Dry Needling Is The Next Big Thing In Physical Therapy

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2017-07-10T02:14:07+00:00 By |

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Here’s What You Need To Know…

1. The practice of Dry Needling has been around for decades and continues to improve Neuro-Musculo-Skeletal function. As these techniques, methods improve, so do the practitioners skill set, making this treatment strategy one of the most effective in the world of rehabilitation.

2. The advancements in dry needling has lead to a number of different models and methods including the myofascial trigger point model, the radiculopathy model and the spinal segmental sensitization model, all which are used to treat the presence of pain or dysfunction.

3. The primary goal of Dry Needling is to desensitize supersensitive structures, to restore motion and function and to possibly induce a healing response to the tissue. For seasoned practitioners, Dry Needling is extremely beneficial for quick and tangible results on top of other movement remediations.

4. Dry Needling is completely different from Acupuncture. Dry Needling is technique to treat the neuromusculoskeletal systems based on pain patterns, muscular dysfunction, and other orthopedic signs and symptoms which depends upon physical examination and assessment to guide the treatment. Acupuncture is a technique for balancing the Flow of Energy or Life Force, known as Qi or Chi, believed to flow through meridians, pathways, in your body.

5. If you are skeptical of Dry Needling, there is indeed a reason why world class athletes from around the globe are being treated for pain and dysfunction using this technique. And as the physical therapy and chiropractic scopes of practice continue to widely accept this practice, we will continue to see marked improvements in practice and possibly the emergence of Dry Needling as a gold standard soft tissue and neuromuscular technique.

The History and Foundation of Dry Needling

The history of Dry Needling (DN) dates back to the 1940’s with Dr. Janet Travell. She identified the muscular trigger points and referral patterns that were elicited with the “wet needling.” Later, she discovered that “Dry Needling” offered the same results. This was groundbreaking work and hence she created the name “Dry Needling.” She and Dr. David Simon carefully identified most of the trigger points located in the human body. Thus, the first generation of modern Dry Needling was established (1).

“Wet Needling” is when a substance (supplement or medication) is introduced to the body via a hypodermic needle. “Dry Needling” involves a physical assessment and is an intervention for neuromusculoskeletal conditions as developed and described by Janet Travell MD, David Simons MD, Dr. C. Chan Gunn and others. It uses small monofilament needles to reactive trigger points and “loosen” shortened muscles. This treatment likely affects the immune, inflammatory, biomechanics, vascular and neurological systems (2).

The APTA (American Physical Therapy Association) states Dry Needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments. Dry Needling is a technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue, and, diminish persistent peripheral nociceptive input, and reduce or restore impairments of body structure and function leading to improved activity and participation (3).

Dry Needling has had several names that Clinicians seem to utilize: TDN (Trigger Point Dry Needling), IMS (Intramuscular Stimulation), IMT (Intramuscular Manual Therapy), FDN (Functional Dry Needling) and several others.

In the United States, Physical Therapists, Chiropractors, Osteopaths, Medical Doctors, Naturopaths and Acupuncturists are utilizing Dry Needling.

Depending on the State you live in and your professional degree of choice, you may be able to practice Dry Needling and/or Acupuncture. Check out your State’s Scope of Practice for PT’s: Scope of Practice. Check out your State’s Scope of Practice for Chiro’s: Scope of Practice.

Popular Dry Needling Theories

dry needling MTP Model (Myofascial Trigger Point): Dry Needling is used primarily in the treatment of myosfascial trigger points (MTrPs) defined as “hyperirritable spots in skeletal muscle associated with hypersensitive palpable nodules in a taut band.” While Dr. Janet Travell is generally credited for bringing MTrPs to the attention of health care providers, MTrPs have been described and rediscovered for several centuries by various clinicians and researchers (4).

Radiculopathy Model: Dr. Chan Gunn developed his Radiculopathy model based off Cannon’s Law of Denervation Supersensitivity and coined the term “intramuscular stimulation.” This model is a developed system for the diagnosis and treatment of myofascial pain syndrome (2).

