Advocacy

California court Issues Temporary Injunction Stopping Companies from Dry Needling in CA following CSM 2016

Today, I received the following press release in my email regarding dry needling in California.  Read and lets discuss….

-Joe B

Press Release

February 24, 2016                                                                                Contact: John Moore

FOR IMMEDIATE RELEASE                                                               (206) 856-9737

California Court Issues Temporary Injunction Stopping Companies from “Dry Needling” in California and Enjoining

Sales of “Myotech Dry Needles”

Orange County, CA – Late last week, the Orange County Superior Court granted a temporary restraining order against several out-of-state companies and their owners after plans surfaced that they intended to insert acupuncture needles and distribute acupuncture needle samples at a physical therapy conference in Anaheim, California.  The Defendants lacked state licensure as acupuncturists or medical doctors and were not registered under California’s Pharmacy Law. Kinetacore, a main Defendant in the case, engages in training workshops marketed primarily to physical therapists for what they refer to as “dry needling.”  US Dry Needling, another main Defendant in the case, sells acupuncture needles under the brand name “Myotech Dry Needles,” while failing to identify the needles as acupuncture needles.  Dry needling is highly controversial since it involves the insertion of FDA-regulated acupuncture needles through the skin and into acupuncture points, which are located in muscles or connective tissue, for therapeutic purposes by physical therapists or chiropractors who can have as little as a weekend of training in acupuncture.

Those practicing “dry needling” claim that they are not practicing “acupuncture” and, therefore, are not required to comply with the strict state safety, training, and licensing requirements that apply to the practice of acupuncture.  California acupuncturists, for example, are required to have at least 3,000 hours of formal training in acupuncture, whereas Kinetacore’s weekend “certification” workshop in “dry needling” is just 27 hours.  There have been a number of high-profile injuries in recent years where physical therapists or chiropractors have punctured the lungs of their patients upon incorrectly inserting acupuncture needles.  Courts in Washington and Oregon have permanently enjoined physical therapists and chiropractors, respectively, from practicing “dry needling” by finding it was outside their legal scopes of practice.

“The insertion of acupuncture needles by physical therapists or other persons who have little or no training in the safe and effective use of acupuncture needles constitutes a significant threat to public safety,” says Dr. Amy Matecki, who is the medical director for the International Center for Integrative Medicine, which filed the lawsuit last week.  “Physical therapists are not trained in the safe use of acupuncture needles and are not legally authorized to use acupuncture needles in the State of California.”

The lawsuit was filed by the International Center for Integrative Medicine in Oakland, California, and alleges that plans by Kinetacore’s owner, Edo Zylstra, to insert acupuncture needles as a part of a dry needling demonstration violates California’s Acupuncture Licensure Act and Medical Practice Act.  The case challenges plans by US Dry Needling and its owners, Paul Killoren, Austin Woods, and Edo Zylstra, to distribute samples and accept on-line sales of the “Myotech Dry Needle,” which is an acupuncture needle.  The lawsuit also alleges that distribution of such needles constitutes a violation of California’s Pharmacy Law.

A copy of the injunction can be found here (http://docdro.id/Kuk6GiY). And a copy of the argument in support of the injunction can be found here (http://docdro.id/kaizQ5P).

The temporary restraining order will stay in effect until mid-March, when the court will consider issuing a preliminary injunction that would continue the injunctive relief until the case can be decided on.

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56 replies »

  1. Seems to be a bit one sided in the explanation against PT’s and lumping PTs and Chiropractors together…what about any adverse responses from acupuncturists, medical doctors, etc. while performing similar techniques? It is also interesting that the training is most often described as being isolated to a weekend course…

    • because there’s only one side needed. PT’s are deliberately trying to steal Acupuncture away from Acupuncturists.

      Just wait until PT’s start doing adjustments and saying it isn’t Chiropractics.

      If PT’s want to do Acupuncture, they can go get a license for it like everybody else. THERE ARE NO SHORTCUTS IN LIFE.

      • Theyve been doing ajustments for years in most states and the Chiros for one in Illinois have lost their case against them….they are a big powerful well-funded political group in almost every state…..

