Acupuncturists, physical therapists battling over so-called 'dry needling' technique
SEATTLE - A turf war is being waged over needles in our state. It's acupuncturists versus physical therapists.
They're battling to use a technique called "dry needling." This debate boils down to one thing: training.
The acupuncturists say they're the only ones qualified to do the technique given their hundreds of hours of training.
Licensed physical therapists insist the technique can be learned in just 54 hours.
"How you doing? any of these feel uncomfortable? no pokies?" asked Washington licensed acupuncturist John Moore inside his home acupuncture studio in Richmond.
He's working on a client with reoccurring shoulder pain.
Moore insists physical therapists are poking around where they don't belong.
"The concern is with safety, this is a public safety issue," insisted Moore.
We watched as a physical therapist dry needled trigger points in a teen dancer's tight muscles.
She gets treatments at least once a week as a way to relieve pain and increase her range of motion. She insisted it's the only treatment that allows her to keep dancing.
"This technique is very safe," said Emilie Jones, a licensed physical therapist.
Acupuncturists use a needle to reach what's called an Ashi point or 'oh yes' point.
Moore, who also serves as the Executive Director for the National Center for Acupuncture Safety and Integrity sees no difference.
"They use the same tool, an acupuncture needle, targeting same tissues which are tight bands, muscle tension called trigger points for the same therapeutic purposes, there's no difference," insisted Moore.
To see dry needling, we had to go to British Columbia where it is widely practiced.
"I would say a tool does not make a profession and acupuncture is a profession and dry needling is a specific tool," countered Jones.
Physical Therapist Emilie Jones serves as the Legislative Committee Chair for the Physical Therapy Association of Washington.
She stressed dry needling has no connection to traditional Chinese medicine or altering the body's energy flow.
Jones says P-T and dry needling focus solely on musculoskeletal impairment while acupuncture treats everything from depression to digestion.
"The most common injuries are bruising and bleeding," said Jones.
But there have been serious dry needling injuries.
Out of 3,666 liability claims filed against physical therapists between 2009 and 2014, 20 were for dry needling.
The claims get filed with CNA, the largest liability insurance carrier for physical therapists.
The most common injury that the insurer found, worries Moore.
"You run the risk of puncturing the lung if you go too deeply, here," said Moore as he points to an area on his patient's back.
"Those cases do exists and those stories are scary but the evidence shows that physical therapists performing this technique is very safe," said Jones.
The company that manages CNA told KOMO based on the thousands of malpractice cases it manages each year, dry needling claims are 'incidental' and haven't impacted insurance rates or increased risk.
Jones also cited a 2013 Journal of Manual and Manipulative Therapy Study putting the risk of adverse effects at less than 1 percent.
Acupuncturists argued they have an ally in the A-M-A and pointed to the American Medical Associations new policy that calls for more training. It reads: "Physical therapists and other non-physicians practicing dry needling should - at a minimum - have standards that are similar to the ones for training, certification and continuing education that exists for acupuncture."
If physical therapists in our state get their way, after one year in the profession, it will take 54 hours of training to add 'dry needling' to their scope of practice.
"We are talking about physical therapists who have a doctoral level education of anatomy, physiology, neurology, neurosciences, all these background sciences that provide baseline education for dry needling," said Jones.
Bridge Boylan brings a unique perspective to this turf war. She's both a licensed acupuncturist...and a licensed physical therapist.
We caught up with her in Everett where she shares office space with a Chiropractor.
"It's not safe and they could be harming people." said Boylan who insisted the dry needling debate makes her 'sad' for her acupuncture profession.
She has spent the last 26 years working as a physical therapist and became a licensed acupuncturist 11 years ago.
"I can't imagine being able to needle someone with just 54 hours of training," said boylan.
But try telling that to Bellingham's Jacqui Berg.
"I've had lots of aches and pains from crashes."
The retired snowboarding pro has plenty of broken bones too. berg swears by dry needling for her re-occurring pain from shoulder surgery and a nagging hip injury.
"The first time I had dry needling it was like 'ahhh' I found what I was looking for, for so many years," said Berg.
She said the relief was so life changing, when she retired from snowboarding, she decided to pursue a career in physical therapy. She's now a licensed physical therapist working in Bellingham, hoping to dry needle clients one day in our state.
More than half the states in the U.S. permit physical therapists to dry needle. The Integrative Dry Needling Institute's website lists them.
9 states, including California prohibit it, others like Washington are grappling with which way to move the needle.
State lawmakers were asked to consider adding dry needling to a physical therapist's scope of practice earlier this year. The measure failed during the last session.
A lawmaker turned to the Department of Health and requested a Sunrise Review. The review specifically asked the Health Department for a recommendation regarding expanding the scope of practice for physical therapists to include dry needling.
The state has been reviewing the training proposal for the last few months, and just this week reached a Draft Recommendation.
The Health Department said based on the information, and comments submitted it could not recommended expanding the scope of practice for physical therapists with 54-hours of dry needling training.
A final recommendation will come in December, after hearing from you.
We are in a public comment period from now until October 10th.
To learn more and comment, click the DOH Sunrise Review Draft Recommendation here.
A spokesperson for the Physical Therapist Association of Washington said it is working on a rebuttal.
Earlier in the year, the Attorney General was asked for an opinion whether licensed Physical Therapist's current scope of Practice includes Dry Needling. The AG's opinion said "no", but on how the law is currently written, but added the Legislature could also e expand the scope of physical therapy by amending the relevant statutes.