Spinal Segmental Sensitization Model: Dr. Andrew Fischer created a Model, which utilizes the works of Travell and Simons’ Trigger Point Model, and Gunn’s Radiculopathy Model. According to Fischer, the most effective methods for relief of musculoskeletal pain include pre injections blocks, needle and infiltration of tender spots and trigger points, somatic blocks, spray and stretch methods and relaxation exercises (5).

Benefits of Dry Needling

dry needling

Dry Needling is becoming a popular modality in medical practices, as musculoskeletal complaints are one of the most reported conditions to seek medical attention.

Musculoskeletal diseases affect more than one out of every two persons in the United States age 18 and over, and nearly three out of four age 65 and over. Trauma, back pain, and arthritis are the three most common musculoskeletal conditions reported, and for which health care visits to physicians’ offices, emergency departments, and hospitals occur each year. (6) This increase in occurrence of musculoskeletal pain is causing people to search for good manual therapists with a plethora of modalities, including Dry Needling, to fix their pain quickly.

According to Kinetacore, the primary goal of Dry Needling is to desensitize supersensitive structures, to restore motion and function and to possibly induce a healing response to the tissue. This goal of treatment will allow you to treat and help a broad spectrum of patients from Chronic Pain Syndrome to MS (Multiple Sclerosis) to Sprain/Strain Injuries (The list could go on).

A Dry Needling Therapist can “feel” with the needle and utilize it as a diagnostic instrument. Dry Needling is often extremely helpful as tight muscles, contractures and trigger points are invisible to X-rays, MRI, CT’s. Contractures deep in the muscles can be felt with the needle via feedback on the quality of the tissues that it is penetrating. I utilize Dry Needling as a diagnostic and therapeutic tool similar to the Graston Technique. From a manual therapist standpoint, it is amazing what you can “feel” in the tissue when you have a needle extending through the deep layers of muscle and fascia. When I penetrate through chronic and fibrotic tissue, it feels very “gooey” to me. It feels very similar to some old school Silly Putty. I can tell that this is an area of muscle amnesia that needs to be woken up, stimulated and re-educated.

Difference Between Dry Needling and Acupuncture

dry needling

Dry Needling is technique to treat the neuromusculoskeletal systems based on pain patterns, muscular dysfunction, and other orthopedic signs and symptoms. Dry Needling depends upon physical examination and assessment to guide the treatment; moreover, this allows you to test and re-test after a Dry Needling treatment has been performed. It gives you the opportunity to show tangible changes pre and post treatment. This allows for good objective information to show the patient or client their improvements in a quick fashion.

Traditional Chinese Medicine explains Acupuncture as a technique for balancing the Flow of Energy or Life Force, known as Qi or Chi, believed to flow through meridians, pathways, in your body. By inserting needles into specific points along these meridians, Acupuncture Practitioners believe that your Energy Flow will re-balance (7). Based off my knowledge of Acupuncture, this is a very brief explanation of what Acupuncture really is.

A monofilament needle is the only thing that is related in TCM Acupuncture and Dry Needling. There are similarities but very significant differences between TCM style of Acupuncture and Dry Needling. Acupuncture follows rules and beliefs, which have been established since early times. Whereas Dry Needling does not follow the Acupuncture philosophy. Most if not all of the TCM is based on pre-scientific ideas whereas, Dry Needling is totally based on modern scientific, neurophysiology and anatomy. Dry Needling provides pain relief and is based on recent understanding of pain science, there is much less mystique surrounding Dry Needling concern pain abatement by the scientific community. TCM Acupuncture can rest a vast range of tomato viscera illnesses as well as being effective in pain relief (8).