      • After spending 7 years studying the human and animal body I feel 100% confident I would not stick a filament needle into a lung. There are no cases of life threatening injuries by PT using needles. That being said there is a lot of falso information out there. PT is not trying to use Qi to treat a patient. PT is using muscle,tendons,ligaments,nerve stimulation to treat a patient. We are the experts in biomechanics and using another treatment option to get a patient to function is our passion. After the patient is educated and can perform the exercises him self we no longer need to see this patient. Many PT’s strive to educated the patient and treat in less visits. There is no need for us to drag out a treatment like chiropractic or acupunture. It’s just not what we do. You guys can have it. No one is trying to step on your toes; we treat differently and should compliment one another to better the patient. Spending 3 years of graduate school surely qualifies one to know where to insert a filament needle.we spend hours on carvers and looking at each system in detail. Have a lot of experience with live patients and rigorously tested along the way. For us it is part of a bigger picture, not for every patient, but maybe beneficial. I would like to see the comparison of chiro and acupunture and PT educational program and for your dysfunction you can choose who would suite you best. Cheers.

      • We already do spinal manipulation. It’s part of our schooling to mobilize joints in order to achieve better biomechanics.

      • Christie, that one case is not very convincing. One case from a PT? There are cases out there from acupunture as well but it’s still considered safe enough for our malpractice insurance to have not paid out any patient for a dry needle injury. Check with HPSO.

      • Well, not exactly. The link provided references the Kietrys et al systematic review with meta-analysis of 12 randomized controlled trials of needling for upper quarter myofascial pain. The critique by the highly-qualified clinical researchers at BIM argue that the authors’ conclusions were far too favorable towards the efficacy of dry needling for this condition.

        Of course there are many other trials investigating other strategies of needling for a variety of conditions, most of which I’m very well aware. However, if you have some unpublished data or something of particularly high quality that is in some obscure journal, I’d like to see it. The best way to contact me is by sending a friend request to my Facebook page (this is my real name and I live in Louisiana), and then we can exchange contact info via private message.
        Thanks.

  2. I’m very glad that California has decided in this direction. If any continuing education provider seeks to give a license in a weekend that generally takes three to four years to earn, one should always act in the best interest of the general public. As a governing body who provides licenses and must maintain standards of education, it is the right thing to do. While my scope of practice includes acupuncture and basic adjustments, I do not perform adjustments, as I would rather to refer to a close group of colleagues who maintain their chiropractic license and are highly trained. It is in the best interest of the patient, which should be everyone’s concern.

  3. Can we all please remember that the hours to become an acupuncturist are not purely putting needles into the skin. Those hours mostly involve learning the anatomy and physiology of the human body due to the lack of a bachelors degree needed to perform acupuncture. With PT being a doctorate degree, anatomy and physiology are already known to a greater extent and depth than many other fields. Yes the dry needling course is a weekend course, but that is because the foundation has already been laid for PTs.

    • I’m sorry, I meant to say a bachelor’s in a related field, however you do need a masters in an acupuncture school to practice. I believe acupuncturists are great at their profession and I’m not taking anything away from them. The way they use needles is for Qi and following meridians, and this is a lot of their eduction. PTs use needling as an integration into western medicine and are educated as such. I would like to see all of these cases of collapsed lungs from PT needling.

      • Joe, it appears you had added a comment while i was writing in response to your first one, so please take some of my “passion” with a grain of salt since you recognized some of what i was arguing already. Thanks.

    • Joe, to which region are you referring to when you say a BA/Bs degree is not required? In many states like CA and TX, a BA/BS is required (or at least 2 years of general ed schooling) before being able to get into specialized BS program and then go on into a Master program for Acupunture and Oriental Medicine. Not to mention we still have to take up to 4 medical boards (varies by state) in order to get an acupuncture license.
      Also, PT is not strictly a doctoral program. Just like acupuncture, PT and Acupuncture have both Master’s and PhD programs.

