I oppose dry needling by PT's.

PT's have demonstrated unethical malpractice already when they have expanded the scope of dry needle to beyond just muscle trigger points for pain.  They have started doing distal (none trigger point acupuncture), retaining of the needle after insertion (dry needle should be quickly withdrawn after insertion) and electric stimulation to acupuncture needles (while retaining).   They now promote dry needle for treating sinus issues and for cosmetic facial rejuvenation.  This expansion of scope beyond pain is simply a move towards practicing preeminent acupuncture techniques without the understand of acupuncture physiology behind it.  This is unethical and simply malpractice.

In regards to PT's training of dry needle.

Physical Therapy’s own math indicates insufficient training of dry needle technique.

1. According to North Carolina’s Physical Therapy Board lawsuit against North Carolina’s Board of Acupuncture (Case No. 1:15-cv-831), Line item 35 states the following “According to a recent study by the Human Resources Research Organization, more than four-fifths (86%) of what physical therapists need to know to be competent in dry needling is acquired during the course of their clinical education alone. This includes knowledge related to evaluation, assessment, diagnosis and plan of care development, documentation, safety, and professional responsibilities.”[i]

In other words, a Physical Therapist still needs to have 14% additional clinical education hours of training to be sufficient in the practice of Dry Needle technique.

1. According to CAPTE Commission on Accreditation in Physical Therapy Education’s Aggregate Program Data 2014 -2015 Physical Therapist Education Program Fact Sheets[ii].  Table 9 states the Mean Number of contact / clock hours in full time clinical education to be 1,421 hours.
2. Let’s do the math.  CAPTE’s mean clinical education hours are 1,421.  An additional 14% of clinical education is required for learning the dry needle technique.  Therefore   a Physical Therapist needs 198 hours (14% of 1421 hours) additional clinical training to be able to practice Dry Needle Technique. 

       Clinical hours do not exist in a vacuum.  Behind them exists the didactic course and curriculum,         which according to The CAPTE Aggregate Program Data 2014 -2015 Fact Sheet Figure 4 there is        approximately 79.6 % of didactic / lab work in proportion to 20.4 % clinical education. 

 Therefore additional didactic study for the dry needle technique would require an almost  additional 800 hours to the 198 hours of clinical dry needle training. 

1. Current Educational Requirements for a Physical Therapist to practice Dry Needle Technique.

    In general (with variance amongst states), for a Physical Therapist to practice the dry needle technique 27-54 hours training are required in the use of needles.  With a portion of those hours allowed to be home / online study[iii]. 

1.  The conclusion according to Physical Therapist own math and clinical education is that 27 - 54 hours of education is grossly insufficient to be able to practice the dry needle technique.
2. Furthermore the quality of these educational programs is questionable at best.  There is one account of a class being provided with excellent didactic education, but when it came to the portion of hands on clinical education, chaos ensued as students fumbled with the most basic of skills like opening a pack of needles and within 20 minutes were dangerously inserting needles unsupervised. [iv]

1. We see classes generally being taught in a “weekend warrior” type of environment where there can be as many as 60 or more students per one instructor[v].  Physical therapist are then sent “home” after a weekend class to practice their clinical dry needle in an unsupervised environment[vi].  These practices are a mockery of a true and proper clinical experience.

1. We believe current allowable training practices of dry needle by Physical Therapist to be thoroughly insufficient and inappropriate for learning an invasive medical procedure. We believe such training environments need to be investigated and regulated more closely.

[i] Analysis of Competencies for Dry Needling by Physical Therapists, Joseph Caramagno Leslie Adrian Lorin Mueller Justin Purl, July 10,2015 page 13

[ii] http://www.capteonline.org/uploadedFiles/CAPTEorg/About_CAPTE/Resources/Aggregate_Program_Data/AggregateProgramData_PTPrograms.pdf

[iii] http://www.keepacupuncturereal.com/

[iv] http://www.liveoakacupuncture.com/dry-needling - “My experience at the “Dry Needling Certification” Course

[v] ibid

[vi] http://www.kinetacore.com/physical-therapy/Trigger-Point-Dry-Needling-Level-II-Training/page18.html