The carrier also disclosed that between 2012 and 2017, 34 dry needling claims arose from 19 states, with the most common injury alleged being pneumothorax (collapsed lung) from patients being treated for neck, shoulder or back pain.

Fashion trends — like ripped jeans and choker necklaces — only appear modern to those who didn’t first see them in the 1980s. So too is the recent fascination with “dry needling,” an invasive acupuncture procedure being touted by physical therapists as a modern treatment to manage pain.


In 1999, the Board of Physical Therapy in New Mexico set in motion two decades of contention when it determined invasive acupuncture was within that state’s PT scope of practice — allowing physical therapists there to perform acupuncture under the lesser known term of "dry needling."


Since then, every state has been challenged with answering questions about the legality, scope and training needed for PTs to perform dry needling. The American Physical Therapy Association claims the law permits PTs to perform dry needling in 34 states and D.C.


This is false and misleading, considering only eight states have enacted such laws. All other state permissions for PTs doing dry needling have been admitted through PT Regulatory Board position statements, rulemaking or silence.


Two Florida bills (HB 467 and SB 792) have been introduced containing pathways for PTs to begin dry needling in 2020. If adopted, the Florida standard would have the fewest hours of study and broadest interpretation for dry needling in the nation.


The present bills’ language provides scarce boundaries for PTs performing dry needling, and the 25 hours of continuing education sought by PTs appears lacking compared to medical acupuncturists, who complete 300 hours of post-doctoral training, and Licensed Acupuncturists, whose four-year 2,700-hour education requires 660 hours of supervised clinical training in patient safety and proper technique.


The Healthcare Providers Service Organization is the main malpractice insurance carrier for the American Physical Therapy Association. In its "Physical Therapy Professional Liability Exposure: 2016 Claim Report Update," dry needling was identified as an “emerging risk exposure” due to an increasing number of claims alleging patient harm due to “lack of informed consent” and “use of improper technique.”


The carrier also disclosed that between 2012 and 2017, 34 dry needling claims arose from 19 states, with the most common injury alleged being pneumothorax (collapsed lung) from patients being treated for neck, shoulder or back pain. Other reported patient injuries include organ and spinal cord punctures requiring hospitalization and emergency surgery. If HPSO has identified dry needling as an emerging risk to the physical therapy profession, what might that mean for Florida’s patients receiving this treatment?


Given that current physical therapy doctoral programs provide limited or no specific coursework or training in dry needling, the Florida State Oriental Medical Association and Florida Acupuncture Association recommended legislators require PTs complete 200 hours of live post-graduate dry needling training prior to using this invasive medical procedure on patients in an unsupervised setting.


David Bibbey, L.Ac, is vice-president of Florida State Oriental Medical Association, co-chair of the Legislative Committee and director of Alternative Primary Care in Crystal River.


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