      Its frustrating that those like me continually studying and practicing acupuncture and oriental medicine for years (taking a total of 7+ years to even obtain such license), are now competing with those who took a “weekend course.”
      I would be in favor for being able to mesh our practices if there was more in depth training (kind of like nurses and paramedics getting licensed as the other through accelerated 1+yrs of training) AND for things being able to go both ways.
      Right now, a lot of the western medical society can take a “weekend course” and learn the science of acupuncture and practice “dry needling” however acupuncturists can not take any sort of weekend course for PT or Chiro or anything “western”, thus screwing our specialty and means of living twice!
      We’re told we cant learn it because we learned eastern medicine not western, therefore we cant practice “western practices” without completely going back to school. However, it is okay for [“real”] western medical practitioners to learn only the basic, mainly the physical science part, of acupuncture and take it as your own without learning the full aspect of Eastern Medicine.
      A bit of a double standard wouldnt you say?

      Not to mention eastern medicine being considered “altenative medicine” though eastern medicine has been around thousands of years longer than the several hundred years old western medcine practices.

      Again, i would fine with it being easier for practitioners to get multiple licenses so they can provide a lot of different services themselves to provide a better holistic treatment but it needs to go both ways and each need to completely learn the other practice, not just the convenient sections of what we want to learn from the other.

      I honestly could go on but that is the main jist of my arguement and why i support the ban of “dry needling.”

    • In my acupuncture training there were 900 hours needling in clinic, along with 3 twelve week long classes of practice needling, before working in the clinical all. There is no comparison to a weekend of learning.

    • Actually, the majority of Chinese Medical Scools are graduate level programs. I studies western anatomy, physiology, pathology, microbiology, chemistry and the humanities extensively before enrolling in Acupuncture School, where yes, we did study western A&P, along with western ideas of pathology, but the majority of my post grad education focused on Chinese medical theory and treatment.

    • Joe, I needed a BS before applying to my acupuncture college. A masters degree for an acupuncture license is a FOUR year masters degree program! My acupuncture program was over 3,400 hours of education with well over 1200 hours interning with patients in clinic. On top of this I had many acupuncture needling classes (easily more than 10 semesters worth). There is no comparison!

  4. The acupuncture needle is what it is… Semantics do not change that. Maybe the PT’s and DC’s should use a hypodermic or sewing needle, but if the tool in question looks like a acupuncture needle in structure and function, that our (Acupuncturist domain). There is the argument over what is an acupoint versus a motor point, or myofascial trigger point etc. Again, semantics… It should be kept in mind that Acupuncture & Oriental Medicine is predicated on a very different paradigm. That said, so-called medical training is not transferable. WE (Acupuncture and Oriental Medicine Practitioners) need to come together in solidarity and present a united front professionally and legislatively, or our profession will be cherry picked by the “takers” until there is nothing left. This is the same thing that happened to the Homeopathic Doctors at the turn of the 20th Century. They were too busy fighting among themselves over “potencies” to notice that their profession was literally stolen from them. Is past going to be prologue in our case?

    • Anyone can give out exercises, but only a PT or PTA can provide physical therapy.

      Have some pride in your profession APs! Do what you do better!

  5. How about if I become a PT or DC in a weekend course because, as someone puts it, the foundation has been laid? This arguments is going from ridiculous to sublime..

  6. I have been practicing Acupuncture for 10 years and went through extensive schooling and training before I was ever licensed to insert needles into my clients skin. I have witness first hand bruising from PT’s a punctured lung client and numerous clients who had their insurance complete wiped out by a local PT and no relief of symptoms. Our local PT, is also inserting ear needles and doing distal treatments. We have filed complaints with DORA about the PT and have had numerous individuals file complaints to the State of Colorado against the PT. I think Colorado should pull the PT dry needling. I have a case of a PT in Boulder who is seeing clients privately in her home to perform acupuncture and she has been reported to the state, she was terminated from her PT position and a court case will follow.

    • You can say the same thing of patient going to acupunture for 3 times a week for years with no functional gains or on a chiro schedule to get adjusted for years with no success.