Athletes Want More Than Pain Relief

dry needling

We know that Dry Needling acts locally, segmentally and systemically on the body. For Example, when a Needle is introduced to the human body, local reactions occur at the point of penetration. The body reacts in such a way that it releases cytokines, substance P and CGRP (Calcitonin Gene Related Peptide). Where the needle penetrates the skin, the body releases CGRP, which causes a cascade of reactions resulting in vasodilation, increased blood vessel formation, and increased tissue repair. In addition, the body will react in such a way that segmentally, at the spinal level, an Enkephalin release will occur resulting in a local pain response. Moreover, a Beta Endorphin release from the brain creating an analgesic affect will result in an overall systemic response. Performance and Injury Prevention is all about Recovery!

One of Many Clinical Success Stories

I had an athlete who came in with complaints of lateral knee pain with Multi-Segmental Flexion and Squatting. He was unable to touch his toes with Multi-Segmental Flexion and unable to break parallel in his Squat Pattern when I assessed him with the Selective Functional Movement Assessment (SFMA). Based off the Patient’s SFMA, biomechanical evaluation, signs, symptoms and palpable trigger points, I decided to Dry Needle his Glutes, Quads and Calf, specifically gluteus medius, gluteus minimus, vastus lateralis, rectus femoris and gastrocnemius.

Videos of Functional Dry Needling

In this video, you will see a “twitch response” in the quad muscle. The “twitch response” is an involuntary contraction caused by pistoning, moving the needle up and down, in to his quad trigger points.

In this video, you will see a “twitch response” in the calf muscle. The “twitch response” in this video is elicited via a Pointer Plus Excell II (0-16Hz). This has a similar response to the pistoning “twitch response”.

The Local Twitch Response (LTR) is an involuntary spinal reflex contraction of muscle fibers within a taut band during needling. Research shows that biochemical changes occur after a LTR, which correlate with a clinically observed decrease in pain and tenderness after MTP release by Dry Needling (9).

Videos of Pre-Post Changes after a Dry Needling Treatment

Here are some pre-treatment videos taken from a multi-segmentation flexion pattern of a patient. There is both a front and side view to check out the toe touch depth along with the curvature of the spine in addition to the pelvic tilt.

Pre-Treatment Front View

Pre-Treatment Side View

And after only a Dry Needling treatment session, this is the post-treatment multi-segmental flexion pattern from both the side and the front.

Post-Treatment Front View

Post-Treatment Side View

Now by no means in the video is his MSF perfect; however, I do want you to notice the increase in his posterior weight shift, spinal flexion and his increase in confidence while moving through this movement pattern. In addition, he had a pain free Squat and Multi-Segmental Flexion movement pattern.

Innovative Thoughts and Technique

dry needling

My formal training in Dry Needling is through Kinetacore. In addition, I’m a Fellow of the International Academy of Medical Acupuncture. My particular gravitation to this modality, Dry Needling, is the incredible impact that it has neurophysiologically, biomechanically and systemically on the body. It expedites the healing process and repair of tissue while decreasing pain and increasing range of motion; this response allows athletes and clients to return back to their sport or activity much quicker. Dry Needling would be my “Reset” in Gray Cook’s theory of Rest, Reinforce, Reload.

One concern that I have seen with Dry Needling, and I will allude to Sue Falsone’s interview a while back on SportsRehabExpert, is the incredible amount of increased range of motion that Dry Needling can introduce to a particular joint or movement pattern. This particular response will alter biomechanics and proprioception which may increase your chance of injury if this range of motion is foreign to the brain or tissue; therefore, you want to make sure that you are following up a Dry Needling session with some sort of rehabilitation exercise, corrective exercise or training session that will improve the dysfunction of a particular movement pattern.

As Clinicians, we need to respect that both modalities, Dry Needling and Acupuncture, are providing results for patients all over. At the end of the day, my goal is to help my clients or patients and improve their quality of life with this modality. I’m still learning and appreciate all the knowledge that I have acquired thus far from my Acupuncture and Dry Needling education. I plan on furthering my knowledge and Dry Needling Education with Kinetacore, Janet Travell’s Myopain Seminars and Dr. Ma’s Systemic Dry Needling. My advice…. Never stop learning and continue to explore new modalities to help your patients, clients and athletes.

