In this November 30, 2013 photo, 17-year-old professional freeskier Torin Yater-Wallace gives the thumbs-down sign from his hospital bed at St. Anthony Summit Medical Center in Frisco, Colorado, while recovering from surgery for a pneumothorax (an accumulation of air in the space between the lung and the chest wall [pleural space], causing the lung to collapse) that he suffered after a physical therapist punctured his right lung with an acupuncture needle. (Photo: @TorinWallace)

 

Top 5 Facts You REALLY Need to Know about Dry Needling

1. Dry needling is acupuncture.

Acupuncture is the act of puncturing and stimulating an acupuncture point (a specific muscle or connective tissue site at which stimulation exerts a maximal therapeutic effect) with an acupuncture needle (a U.S. Food and Drug Administration [FDA]-regulated medical device) of up to six inches in length to cure, mitigate, treat, or prevent disease or other conditions (1). Acupuncture, which originated in China more than 2,000 years ago, is a surgical operation (1–4) and is based on anatomy, physiology, and pathology (1,5–12).

Dry needling is acupuncture that involves puncturing and stimulating a reactive (painful) acupuncture point, more commonly known in the West as a trigger point, with an acupuncture needle of up to six inches in length to cure, mitigate, treat, or prevent disease or other conditions, especially musculoskeletal and connective tissue disorders, including musculoskeletal pain (1). The reactive (painful) acupuncture point is identified by a flinch reaction on palpation (1).

Dry needling is not new. It was first described in the Chinese medical literature in the first century BCE (1).

2. Dry needling is unsafe when performed by unqualified practitioners of acupuncture, such as physical therapists.

As exposed by the National Center for Acupuncture Safety and Integrity’s (NCASI) Dry Needling Adverse Event Tracking System map, dry needling is unsafe when performed by unqualified practitioners of acupuncture, such as physical therapists.

Dry Needling Adverse Event Tracking System Map

To view some of the serious adverse events from dry needling performed by unqualified practitioners of acupuncture, such as physical therapists, click on the red-colored states in the map below.

 
 

This map was last updated on June 15, 2017.

3. It is a violation of Federal law when unqualified practitioners of acupuncture, such as physical therapists, purchase, possess, or use an acupuncture needle (13).

FDA has restricted the sale, distribution, and use of an acupuncture needle to prescription use (14). 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” (15).

Accordingly, the Federal Food, Drug, and Cosmetic Act (FDCA) and FDA regulations require that the label on a box of acupuncture needles bears the prescription statement “Caution: Federal law restricts this device to sale by or on the order of qualified practitioners of acupuncture as determined by the States” (16).

4. It is a violation of Federal law when unqualified practitioners of acupuncture, such as physical therapists, reinsert a used acupuncture needle into an acupuncture needle insertion tube (17).

This practice can transmit bacterial, fungal, and viral infections.

5. It is a violation of Federal law when unqualified practitioners of acupuncture, such as physical therapists, reinsert a used acupuncture needle into a patient (18).

This practice can transmit bacterial, fungal, and viral infections.

Pursuant to the FDCA and FDA regulations, an acupuncture needle is labeled for “single use only”: it must be used for a single patient only and a single insertion only and must be discarded immediately at the end of the surgical operation (19).

References

  1. Yellow Emperor’s inner classic (黃帝內經, Huáng Dì nèi jīng). China; compiled in the first century BCE.

  2. The national encyclopaedia: a dictionary of universal knowledge. Library ed. London: William Mackenzie; 1876.

  3. 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: W. and R. Chambers; 1903.

  4. State v. Wilson, 11 Wn. App. 916, 528 P.2d 279 (1974).

  5. Ban B, Ban G, Ban Z. Book of Han (漢書, Hàn shū). China; 111.

  6. Zhu J. Drawings of Ou Xi Fan’s five viscera (歐希范五臟圖, Ōu Xī Fàn wǔ zàng tú). China; 1041–1048.

  7. Yang J. Drawings for preserving the truth (存真圖, Cún zhēn tú). China; 1102–1106.

  8. Kendall DE. Dao of Chinese medicine: understanding an ancient healing art. 1st ed. New York (NY): Oxford University Press; 2002.

  9. Wang JY. Robertson JD, translator, editor. On the nature of channels. Lantern. 2010;7(3):4–14.

  10. Schnorrenberger CC. Anatomical roots of acupuncture and Chinese medicine. Schweiz Z Ganzheitsmed. 2013;25(2):110–118.

  11. Neal E. Introduction to Neijing classical acupuncture Part II: clinical theory. J Chin Med. 2013;(102):20–33.

  12. Shaw V, McLennan AK. Was acupuncture developed by Han Dynasty Chinese anatomists? Anat Rec. 2016;299(5):643–659.

  13. See 21 U.S.C. §§ 331(a)–(c), (g), and (k); 21 U.S.C. § 352(q).

  14. See 21 CFR § 880.5580(b)(1); 21 CFR § 801.109; see also 21 U.S.C. § 360j(e)(1); 21 CFR § 807.3(i).

  15. See 61 Fed.Reg. 64616 (Dec. 6, 1996) (emphasis added). See 21 CFR § 880.5580(b)(1); 21 CFR § 801.109; see also 21 U.S.C. § 360j(e)(1); 21 CFR § 807.3(i).

  16. See 21 CFR § 880.5580(b)(1); 21 CFR § 801.109(b)(1); see also 21 U.S.C. § 360j(e)(2); 21 CFR § 807.3(i).

  17. See 29 CFR § 1910.1030(d)(1); 29 CFR § 1910.1030(d)(2)(vii); 29 CFR § 1910.1030(d)(4)(iii)(A)(1); 29 U.S.C. § 654.

  18. See 21 U.S.C. §§ 331(a)–(c), (g), and (k); 21 U.S.C. § 352(q); 29 CFR § 1910.1030(d)(1); 29 CFR § 1910.1030(d)(4)(iii)(A)(1).

  19. See 21 CFR § 880.5580(b)(1); 21 CFR § 801.109; see also 21 U.S.C. § 360j(e); 21 CFR § 807.3(i).