  7. Setting the theoretical plausibility for the necessity of needling aside (which does carry a valid discussion in and of itself), it appears a large disagreement amongst the two groups is the amount of training necessary to proficiently stick needles (whether it be called acupuncture or dry needling). So let’s attempt to have more interprofessional discussion and answer:

    1. How many hours are necessary to become proficient and safe in the practice of dry needling?

    2. What prerequisite education is necessary to stick a needle into the skin, safely?

    Does anyone have evidence for above? Does anyone have any evidence on the epidemiological risk of needling (by either a PT or Acupuncturist)? Without this, the discussion falls into the category of a turf war (which this is) vs. science.

    We can always draw comparisons amongst regional competitors (“the PT/acupuncturist/chiro/MD/etc down the street does…”) but I would like to see a more substance-driven argument from either side.

    • Your question belittles and reduces EVERY modality to simply the safety of “sticking needles into skin” as if there is no other issue except safety.
      The Pts’ usage of acupuncture needles for the purpose of dry needling has been rather recent therefore there are likely no amounts of data recorded to prove 3000 years of acupuncture has produced a lot less collapsed lungs than physical therapists.
      The training that involves understanding how to safely “stick needles into skin” varies from profession and modality requirement because the techniques differ and the intention of where and how the needles are stuck is different.
      Acupuncturists like myself, trained in myofascial release (dry needling) will all agree that the more understanding you have of the complexity of different body types, needle gauges, needling techniques necessary to release musculature in certain areas, and other variables that 200 hours doesn’t simply cut it for safety.

    • I don’t think you can make that separation, Joe. This discussion becomes one akin to arguing over which end of the egg should be broken open. It’s moot. It’s silliness. Why do PTs want to engage in silly and unproductive turf battles over alternative treatment “table scraps”?
      These discussions, in all their detailed analysis about whose qualified to jab patients with needles, the “science” of acupuncture” compared to the “science” of dry needling, etc., are a collosal waste of time.
      If you want to have a germane discussion, then why don’t you address the arcane and choice-limiting state licensure laws, which healthcare professions ostensibly use to protect the public when really it’s about protecting turf and therefore income.
      Ironically, the only ones who end up making any money are the lawyers.

    • I don’t think you can make that separation, Joe. This discussion becomes one akin to arguing over which end of the egg should be broken open. It’s moot. It’s silliness. Why do PTs want to engage in silly and unproductive turf battles over alternative treatment “table scraps”?
      These discussions, in all their detailed analysis about whose qualified to jab patients with needles, the “science” of acupuncture” compared to the “science” of dry needling, etc., are a collosal waste of time.
      If you want to have a germane discussion, then why don’t you address the arcane and choice-limiting state licensure laws, and healthcare professions ostensibly using them to protect the public when really it’s about protecting turf and therefore income.
      Ironically, the only ones who end up making any money are the lawyers.

      • Susie, the important issue here is not one of safety. Taking a broader perspective, I see the issue being more about one paradigm competing with another. The PT practice of “dry needling” follows a biomedical reductionist model, whereas “acupuncture” practice is grounded in the philosophy of Traditional Chinese Medicine (TCM). As everyone who studies the topic must know by now, Drs Travell and Simons invented a lesion in muscle, which has become known as the “myofascial trigger point”. But the repeated failure of attempts to confirm such a lesion means that their theory was only ever conjectural and that all hypotheses derived from it are not worth the paper upon which they are written. By rights, there should be no contest! Those who espouse acupuncture, as one component of TCM, should think seriously about exposing the big lie that is being peddled by the PTs.

    • Like you, I am not for a turf war. Let acupuncturists take a weekend course and do PT and bill insurance for it then we will be on a level playing ground.

      • Dry needling is just a technique not a profession. We already identify and treat trigger points with manual therapy, now we can penetrate deeper for those rare cases that do not resolve with just manual. Not trying to treat the common cold or anything else, nor are we trying to say we do acupuncture. Surely there is more to it than a needle? Just look at PT curriculum, we already have the background training, this requires very little more training

      • Fyi PTs are also allowed to do sharp debridement of wounds. That means taking a scalpel and scraping off dead tissue. Just an additional technique not a profession..

  8. I cannot answer Question 1 because it would be grossly insulting to those PTs who have on scientific grounds rejected this irrational approach to people in pain. Question 2 is answerable if one extrapolates from the course requirements for those whowish to train in phlebotomy. About 42 hours of classroom training and 120 hours of clinical experience are required.