About The Author

james spencer 

Dr. James Spencer – I am a Sports Performance Chiropractor, a Certified Athletic Trainer, and a Fellow of the International Academy of Medical Acupuncture. I am originally from Sarasota, Florida but work in South Florida. Each individual encounter or training session allows me to positively impact my client, and for that, I am excited to be able to share my passion with others. My physical background includes kettlebells, indian clubs, steel clubs, maces, juggling, skateboarding, surfing, wakeskating, paddleboarding, slacklining, climbing trees and enjoying life in South Florida. I have written multiple guest blogs for John Rusin Fitness Systems. My formal training is in: Active Release Techniques (ART) Graston Technique, Kinetacore Functional Dry Needling, SpiderTech Kinesiology Tape, RockTape Fascial Movement Taping (FMT), Postural Restoration Institute (PRI), Y-Balance Test (YBT), Functional Movement Screen (FMS), Selective Functional Movement Assessment (SFMA), Mike Boyle’s Certified Functional Strength Coach (CFSC)and the Onnit Academy of Unconventional Training.

Follow Dr. Spencer on Instragram

Additional Dry Needling Resources

Patient Education

Dry Needling for Chronic Ankle Instability

Dry Needling for Acute Neck Pain

Dry Needling for Chronic Low Back Pain

Dry Needling Success Story Podcast

References

1. http://integrativedryneedling.com/resources/history-integrative-dry-needling/

2. Zylstra E., Kinetacore Functional Dry Needling: Level 1, Applications for Management of Movement Impairments, Pain and Sports Injuries. Pg 9&12.

3. http://www.aaompt.org/documentspdf

4. http://www.restoresportsmassage.co.uk/trigger%20points%20research%20review.pdf

5. Dommerholt, J. Dry Needling in Orthopedic Physical Therapy Practice. In, Orthopedic Practice, 2004;Vol.16 (3) 15-20.

6. http://www.boneandjointburden.org

7. http://www.mayoclinic.org/tests-procedures/acupuncture/basics/definition/prc-20020778

8. http://www.iama.edu/Articles/DryNeedling.htm

9. Shah JP, Gilliams EA. Uncovering the Biochemical Milieu of Myofascial Trigger points using In Vivo Microdialysis: an Application of Muscle Pain Concepts to Myofascial Pain Syndrome. J Bodyw Mov Ther. Oct 2008;12(4):371-384

34 Comments

  1. jim March 31, 2016 at 8:03 am - Reply

    Seems like that might have been the case/article 10yrs ago, cute placebo though. You could just have somebody slap you and get the same nervous system response.

    • Sam March 31, 2016 at 9:46 am - Reply

      Jim have you read the research on it?
      I’m currently doing a paper on it for my DPT schooling and the majority of publication on it in RCT show there is more than placebo effect when it utilizes the twitch response.
      It shouldn’t be utilized as a first choice in most cases, but it can be more beneficial than a placebo, or a slap in the face

  2. jim March 31, 2016 at 11:49 am - Reply

    LOL true but it is hardly new or the next big thing. Ill say it is likely a unique benefit to 5%. Of course if your a college or pro athlete and you have access to free or on tap care why not. I just hate the general public wanting 50 needles in them because ESPN did a story on DN.

  3. AcuDoc March 31, 2016 at 6:26 pm - Reply

    Please don’t presume to define what acupuncture and Chinese medicine are or are not. Your explanations are inaccurate, appear quite biased, and are based on the most superficial (and seemingly dismissive) understandings of a very deep and substantial practice that includes many muscular and fascial techniques validated by both a substantial body of research and thousands of years of refinement. It’s inappropriate and entirely presumptuous for you to seek to define acupuncture based on your misunderstanding of the practice of another profession.

