The Board of Registration of Allied Health Professionals, which oversees the practice of Physical Therapy in Massachusetts, is considering a motion to get dry needling for intramuscular therapy covered under the scope of practice for physical therapists. The motion comes up for review next Thursday July 26th.
The American Physical Therapy Association defines dry needling as “an invasive technique used by physical therapists (where allowed by state law) to treat myofascial pain that uses a dry needle without medication or injection, which is inserted (subcutaneously) into areas of the muscle known as trigger points. A trigger point describes a taut band of skeletal muscle located within a larger muscle group. Trigger points can be tender to the touch and can refer pain to distant parts of the body.”
The Massachusetts General Laws define Acupuncture as:
“Acupuncture”, the practice of medicine based on Traditional Oriental Medical Theories; primarily the insertion of metal needlesthrough the skin at certain points on the body”
I emphasized through because by needling through the skin, you are practicing subcutaneous needling, and therefore practicing acupuncture according to Massachusetts law.
The definition of dry needling is an attempt to redefine the practice of acupuncture to allow physical therapists to circumvent current state laws. The practice of subcutaneous needling is not part of the professional competencies of physical therapists. There is currently no standard of teaching, monitoring or ensuring competency in dry needling within the physical therapy field.
In contrast, Acupuncturists need to complete 2500 hours of education in acupuncture theory, methodology and supervised clinical training in a Master’s level program at an accredited Acupuncture school. In addition, acupuncturists have to pass National Level board exams to become licensed by the Massachusetts Board of Medicine Committee on Acupuncture.
Furthermore, within the definition of acupuncture in the Massachusetts General Laws is this provision regarding physical therapists:
“Nothing contained herein shall prevent physical therapists from practicing transcutaneous (emphasis added) nerve stimulation, the stimulation of muscle contractions for the purpose of diagnosis or rehabilitation, or other techniques in the context of standard Western Medical Procedure and neither defined as nor held out to be acupuncture . Nothing contained herein shall prevent licensed physicians from practicing acupuncture.”
So if this is issue is important to you, please fill out this online petition to help keep acupuncture practiced by Licensed Acupuncturists.
I want to be clear that I have nothing against the practice of Physical Therapy or Physical Therapists. Anytime I have a patient with a musculoskeletal injury, I encourage them to continue going to physical therapy and to continue doing the recommended exercises at home. After having my own shoulder surgery many years ago, I readily acknowledge how important physical therapy was to getting my shoulder functioning again.
I think Acupuncture and Physical Therapy are best used as complementary therapies to help patients get well.
Thank you for your support!