  9. Injuries or not, the bottom line is respect what we have studied and let us do the puncturing just like PT’s and Chiros would like others to respect their scope of practice!

  10. Surely the bottom line is more about therapeutic outcomes than therapists’ incomes. In saying this, please note that I do not have a financial conflict of interest to declare.

  11. Are you able to make the second document you posted regarding the injunction support document available? It is showing it requires a password? Thanks!

  12. This is a power, ego and global financial monies struggle between what is true and what is not true. How will Allopathic investors keep up the lie about WHERE pain is located. Definitions were cluttering my logic and reasoning until I discovered a few textbooks which clarified all the words and terminology.

    1. The most common primary location of everyday and long-term aches, pains and stiffness can only come from the soft, connective and muscle tissues.

    2. The specific organ system which can collect micro-scars is the muscular system.

    3. The most common primary cause of everyday soft tissues aches, pains and stiffness is simply the trials, tribulations, falls, contusions, stresses, strains of life, living from work, play and fun.

    4. The only treatment for soft, connective and muscle tissue pain from life and living is physical therapy (PT).

    5. PT has historically come in a broad spectrum of options from hands-on massage, kneading, stretching, spinal adjustments, tendon, ligament and intramuscular stimulating needling.

    6. The perfect metallic tool man has discovered is the wire-like probe. The modern needle can be inserted into the body to treat pain.

    Why? To re-injure thus re-ignite the healing necessary to repair the cellular damages embedded in sick and diseased muscles, the most common location of pain.

    Muscle pain can only be cured with re-injury, stretching, kneading and wellness.

    The historical logical and vetted means by which to re-injure healing deep within muscle are the many physical therapy options:

    A. Massage, Tissue release; strain and counterstrain; spray and stretch and Joint and Spinal Manipulations.

    B. Thin intramuscular needling options, Dry needling, GunnIMS, Chinese, Japanese, French Energetic and various other “Acupuncture Disciplines.”

    C. Hypodermic intramuscular needling options, Wet Needling aka Tender Point Stimulative Needling, Tendon and Ligament Injections, prolotherapy, biopuncture, Stem Cell and PRP.

    The Keystone Discovery:
    Thanks to C. Chan Gunn and Dr. Cannon, we now have a viable “Mechanism of Action” (MoA) of the needles. With a MoA a scientist can predict the outcomes more accurately with logic and certainty. With a MoA a lot of the variables remove and clarified. With a MoA as per Gunn/Cannon we can logically connect all the volumes of muscle treatment into a full encyclopedia set.

    The is the perfect cause and effect healing equation:
    Pain in the soft tissues + Full Spectrum of Physical Therapy Options + Natural Forces = Resolution of the original pain.

    This will be an epic battle of power and money which will ultimately leave millions of people to have to suffer for-profits without the integrity and support of US, UK and
    Austrian honorable societies.

    Today we can witness millions of unnecessary amputation surgeries, overdoses and human sacrifices from suicides, for-profits, due to these few defintion confusions.

    • Stephen,

      In appreciation for your intent to end the needless deaths from suicide and overdose, as well as unnecessary amputations, I encourage you to work for non-profits, and with those of us working toward seeing the end of the epic battle.

      Please notice that you’ve neglected to mention neurological pain etiologies. Nerve compression stemming from degenerative diseases, such as spinal stenosis and osteo-arthristis, is usually agitated by DC/PT manipulations which increase nerve compression and increase pain; soft tissue work does not treat disease processes causing bone disorders. Post-op and diabetic neuropathy are also conditions that cannot be explained by the simplified equation you describe, nor the more complex neurological syndromes stemming from biological warfare and genetic damage. Acupuncture, Moxibustion, and botanical therapeutics, when properly utilized both topically and internally, stimulate multiple restorative mechanisms.