  4. […] Dry Needling is the Next Big Thing in Physical Therapy – Dr. James Spencer offers a tremendously thorough review of what dry needling is, and how it works. James has been a great resource for many athletes at Cressey Sports Performance – Florida. […]

  5. Natalie April 1, 2016 at 7:28 pm - Reply

    Completely agree that “It’s inappropriate and entirely presumptuous for you to seek to define acupuncture based on your misunderstanding of the practice of another profession.” It’s beyond presumptuous – more like brazen ignorance. Particularly considering that based on licensing laws, licensed acupuncturists have much more extensive training (including, yes, on musculoskeletal approaches, considering that’s a primary use of acupuncture) than the author’s intended weekend seminars or whatever. I suppose next the author is going to inform us that acupuncturists are still living in caves and swinging from trees.

    Fascinating mix of comments.

  6. Megan April 1, 2016 at 7:54 pm - Reply

    If dry needling is the next best thing for physical therapists, which has essentially been stolen and bastardized from acupuncturists and Chinese medicine, then that is sad to me. Your weekend course does not qualify you to stick needles in anyone, from all of the “weekend Needlers” I have met, the lack of understanding of how the needles effect the nervous system is alarming. Recognize when you are not the expert and walk away.

    • Dr. James Spencer September 8, 2016 at 9:12 pm - Reply

      Megan,
      Based on my 10+ Years of Sports Medicine Education and well over 5000 hours of Clinical Sports Medicine Education, including my dual educational training in Acupuncture and Dry Needling, allow me to Speak on this Topic. In regards to the NeuroPhysiology, It’s unfortunate you didn’t read the entire article as it states “We know that Dry Needling acts locally, segmentally and systemically on the body. For Example, when a Needle is introduced to the human body, local reactions occur at the point of penetration. The body reacts in such a way that it releases cytokines, substance P and CGRP (Calcitonin Gene Related Peptide). Where the needle penetrates the skin, the body releases CGRP, which causes a cascade of reactions resulting in vasodilation, increased blood vessel formation, and increased tissue repair. In addition, the body will react in such a way that segmentally, at the spinal level, an Enkephalin release will occur resulting in a local pain response. Moreover, a Beta Endorphin release from the brain creating an analgesic affect will result in an overall systemic response. Performance and Injury Prevention is all about Recovery!”

  7. Troy April 1, 2016 at 8:49 pm - Reply

    “Weekend needlers” … Like The people taking these courses just walked out of their jobs at Walmart and decided to take the course instead of having doctorate level degrees.

  8. Jason April 2, 2016 at 8:00 am - Reply

    It’s called acupuncture. It’s been around for 2,000 + years. I would not trust someone to stick needles in my body who has such a poor grasp of history, concepts, and reality as somone praticing “dry needling”.

  9. Elliott April 3, 2016 at 10:25 am - Reply

    Dry needling and acupuncture are 2 very different things. How about both groups check themselves. I’m with Jim if you feel off Just SLAP yourself in the face. It clears the meridians, gives a twitch response, revitalizes, and done in repetition provides a upper extremity conditioning effect. So everybody here just give it a shot right now ! now don’t you feel better for being two distinct groups of ass holes.

  10. Natalie April 11, 2016 at 10:28 pm - Reply

    Appreciate the dose of levity from Elliot, however painting this as two groups bickering misses the point. An analogy would be saying that physical therapists either practice soft tissue work or exercises. Or a chiros just crack backs or sell supplements or health advice or whatever. Certainly it’s possible to meet people who seem to fall into one camp or the other. However the best practitioners have broader skills and knowledge, regardless of their professional stripes. The weird thing about this article is that the author superficially shows historical and interdisciplinary knowledge, but then when it comes to acupuncture he turns to be biased, ill-informed and rather backwards. Whether he’s interested in turf wars and grinding his ax or just ignorant is unclear, but it’s odd.

