PDF Version [PDF - 196 KB] (Updated on March 29, 2018)
Originating in ancient China, acupuncture is a surgical operation [1–4] in which an acupuncture point (a specific muscle or connective tissue site at which stimulation exerts a maximal therapeutic effect) is punctured with an acupuncture needle (a fine needle of up to six inches in length) to cure, mitigate, treat, or prevent disease or other conditions . Acupuncture is based on anatomy, physiology, and pathology [1,5–13].
Dry needling is acupuncture in which an acupuncture point that has become reactive (exquisitely tender to palpation), commonly known in the West as a trigger point, is punctured with an acupuncture needle to cure, mitigate, treat, or prevent disease or other conditions, especially musculoskeletal and connective tissue disorders, including musculoskeletal pain .
Dry needling is not new. It was described in the first century BCE in the Yellow Emperor’s Inner Classic (traditional Chinese: 黃帝內經; pinyin: Huáng Dì nèi jīng), the foundational text of Chinese medicine .
As exposed by the Dry Needling Adverse Event Tracking System (DNAETS) map, dry needling is unsafe when performed by unqualified practitioners of acupuncture, such as physical therapists.
Dry Needling Adverse Event Tracking System (DNAETS) Map
To see some of the serious adverse events caused by unqualified practitioners of acupuncture, such as physical therapists, performing dry needling, click on the red-colored states in the DNAETS map below. The DNAETS map was updated on March 29, 2018.
To report a serious adverse event caused by an unqualified practitioner of acupuncture, such as a physical therapist, performing dry needling, use the Dry Needling Adverse Event Reporting System (DNAERS) form. The National Center for Acupuncture Safety and Integrity (NCASI) will use the information as part of our legislative and administrative advocacy work.
An acupuncture needle is a restricted medical device under section 520(e) of the Federal Food, Drug, and Cosmetic Act (the FD&C Act) (21 U.S.C. § 360j(e)) .
The U.S. Food and Drug Administration (FDA) has restricted the sale, distribution, and use of an acupuncture needle “to prescription use” . In addition, in order to ensure the safe and effective use of an acupuncture needle, FDA has further restricted the sale, distribution, and use of an acupuncture needle “to qualified practitioners of acupuncture as determined by the States” . Therefore, it is a violation of Federal law when unqualified practitioners of acupuncture, such as physical therapists, purchase, possess, or use an acupuncture needle .
Yellow Emperor’s inner classic (traditional Chinese: 黃帝內經; pinyin: Huáng Dì nèi jīng). (China); compiled in the first century BCE.
The national encyclopaedia: a dictionary of universal knowledge. Library ed. London (United Kingdom): William Mackenzie; 1876.
Davidson T. Chambers’s twentieth century dictionary of the English language: pronouncing, explanatory, etymological, with compound phrases, technical terms in use in the arts and sciences, colloquialisms, full appendices, and copiously illustrated. London (United Kingdom): W. and R. Chambers; 1903.
Ban B, Ban G, Ban Z. Book of Han (traditional Chinese: 漢書; pinyin: Hàn shū). (China); 111.
Zhu J. Drawings of Ou Xi Fan’s five viscera (traditional Chinese: 歐希范五臟圖; pinyin: Ōu Xī Fàn wǔ zàng tú). (China); 1041–1048.
Yang J. Drawings for preserving the truth (traditional Chinese: 存真圖; pinyin: Cún zhēn tú). (China); 1102–1106.
Kendall DE. Dao of Chinese medicine: understanding an ancient healing art. 1st ed. New York (NY): Oxford University Press; 2002.
Wang JY. On the nature of channels. Robertson JD, translator, editor. Lantern. 2010;7(3):4–14.
Fung PCW. Plausible biomedical consequences of acupuncture applied at sites characteristic of acupoints in the connective-tissue-interstitial-fluid system. In: Chen LL, Cheng TO, editors. Acupuncture in modern medicine. Rijeka (Croatia): IntechOpen; 2013. p. 95–131.
Schnorrenberger CC. Anatomical roots of acupuncture and Chinese medicine. Schweiz Z Ganzheitsmed. 2013;25(2):110–118.
Neal E. Introduction to Neijing classical acupuncture Part II: clinical theory. J Chin Med. 2013;(102):20–33.
Shaw V, McLennan AK. Was acupuncture developed by Han Dynasty Chinese anatomists? Anat Rec. 2016;299(5):643–659.