      The mechanisms of actions of acupuncture that you mention are indeed wonderful to “discover.” And, there are many more. However, as much as we’ve come to understand scientifically about acupuncture effects, using our state of the art technologies, we are indeed but infantile in our understanding through this lens. The body and universe are extremely complex and interdependent, our minds so small, technology so primitive, and there is much cross-culturally to share as we gradually come to know more about the world around us, and within us. Advanced acupuncture theory is highly scientific, and quite sophisticated actually (that’s why it takes four years to learn and lifetime to master).

      With your interest in acupuncture, rather than invest in DN classes, I urge you to enroll in a California acupuncture college where your money will be well spent. After visiting acupuncture colleges around the states, I chose to relocate to California in order to take advantage of the superior opportunities there. Many MDs, RNs, and DCs walked across the stage with me to receive their diploma from the acupuncture college I attended in California. Now, back in my Midwestern hometown, and employed in a pain specialty clinic, I see it was well worth the 180K student loan debt and grit through an incredibly grueling curriculum (as any med-school is). Now, I’m saving lives when all hope has been lost, surgeries and injections exhausted, PT and DC options exhausted, the pharmaceuticals don’t work anymore, patients are suicidal, while greater majority are with mental disorders and comorbidities.

      DCs and PTs down the street practice their version of acupuncture with 24-100 hours but their outcomes are too sorry to report, I feel bad that these distinguished health care professionals wasted their time and money on greedy acupuncture/DN teachers/companies. These well-intentioned individuals would have been better off seeking out training in accredited full-time acupuncture degree programs from a non-profit college. Their biomedical course work would transfer. (Yes, contrary to myth, acupuncturists in CA acquire as much biomedical course work as PT, DC, PA, NP, and even overlap with much of the MD curriculum).

      I applaud California for maintaining practice standards and urge every one, with an interest in acupuncture, to take the time to learn the real deal, not a short-course. The profession desperately needs you. Two people die every hour to opioid overdose in America. Acupuncture is their last hope. And, it is working, lives are changing, domestic violence and psychotic episodes are ending, and people are learning how to be alive again, to love again. Please, I beg you to care enough about patients to take the time to become a professional acupuncturist. PTs who have become LAcs rave about the value of doing so!

  13. Turf war BS. Just like PTs can’t own exercise or manual therapy, but wait acupuncture is not dry needling so step off of our turf. btw yes you are better off seeing most PTs over other providers for those but I’m biased. People have different levels of training for the same thing, HOWEVER dry needling is not even acupuncture nor based in meridians or other disproved principles… Learning that knowledge, I’ve heard from those studying acupuncture, is most of the education hours. Too bad. PTs are some of the best and brightest to even get into the school and the school is very intensive including human cadaver lab, medical physiology, differential diagnosis, wound care etc … So the training background is plenty to learn superficial skin penetration into muscle. i mean really, I’ve removed drain tubes after shoulder surgeries, used a scalpel to debride a wound, have training to appropriately manipulate upper cervical spines. Want to know how to not puncture a lung? Stay transverse, pinch the upper trap muscle, and don’t aim caudally. Not rocket science folks.
    Plenty of references below https://www.fsbpt.org/download/DryNeedlingResourcePaper_4thEdition.pdf

    http://www.aaompt.org/documents/dryneedlinginptclinicalpracticeeducationalresourcepaper.pdf

    http://www.apta.org/StateIssues/DryNeedling/ResourcePaper

    Also, citing anecdotal evidence about PTs safety issue only makes AP look bad because there is actually documentation in the research showing acupuncturists injuring patients. There is a certain amount of risk with everything for even the best trained, e.g. Surgery, and informed consent is needed, but it’s not PTs to be afraid of.

    • Over the several thousand years since its inception many different schools or styles of acupuncture emerged (including local and distal) along with new techniques. There are numerous techniques including “lift and thrust, threading, bone pricking, shallow vs deep insertion, seven star, surround the dragon”….etc and many of these techniques are designed to increase microcirculation( move qi(oxygen) and blood) in the injured area. Thousands of studies have been done exploring the effects of acupuncture and much of our current scientific understanding of human neurophysiology comes from these studies. The complex mechanisms of acupuncture have been largely worked out. Unfortunately the acupuncture community has not completely adopted the western terminology to explain what we are doing. This creates a gap in the public’s understanding which is now being exploited by PT’s who want to do acupuncture.