  11. John April 13, 2016 at 9:56 am - Reply

    “My particular gravitation to this modality, Dry Needling, is the incredible impact that it has neurophysiologically, biomechanically and systemically on the body. It expedites the healing process and repair of tissue while decreasing pain and increasing range of motion; this response allows athletes and clients to return back to their sport or activity much quicker.”
    I think you will find that traditional acupuncture does exactly the same thing and that numerous athletes advocate the benefits of traditional acupuncture.
    Your article is misleading and ill-informed.

  12. Katarina April 13, 2016 at 10:05 am - Reply

    Dry Needeling is a form of acupuncture. To try to undermine Acupuncture the way you describe it is actually illigal .and it is called slander. You cannot legally discredit another profession. Be careful with this. If you want to be an expert on what acupuncture is , go to acupuncture school.

    • Dr. James Spencer September 8, 2016 at 10:24 pm - Reply

      Katarina,
      My goal of this Article is clearly stated in this Quote, “As Clinicians, we need to respect that both modalities, Dry Needling and Acupuncture, are providing results for patients all over. At the end of the day, my goal is to help my clients or patients and improve their quality of life with this modality. I’m still learning and appreciate all the knowledge that I have acquired thus far from my Acupuncture and Dry Needling education. I plan on furthering my knowledge and Dry Needling Education with Kinetacore, Janet Travell’s Myopain Seminars and Dr. Ma’s Systemic Dry Needling. My advice…. Never stop learning and continue to explore new modalities to help your patients, clients and athletes.” This clearly does not coincide with Slander, nor is that my intention of this Article.

  13. Erin Smith, L.Ac. April 13, 2016 at 10:10 am - Reply

    Dry needling is acupuncture. Period. Stop portraying otherwise to patients and the medical profession. It’s dangerous to perform acupuncture after so little study, and luckily the legal system is getting involved nationally for this issue. So find an acupuncturist to work together with to help your patients, or go to acupuncture school. And yes, acupuncture is very effective for pain management, it has been used for thousands of years (not decades).

    • Dr. James Spencer September 8, 2016 at 10:00 pm - Reply

      Erin,
      I would agree that Dry Needling falls under the umbrella of Acupuncture; however, I believe there is a difference between the 2 modalities… the difference comes down to intent. In my practice, I use Dry Needling for a Movement and Functional Approach (pain, ROM, dysfunction, recovery, etc). That’s my intent…. Not for any Meridian System Stimulation, Energy/Chi Influence or TCM Tradition (or any other connotation of Acupuncture you may have). I’m formally trained as a Fellow of the International Academy of Medical Acupuncture, yet I refer patients to a LAc down the street from me because I respect the modality too much. I hope this sheds some light on the situation.

    • daniel March 4, 2017 at 4:54 pm - Reply

      It’s not acupuncture and why would he go to school for that? Do you know how much BS they learn? Most of it’s useless. PT’s should be the ones using these needles. They practice under western medicine and have the anatomical training to know where to apply needles.

  14. Steven Hoffman April 13, 2016 at 11:33 am - Reply

    https://www.youtube.com/watch?v=ygtOBE_qkZ0
    Nice link that explains the difference between acupuncture and dry needling

  15. Steven Hoffman April 13, 2016 at 11:37 am - Reply

    A great article for anyone interested in the truth and not a turf war
    https://www.liveoakacupuncture.com/dry-needling/

  16. Jonathan Schell L.Ac. April 13, 2016 at 11:38 am - Reply

    It seems the issue here is mainly about scope of practice. Does a chiropractor or physical therapist have enough training to practice acupuncture or dry needling as this page calls it. Does an acupuncturist or physical therapist have enough training to practice bone setting? Does a chiropractor, physical therapist, or acupuncturist have enough training to practice surgery? We can all acknowledge that there are disciplines that we go to when we need certain therapies – we go to specialists in these disciplines because they are experts in their field, for example – I would never have an acupuncturist prescribe western drugs to me and formulate which drug and how much of it – that would be crazy. On the other hand so would expecting a nurse practitioner to be able to formulate a decoction of Chinese or Western herbs as part of their professional practice. So I think it is agreed that we go to the experts for what they are expert at.

