When I was going to PT for neck pain, they would put warm compresses on my neck/shoulder, while at the same time they would hook me up to a TENS machine for 15 minutes (small electrical pulses into tight trapezius muscles).

Then the Physical therapist would come in and insert 4-5 long very thin needles into the muscle area that was affected. I went to another PT provider and they hooked up the TENS machine to the needles. After that I would do the stretching exercises.

Acupuncture uses very thin needles inserted into acupressure points throughout the body. The goal is to break through blockages in the meridians or between the acupressure points. The needles are not put where the pain is necessarily, but at the acupressure point corresponding the affected body part. For example, one day I told her I could feel aching in my ankle after the session. She said the ankle acupressure point corresponds to the neck, and I was there to work on relieving my neck pain.

When I asked the doctor of Asian and Oriental medicine what the difference is between acupuncture and dry needling she said acupuncture puts needles into acupressure points and dry needling uses needles into the trigger points of the muscles.

Of course acupuncture is not widely accepted in main-stream medicine in the US, but my acupuncture doctor says when she worked in NJ before moving her practice to Alabama, she worked hand-in-hand with pain management doctors and chiropractors. I think it definitely has merit and I have seen improvement in my sinus, neck and general pain level.

Great question, hope this helped (or brought up more questions!).