Dry Needling - Controversy

Controversy

Many physical therapists and chiropractors have asserted that they are not practising acupuncture when dry needling. They assert that much of the basic physiological and biomechanical knowledge that dry needling utilizes is taught as part of their core physical therapy and chiropractic education and that the specific dry needling skills are supplemental to that knowledge and not exclusive to acupuncture. However, the originators and proponents of dry needling acknowledged the origin and inspiration of this techniqe to be acupuncture. Many acupuncturists have argued that dry needling appears to be an acupuncture technique requiring minimal training that has been re-branded under a new name ("dry needling"). Whether dry needling is considered to be acupuncture depends on the definition of acupuncture, and it is argued that trigger points do not correspond to acupuncture points or meridians. They correspond by definition to the ad hoc category of 'a-shi' acupoints. It is important to note that this category of points is not necessarily distinct from other formal categories of acupoints. In 1983, Janet Travell et al. described trigger point locations as 92% in correspondence with known acupuncture points. In 2006, Peter T. Dorsher, acupuncturist at the Mayo Clinic, concludes that the two point systems are in over 90% agreement. In 2009, Dorsher and Fleckenstein conclude that the strong (up to 91%) consistency of the distributions of trigger point regions’ referred pain patterns to acupuncture meridians provides evidence that trigger points most likely represent the same physiological phenomenon as acupuncture points in the treatment of pain disorders. An article in Acupuncture Today (May 2011, p. 3, “Scope and Standards for Acupuncture: Dry Needling?”) further corroborates the 92% correspondence of trigger points to acupuncture points. The North Carolina Acupuncture Licensing Board has published a position statement asserting that dry needling is acupuncture and thus is covered by the North Carolina Acupuncture Licensing law, and is not within the present scope of practice of Physical Therapists, and Physical Therapists are not among the professions exempt from the law.

In May 2011 the Oregon Board of Chiropractic Examiners ruled to allow "dry needling" into the chiropractic scope of practice with 24 hours of training. In July 2011 the Court of Appeals of the State of Oregon issued an injunction, preventing chiropractors from practicing dry needling until the case is heard in court. The document issued by the court states that "dry needling" is "substantially the same" as acupuncture and that the "respondent has not explained how 24 hours of training, with no clinical component, provides sufficient training to chiropractors to adequately protect patients." In September 2011, the Oregon Board of Chiropractic Examiners And Oregon Attorney General appealed said order on the grounds that they feel the commissioner who issued the order was mistaken in his assertion. On November 10, 2011, The Court of Appeals of the State of Oregon issued an Order Denying the Motion for Reconsideration. The document states, "The stay was proper based on a showing by petitioner of irreparable harm and the likelihood of prevailing on merits. The motions are denied." The effect of said ruling is that the entire Appeals Court will now determine if the stay was appropriate. The stay is relevant only in the State of Oregon.