As a current doctoral candidate for physical therapy here in Virginia, I can attest to the high level of education that must be attained in order to graduate and then sit for the physical therapist licensure exam. PTs are highly trained and educated experts on the Human Movement System. In order to fully appreciate and specialize in the movement system, we must have a full understanding of how the skeletal, muscular, and neurological systems work together to produce movement. In order to optimize movement in all patients, we use modalities such as manual therapy, therapeutic exercise, and electrical stimulation, among many others, to provide the best possible treatment for each patient’s needs. Dry needling is another of these modalities.

The knowledge required to perform dry needling is the same knowledge used to palpate, locate, and perform release techniques to trigger points found in the patient’s myofascial tissue. Post-graduate training and certification in the dry needling technique provides us the skill of pin-pointing these trigger points with needles to provide a more targeted release of tissue that doesn’t respond to other modalities or manual release as efficiently.

The dry needling technique is very different from the needling provided in acupuncture as it is not based on placing needles at points of meridian crossings in order to improve the body’s energy flow. Needle placement in dry needling uses clinical reasoning with a goal of addressing hyper-irritable points in muscle and myofascial tissue in order to elicit a physiological response that will help to enhance and progress other treatments applicable to the patient’s impairments. These two practices can easily coexist with trained practitioners in each field – even if the end goal for the patient is the same, the two treatments can travel different paths to get there.

Please support the proposed regulations under 18VAC112-20-121 requiring a written referral, recognizing the additional training required in order to be a dry needling practitioner, and the requirement of obtaining informed consent prior to treatment.

Thanks and regards,

Julie Kraus, SPT

Murphy Deming College of Health Sciences, Mary Baldwin University, Fishersville, VA