    It is an odd thing then when one discipline decides to borrow from another discipline. If I took weekend courses (even if over a period of years) to learn surgery would you trust me to be your surgeon? I wouldn’t trust this. What I know about medicine – which ever form that we practice, is that it is extremely complicated. There is nothing that we do in medicine that is easy and works 100% of the time, there are too many variables, and each patient is quite different – this is where being an expert in your field helps you discern how and when to use a particular type of therapy. Needles are not the answer to everything, by the way.

    In Oregon, where I live, it is against the law for Physical Therapists to practice Dry Needling, because our medical system recognizes that inserting filiform needles into the body has already been defined as acupuncture, and does not need another name. A person who wants to practice acupuncture, must go through acupuncture school. In the same way if I wanted to adjust bones professionally, I would have to go through Chiropractic school. I expect that as time goes on, more states will see that the definition of acupuncture precedes the definition of dry needling, and that state by state the scope of both professions will become more defined.

    The patients that you are able to heal with your method are the success stories. But what of the patients that are hurt by your method, what happens to them? Where do you send people whom have changes that you do not expect? If a person starts to waste away, or have heart problems, or has extreme tiredness – do you refer them out to an M.D. to treat a different disease, when in fact these are some possible signs of mistreatment by needles. Or do you refer them to someone with more experience using filiform needles than you have? The easy path is to believe that no adverse effect and only good can come from doing a therapy, but we know from all other forms of medicine that there are risks, and the use of any technique is always a weighing of the potential risks and rewards. Good luck in your practice!

  17. Ashley April 15, 2016 at 11:33 pm - Reply

    Does insurance cover acupuncture if performed by a physical therapist who is not licensed in the state? I’m pretty sure it’s illegal to practice acupuncture without a license.

    • Dr. James Spencer September 8, 2016 at 9:35 pm - Reply

      Ashley,
      I don’t believe an Insurance Company would cover it but look in to that state’s scope of practice and reciprocity rules.

    • daniel March 4, 2017 at 4:58 pm - Reply

      It’s not billed as acupuncture when a PT does it R-tard.

  18. https://www.apta.org/uploadedFiles/APTAorg/Advocacy/State/Issues/Dry_Needling/AnalysisCompetenciesforDryNeedlingbyPT.pdf
    For those questioning the educational background PTs have regarding sticking needles and for those who claim PTs are “weekend warrior needlers”. 86% of the education needed to needle someone is learned in entry level PT school. For those ACU’s who create fear mongering to patients because you are upset with someone “encroaching” on your skill set, get over it. ACU and DN is different. It is not going anywhere. ACU definitely has its place, just as DN does. Clients should have all options available. ACU is good stuff when it works, just like DN. PT education is not inferior to ACU. 2 completely different schools of thought. Why not find a PT who needles and hook up a referral pathway instead of fighting each other?

    • Dr. James Spencer September 8, 2016 at 10:27 pm - Reply

      Cross Referral is the Key. I work with a LAc down the street from me. It’s Great!

  19. Jamie May 20, 2016 at 12:18 pm - Reply

    Is this article by James Spencer or John Rusin? Confusing on whom to give credit to.

    • Dr. James Spencer September 8, 2016 at 9:30 pm - Reply

      James Spencer

      • Janie Turner September 17, 2017 at 10:27 pm - Reply

        I am searching for a PT or someone who is trained in dry needling. I am a firm believer in its worth! I have just moved from CO (where I was introduced to dry needling by my PT that I first sought as a myofasical release specialist). I am DESPERATE to find someone near me ( I live in Vero Beach, FL) who has the ability to dry needle. I have Fibromyalgia and Interstitial Cystitis and Dry Needling has brought me more relief than anything I have ever found. My email is [email protected]. Please let me know if you are near me or if you know of another practitioner who is close to me. I will drive as far as I can to obtain what I need. Thank you!

