recovery by dampening inflammatory processes.

5. Modulation of Pain Signal Processing

There’s evidence that acupuncture inhibits hyperactive pain pathways: reducing activity in pain-related ion channels, suppressing glial cell activation, and stimulating descending inhibitory systems that release serotonin, norepinephrine, and opioid peptides.
In carpal tunnel syndrome, real acupuncture (especially electro-acu) improved nerve conduction and triggered cortical brain remodeling—while sham acupuncture yielded only temporary symptom relief.

🧾 Conclusion

The World Health Organization (WHO) has recognized acupuncture as a potentially effective treatment for over 100 conditions—ranging from migraines and digestive issues to anxiety, allergies, and infertility. Each of those conditions involves its own unique physiological patterns, and in each case acupuncture works through a wide range of mechanisms to support the body’s return to balance.

For today though, addressing some of the ways in which acupuncture helps with pain seems like plenty—both by calming the nervous system and by supporting long-term healing where the body needs it most.