Quality NCASI content is available to everyone online thanks to people like you.
Won’t you help us achieve our mission by supporting us today? Contributions to NCASI are tax-deductible to the fullest extent of the law.
Here are the top two facts you really need to know about dry needling:
1. Dry needling is acupuncture.
More specifically, dry needling is acupuncture that involves inserting an acupuncture needle (a U.S. Food and Drug Administration [FDA]–regulated medical device) through the skin and into an acupuncture point that is eliciting a flinch reaction on palpation, now commonly referred to as a trigger point, to cure, mitigate, treat, or prevent disease or other conditions, especially musculoskeletal and connective tissue disorders, including musculoskeletal pain (1).
Dry needling is not new. It was first described more than 2,000 years ago in the Chinese medical literature (1).
2. Dry needling is unsafe when performed by physical therapists.
Dry needling is safe when performed by qualified practitioners of acupuncture, such as physicians and acupuncturists, but it is unsafe when performed by physical therapists—due to inadequate and improper training in acupuncture—as evidenced by the following examples:
In Colorado, a physical therapist punctured freeskier Torin Yater-Wallace’s right lung with an acupuncture needle, causing damage to the lung that led to a pneumothorax (an accumulation of air between the lung and the chest wall, causing the lung to collapse) (2,3). He required surgery to treat the pneumothorax and was hospitalized for five days (2).
- In Georgia, a physical therapist performed dry needling on a 15-year-old girl without obtaining the consent of her mother (4). She collapsed from the dry needling (4).
- In Maryland, a physical therapist punctured a nerve in high school teacher Emily Kuykendall’s left leg with an acupuncture needle, causing damage to the nerve that led to pain, numbness, and paresthesias (abnormal sensations of tingling [pins-and-needles]) (5). She required drugs to treat the pain (5).
“This [nerve injury] is really taking a physical and emotional toll on me,” Ms. Kuykendall wrote three weeks after the adverse event. “There is almost not a minute in the day that goes by that I wish that I had not gone to see [the physical therapist]” (5).
In Arizona, three physical therapists performed dry needling through patients’ clothing, which resulted in “findings of substandard care” (6–8). This action placed the patients at risk for injuries (for example, to the heart or lungs) and infections (for example, with “flesh-eating” Streptococcus pyogenes or methicillin-resistant Staphylococcus aureus [MRSA]) (6).
In Arizona, a physical therapist disposed of used acupuncture needles in a public recycling container, which violated Arizona’s Biohazardous Medical Waste Regulations (Arizona Administrative Code [A.A.C.] R18-13-1401 et seq.) (9). This action placed the public and recycling workers at risk for needlestick injuries and infections (for example, with hepatitis B virus [HBV], hepatitis C virus [HCV], or human immunodeficiency virus [HIV]).
“Dry needling is unsafe when performed by physical therapists.”
CNA, a professional liability insurance company, provided the following examples:
- A physical therapist punctured a patient’s right lung with an acupuncture needle, causing damage to the lung that led to a pneumothorax (10). She was hospitalized and underwent treatment for the pneumothorax (10).
A physical therapist punctured a patient’s left lung with an acupuncture needle, causing damage to the lung that led to a pneumothorax (10). She was hospitalized and underwent treatment for the pneumothorax (10).
A physical therapist punctured a patient’s lung with an acupuncture needle, causing damage to the lung that led to a pneumothorax (10). She required surgery to treat the pneumothorax and was hospitalized for three days (10).
A physical therapist was performing dry needling on a patient’s hip when the handle of the acupuncture needle broke off (probably due to the physical therapist using excessive force when manipulating [rotating or pistoning] the acupuncture needle), leaving the shaft of the acupuncture needle lodged in the hip (10). She was hospitalized and underwent surgery to remove the shaft of the acupuncture needle (10).
A physical therapist performed dry needling on a patient’s calf while failing to adhere to basic infection prevention and control practices, resulting in the patient developing a calf infection (10). She required “intravenous therapy and two surgical procedures” to treat the calf infection (10).
Patient safety and quality of care are paramount. Therefore, the National Center for Acupuncture Safety and Integrity (NCASI) agrees with the American Medical Association (AMA) that dry needling should only be performed by qualified practitioners of acupuncture, such as physicians and acupuncturists (11).
Download a free copy of Top Two Facts You REALLY Need to Know about DRY NEEDLING today!
- Yellow Emperor’s inner classic (黃帝內經, Huang Di nei jing). China; compiled in the first century BCE.
- Axon R. Torin Yater-Wallace bounces back from collapsed lung with top run. USA Today. 2013 Dec 14. http://www.usatoday.com/story/sports/olympics/sochi/2013/12/13/torin-yater-wallace-dew-tour-ion-mountain-championship-halfpipe-qualifying/4019707/.
- Mutrie T. Torin under pressure. X Games. 2014 Jan 13. http://xgames.espn.go.com/xgames/skiing/article/10269254/torin-yater-wallace-ski-halfpipe-favorite-winter-olympics.
- Adrian L. Dry needling competencies require a minimum of specialized skills. Forum Magazine. 2015;30(2):1–3. http://www.fsbpt.org/Portals/0/documents/free-resources/Forum_Winter2015_DryNeedlingCompetencies.pdf.
- Kuykendall E. Complaint. 2012 Oct 22. (Internal emphasis removed.)
- Arizona State Board of Physical Therapy. Consent agreement and order for probation (concerning Michael Duncan, PT). Phoenix, AZ: Arizona State Board of Physical Therapy; 2014 Aug 8. http://directoryptboard.az.gov/docmgt/10347-14-11-1.PDF.
- Arizona State Board of Physical Therapy. Consent agreement and order (concerning Carol Dickman, PT). Phoenix, AZ: Arizona State Board of Physical Therapy; 2014 Oct 31. http://directoryptboard.az.gov/docmgt/4210-14-30-1.PDF.
- Arizona State Board of Physical Therapy. Consent agreement and order (concerning Jacob La Shot, PT). Phoenix, AZ: Arizona State Board of Physical Therapy; 2014 Oct 31. http://directoryptboard.az.gov/docmgt/8937-14-31-1.PDF.
- Arizona State Board of Physical Therapy. Regular session meeting minutes (concerning Noah Abrahams, PT). Phoenix, AZ: Arizona State Board of Physical Therapy; 2014 Sep 23. https://ptboard.az.gov/sites/default/files/Board%20Meeting%20Minutes%20-%20092314.pdf.
- CNA, Healthcare Providers Service Organization. Physical therapy professional liability exposure: 2016 claim report update. Chicago, IL: CNA Financial Corporation; 2016. https://www.cna.com/web/wcm/connect/2d3eaa76-aca2-4f6f-bfd8-e7706368cdac/RC_Healt_PT_Claim_Report_Update.pdf?MOD=AJPERES&CACHEID=2d3eaa76-aca2-4f6f-bfd8-e7706368cdac.
- American Medical Association. Physicians take on timely public health issues. AMA Wire. 2016 Jun 15. http://www.ama-assn.org/ama/ama-wire/post/physicians-timely-public-health-issues.