  20. seksrijpevrouwen July 7, 2016 at 1:00 pm - Reply

    I found ur blog is very handy to me. When you keep going the perfect work I’ll come back at ur site.

  21. John Quintner September 10, 2016 at 5:01 pm - Reply

    This is a nice example of a pseudo-scientific argument: “Dry Needling is technique to treat the neuromusculoskeletal systems based on pain patterns, muscular dysfunction, and other orthopedic signs and symptoms which depends upon physical examination and assessment to guide the treatment.” I suspect the author has yet to read this devastating expose of the “myofascial pain/trigger point” construct: http://www.fmperplex.com/…/travell-simons-and-cargo…/

  22. Peter March 28, 2017 at 7:00 pm - Reply

    I have to really thank Dr. John for all the amazing info and work he does. He definitely provides great stuff. BUT….

    The picture you use in your own article (knee treatment w/ stim) uses exclusively old school TCM acupuncture points. The other knee below uses too many needles, because the practitioner doesn’t know what the heck he is doing . And the lower back (“innovative ideas”) is seriously a war crime and the PT should be prosecuted in the Hague for that mess

    Dry Needling and acupuncture are the same thing….period. Let’s hear about the differences of dry needling and acupuncture from a Acupuncturists (L.Ac) point of view. Before you make the distinction between the two, shouldn’t you be educated in both?

    There are countless styles of acupuncture. Distal and proximal needling are two. Dry Needling is a proximal needling style that has existed in Chinese medicine for hundreds of years and now has become a term developed for PTs to appropriate and go outside of their scope of practice. I think many PTs get confused when they see distal styles of acupuncture and think that’s all there is to it. Without the education or understanding of the orthopedic history in Chinese medicine. So, no Travell didn’t invent or discover trigger points.

    PT’s doing this type of work is a scam at best and dangerous at worst. If you want to needle folks, get the proper training. Acupuncture school is about four years…go for it and then tell me how it’s different.

    And the issue is not only training…do you want someone sticking a needle into you, if it’s a side certification to their real PT work? I needle patients at least 40 hours a week minimum. The experience gained from this is huge and PTs just don’t have this, because they are busy, you know…being PTs.

    “Lax regulation and nonexistent standards surround this invasive practice. (Dry Needling). For patients’ safety, practitioners should meet standards required for licensed acupuncturists and physicians,” AMA

    It is illegal under the Federal Food, Drug, and Cosmetic Act (FDCA) and FDA regulations for unqualified practitioners of acupuncture, such as physical therapists, to purchase or possess acupuncture needles.

    Acupuncture needles are Class II (special controls) medical devices regulated under 21 CFR § 880.5580.

    Also, there are no billing codes for dry needling in PT. Many states are outlawing PTs performing acupuncture and more to follow.

    Acupuncture is Dry Needling.
    Gua Sha is Graston.
    Cupping is myofascial decompression.
    Seriously, what is next? PTs doing surgery and giving hair cuts? The cultural and professional appropriation is staggering. PTs may think they are improving Chinese medicine, but they generally don’t even know anything about Chinese medicine.

    .

  23. Kelly June 5, 2017 at 8:36 pm - Reply

    Shut up. I live in NYS and I have called several acupuncturist and they said no. We do NOT do dry needling but we get the same results. I had acupuncture done for 8 weeks. Never once put into a trigger point. It did nothing. I bought my own acupuncture needles from China and got better results. I am a patient. And acupuncture is not dry needling. Mind your own business or find another career.

  24. Kevin June 19, 2017 at 11:06 am - Reply

    Through which company would you recommend getting certified in Dry Needling?

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