Action | Practice of dry needling |
Stage | NOIRA |
Comment Period | Ended on 12/30/2015 |
Safety:
Needling is in an invasive procedure that carries risk of harm to blood vessels, muscles, tendons, and internal organs.
For public safety, any courses in needling should also include contraindications for treatment, how to adjust treatment for people with different constitutions, safe and normal vs. adverse needle responses, and how to handle an emergency involving needles.
Education:
There is no accreditation process for Dry Needling courses. How do you ensure proper training? The proposed regulations say the burden of proof of adequate training is on the licensed physical therapist. That is inadequate. There are many different courses available today. Some adhere very closely to the original definition of Dry Needling. Some are using acupuncture points. These classes should not be available to anyone who does not complete a full acupuncture education.
Scope of Practice:
Any Dry Needling regulation should require very defined Scope of Practice for non acupuncturists. I am happy to see the proposed regulations do include a defined Scope of Practice. There are physical therapists advertising “Facial Rejuvenation” Dry Needling. This is beyond the scope of therapy of muscle pain, including pain related to myofascial pain syndrome.” The face is a sensitive area and patients tend to be more upset with facial bruising. Any facial needling should require more specialized training. Physical therapists are also advertising that they are treating sinusitis, an internal condition. Though sinuses can indeed be treated needling facial muscles, an acupuncturist would make a proper diagnosis to treat the underlying cause of the inflammation as well as give dietary and and lifestyle advice. A physical therapist treating onlyfacial muscles only would be circumventing proper medical treatment. A physical therapist was advertising treating headings by needling the hand. The picture clearly shows a distal acupuncture point known for treating pain. This is using acupuncture while circumventing proper education. Chinese Medicine has over 2000 years of theory, practice, and research to ensure proper use of points.
If the same points are used in Dry Needling, they should not be used by undetrained practitioners. Modern research is showing the underlying mechanisms of how needling these points reduce pain and some physical therapists are using the research to advertise dry needling as a superior technique to acupuncture. Dry Needling, when using a solid filoform needle, is an acupuncture technique.
I also like that the proposed regulations require written referral and direction for dry needling.
I second the comments by Matthew Bauer:
http://www.townhall.virginia.gov/L/viewcomments.cfm?commentid=48422
and Bianca Beldini:
http://www.townhall.virginia.gov/l/viewcomments.cfm?commentid=48721
Thank you,
Christie Savage