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 traumatic pneumothorax (an accumulation of air in the pleural cavity resulting from blunt or penetrating chest injury and causing lung collapse) that he suffered after a physical therapist punctured his right lung with an acupuncture needle. (Photo: @TorinWallace)
PDF Version [PDF - 197 KB] (Updated on February 9, 2018)
Originating in ancient China, acupuncture is a surgical operation (1–4) in which an acupuncture point (a specific muscle or connective tissue site) 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 (1). Acupuncture is based on anatomy, physiology, and pathology (1,5–12).
Dry needling is acupuncture in which an acupuncture point that has become exquisitely tender, 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 (1). An acupuncture point that has become exquisitely tender is identiﬁed by a flinch reaction on palpation (1).
Dry needling is not new. It was described in the first century BCE in the Yellow Emperor’s Inner Classic (黃帝內經 [Huáng Dì nèi jīng]), the foundational text of Chinese medicine (1).
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.
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 February 9, 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)) (13).
The U.S. Food and Drug Administration (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). Therefore, it is a violation of Federal law when unqualified practitioners of acupuncture, such as physical therapists, purchase, possess, or use an acupuncture needle (16).
Yellow Emperor’s inner classic (黃帝內經 [Huáng Dì nèi jīng]). China; compiled in the first century BCE.
The national encyclopaedia: a dictionary of universal knowledge. Library ed. London: 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: W. and R. Chambers; 1903.
Ban B, Ban G, Ban Z. Book of Han (漢書 [Hàn shū]). China; 111.
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.
Yang J. Drawings for preserving the truth (存真圖 [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. Robertson JD, translator, editor. On the nature of channels. Lantern. 2010;7(3):4–14.
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.