      The argument put forth by the “dry needling” community to convince the public that what they are doing is different is by definition only. For example they say “acupuncturists manipulate qi along meridians” etc. and PT’s use trigger points found via palpation. It is a semantic loophole they are trying to exploit in order to expand their scope of practice. They cannot prove scientifically that what they are doing, i.e the effects of dry needling in the body are inherently different from the various types of acupuncture used today. The effect in the body is the same. The body cannot tell the difference.

      No well educated PT or MD would say that dry needling has a fundamentally different mechanism in the body than what modern acupuncture research has shown to be the case. Their idea that when an acupuncturist needles the body he or she is just manipulating “Qi in meridians” and that when a PT needles the body he is “treating musculoskeletal dysfunction” shows a gross misunderstanding of the current methods and mechanisms of acupuncture, a denial of basic human physiology and is quite frankly an absurd argument. To make such an argument one must believe that, “Qi” and “meridians” actually exist which has never been proven. When you realize how illogical their argument is you must conclude that it is just a well orchestrated ruse.

  14. Give me a break Acupuncture lobby. PTs learn learn every single structure in the body in PT school in cadaveric anatomy, including being trained and functioning in many situations as primary care PTs. 1) physicians coined the term dry-needling not PTs 2) PTs came out of the medical model 3) we know where EVERY nerve, artery, anatomical structure is located from PT school and have amazing hands on ability such as our background as PTs to control any needle. we also know the mechanisms based on science 4) others use needles with much less training and knowledge 5) our “weekend course” is on top of a very rigorous training background (ie Doctor of PT school), and is more than a weekend for higher level certs 6) dry needling represents a fraction of our practice as it should since it has limited support in research and most of the time manual therapy works just fine 7) we have plenty of tools at our disposal and know when to apply which to the most appropriate patient 8) we are not taking shortcuts just happen to be qualified to also use needles in our practice for non pharm interventions 9) we have been using, studing, and pioneering spinal manipulation / thrust mobilizations for DECADES 10) a technique doesn’t define a profession, the training to enter it does. there are many brands of donuts, generic drugs (same as brand name), anyone can give out exercises, etc… if you want to do dry needling (which is technically defined based on physiology and trigger points) then do it better than PTs and you will have your business. unfortunate that you are a 1 trick wonder unlike PTs. 11) PTs are safe until proven otherwise. what about the cases of Acupuncturists puncturing lungs, surgeons with poor outcomes to surgeries (you don’t take away their license do you?) 12) Dry-Needling is easy, the difficult part is: taking in the entire patient presentation and making a diagnosis including the tissue injured or not injured (neuropathic pain), impairments related to functional impairments, the impact of contextual factors (environment/individual), and then selecting the most appropriate interventions to get the best outcomes possible. THE END

    • oh I should have also said administering the interventions including consideration of specific exercise dosing based on the individual patient and other factors previously listed, skill to perform manual interventions or know when not to, also knowing when to refer back for additional testing… not enough space here.

  15. In my experience as a licensed acupuncturist, I have heard more complaints about PT not working than working. I see patients after PT hasn’t worked. Unfortunately I wish people would try Acupuncture first rather than as a last resort to everything else they’ve tried and failed. In 14 years I’ve heard nothing positive about physical therapy. Maybe that is why they are grasping on to this dry needling therapy to try and help their own profession…

    • you clearly are not aware of the large body of evidence in support of PT, the many journals dedicated to it, and the large studies showing no effect or evidence of benefit of acupuncture. aside from that, the last thing people need is to see a passive modality practitioner and part of the chronic pain epidemic (in addition to opiate) is that people want a quick fix, and are told they are broken, among other reasons by someone they saw most likely NOT a PT first. evidence shows PT first is extremely beneficial, but significantly underutilized. active treatment does much better and empowers the patient versus depending on someone for life on a regular basis. a good PT will empower a patient and give them tools, then see them as needed to guide them. majority of my patients do very well. the people you see are likely in that position for a reason – they prefer passive treatments and do not want to take control of their lives, have not had someone empower them, or also need psych involvement. you likely work near a crappy PT clinic owned by a doc and not a PT, or FOS and a troll. (4 patients an hour, no residency or fellowship training after PT school, etc..) honestly, dry needling, like i said, is 1 very small tool in the toolbox, and will not make or break any patient’s POC.

