Acupuncture is the stimulation of specific points on the body that correspond to sites of nerve branching, blood plexuses, neurovascular bundles, and motor endplate zones. Neurophysiologic effects of analgesia in response to acupoint stimulation include release of endogenous opioids and neurotransmitters, activation of the descending pain inhibitory pathway, and inhibition of inflammatory mediators. It also causes micro-trauma and vasodilation to improve circulation and catalyze healing. Dry needling involves the insertion of fine, sterile needles into the acupoints. The size (28- to 36-gauge) and length (0.25 to 3 inches) can vary. They are typically left in place for at least 20 minutes.

The acupoints are stimulated by applying electricity through the needles for 10 to 30 minutes. Electroacupuncture provides a more profound and prolonged analgesic effect than dry needling alone. It is useful for neuralgia, nervous system injury, and persistent pain.

With aquapuncture, sterile fluid or Vitamin B12 is injected into the acupoints. It is commonly used after dry needling and/or EA to prolong the effect of the acupoint stimulation. It can also be used as a stand alone treatment.