Agencies | Governor
Virginia Regulatory Town Hall
Agency
Department of Health Professions
 
Board
Board of Physical Therapy
 
chapter
Regulations Governing the Practice of Physical Therapy [18 VAC 112 ‑ 20]
Action Practice of dry needling
Stage Proposed
Comment Period Ends 7/26/2019
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7/22/19  7:43 pm
Commenter: Nicholas Zimet

The American Medical Association Opposes Dry Needling by PTs and so should you!
 

"Dry needling" is an attempt to re-brand an existing skill set and in doing so bypass all meaningful regulation and training requirements established by state and national norms. The american medical association states in its position that Physical therapists are not qualified to provide invasive procedures like it and adds "Lax regulation and nonexistent standards surround this invasive practice. For patients' safety, practitioners should meet standards required for licensed acupuncturists and physicians."  I have included information below to summarize my professional stance with data rather than simple opinion.

Dry Needling is an Invasive Procedure H-410.949

Topic: Practice Parameters Policy Subtopic: NA
Meeting Type: Annual Year Last Modified: 2016
Action: NA Type: Health Policies
Council & Committees: NA

Our AMA recognizes dry needling as an invasive procedure and maintains that dry needling should only be performed by practitioners with standard training and familiarity with routine use of needles in their practice, such as licensed medical physicians and licensed acupuncturists.

 

FURTHER INFORMATION TO SUBSTANTIATE MY FEELINGS:

HISTORY

“Dry Needling” was originally done ONLY by physicians using a hypodermic needle to stimulate a Myofascial Trigger Pointwithout injecting a solution, like saline or lidocaine. Travell, Simons, & Simons, 1999, pp. 154–155

•Janet Travell was the first to use the term "dry needling" to differentiate between two hypodermic needle techniques when performing trigger point therapy. However, Travell did not elaborate on the techniques of dry needling; the current techniques of dry needling were based on the traditional and western medical acupuncture.   Travell, Simons, & Simons, 1999, p. 156

•Myopain Seminars and other Dry Needling training companies have instructed students to use Seirin filiform needles, and to purchase them from Lhasa OMS.

DEFINED

“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. 

-American Physical Therapy Association

 

 

http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/

https://www.researchgate.net/publication/232397899_Trigger_Points_and_Classical_Acupuncture_Points

 

“Up to 93% of classical acupuncture points anatomically correspond with common myofascial trigger points, likely describing the same physiologic phenomena.”

 

DEFINED

A medical intervention performed by highly skilled,  licensed acupuncturists or medical physicians that uses a thin filiform needle to penetrate the skin and stimulate neural, muscular and connective tissues for the prevention and management of pain and movement impairments.

        ALSO KNOWN AS ACUPUNCTURE.

 

 

TRAINING & CREDENTIALING

EVIDENCE BASED MEDICINE  

Scientific Literature

PUBMED

ACUPUNCTURE: 28,066

DRY NEEDLING: 370

DRY NEEDLING AND ACUPUNCTURE: 182

Using Biomedical Language

Strengthens the argument that acupuncture is dry needling

Enhance credibility and understanding within the medical community

 

 

DRY NEEDLING EXPERTS

THE POINTS

Myofascial Trigger Points (Ashi Points)

 A sensitive area in the muscle/connective tissue that becomes painful when palpated

Motor Points

The most electrically excitable area containing the greatest concentration of nerve endings in the muscle

Eliciting a twitch releases lactic acid and calcium build up

TRAINING

FALL 2018 | MN

Lecture, Demonstration & Clinical Practice

Motor Point Location, Needle Techniques, EBM, Pt Education

 

 

PUBLIC SAFETY

 

The National Institute of Health warns that use of FILIFORM needles in treatment “can cause serious adverse effects, including

infections, punctured organs, collapsed lungs, and injury to the central nervous system.”

•Report all known DN adverse events

•Confirmed cases in MN of PTAs assisting PTs in treatments by removing needles

 

INSURANCE FRAUD

Insurance Companies DO NOT Recognize “Dry Needling” as a Billable Charge.

Educate and Instruct Patients on How to Report Possible Insurance Fraud

§If patients are NOT paying for “dry needling” at the time of service, it is likely that the provider is improperly billing the insurance company



CommentID: 73818