      • oh, and how do i know my patients do well? I utilize standardized self report outcomes, patient specific outcomes, and also performance based outcomes. not “yea, that felt great”

    • Carrie – I’ll be the first to admit that PT does not fix every patient that comes in the door. I have sent many patients to acupuncture for pain relief and have seen good results. However, many of these stories also end with the patient stating that acupuncture helped for a while, then stopped helping.

      It is indeed sad that you have heard so many stories of failed treatments at the hands of PTs. Your claim however, sounds more like biased observation on your part: IF PT was working, those clients would not end up in your clinic after all. In fact, you would never see them. “You only know what you know.”

      You should feel relieved to know that I get the same story, with patients coming to see me after acupuncture stops working.

      Since you are clearly of the mind that PT is useless, I would love to hear your success stories of using acupuncture to teach someone to walk again; return to sports after an ACL reconstruction (substitute almost any activity and surgery); resolve vestibular issues; recover from any overuse injury; etc.

      Good luck finding a good PT in your area – they are out there!

      Kevin, PT, OCS

  16. I lived in Montana for 20 years and found the PTs use of dry needling very effective and long lasting. I am being denied the treatment I need in California. Is there anything I can do to help change that?

  17. I’m coming to this party a bit late, but I am shocked by the amount of anger, fear and loathing associated with PTs doing Dry Needling (not acupuncture) displayed in the comments for this post and an older one (Oct 16 2014). I live in one of the states that specifically prohibits PTs from doing dry needling (DN), mainly as a result of the acupuncturists’ lobbying groups and lawyers. In essence, I am being prevented from providing a valuable treatment modality to my clients – one that may make a big difference in their health and well-being. Kind of sounds like the historic legal battle between PTs and Chiros in WA, where PTs were not allowed to manipulate the spine until just recently – regardless of education or experience.

    Acupuncturists: I would enjoy hearing how many acupuncturists perform DN as described in the PT literature. For my money, I have sent patients to acupuncturists specifically for DN, only to have the patient come back to me saying that the acupuncturist refused to take “orders” from a PT.

    Consider this opinion of one licensed acupuncturist (http://www.apta.org/PTinMotion/2015/5/DryNeedling/):
    “He rejects the notion that PTs are performing acupuncture when they use dry needling on patients.

    ‘Acupuncture and dry needling, as it is practiced by physical therapists, are completely distinct from each other in terms of diagnostic criteria, palpation, selection, location, and needle manipulation,” he says. “Physical therapists use dry needling as a modality,” he says. “With proper education, they can—and do—use it safely and effectively. It’s a nonissue as far as I’m concerned.’

    Carney attributes attacks by acupuncturists to 2 things: poor understanding of what PTs do and fear that PTs will hurt acupuncturists’ economic livelihood. On the latter score, his colleagues needn’t worry, he says. Not only is there little patient or client overlap between the 2 professions, but when it comes to dry needling, “There’s a gaping hole in the health care system’s ability to offer people relief from myofascial pain. Given the huge need, the more practitioners there are to help fill that hole, the better.”

    Personally, I would (were I allowed legally to do so) use DN as a small part of my practice, in the same way that I use spinal manipulation. The PT research on DN is certainly getting a lot of publicity and print space of late. While I respect the statistics and opinions out there that DN is no better than placebo, it appears to me that DN is like a lot of PT interventions: it helps some people a lot; others not so much; some not at all. If it’s legal, safe, and I have the training to administer the treatment safely and competently, why not try DN if it’s indicated? After all, DN is only one tool in a PTs bag.

    (for the sake of avoiding making this post into a long boring piece, I have omitted all the info on PT training/education, specific research findings, evidence based practice, outcome tools, patient satisfaction, etc).

    Rather than engaging in a turf war, shouldn’t health care providers focus on helping clients to overcome their pain and injuries and optimize their health and well-being?

    Kevin, PT, OCS

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