Marshall H. Sager, DO, FAAMA
Rey Ximenes, MD, FAAMA
The American Academy of Medical Acupuncture (AAMA) is the premier North American organization
of physician acupuncturists. The AAMA is committed to insuring public health and safety by ensuring
that all persons practicing any type of medicine, including acupuncture, are properly trained and educated.
It is imperative that courts and medical bodies maintain and preserve strict standards of education and
training in acupuncture before any person undertakes inserting a needle into a patient. An ill-trained
practitioner could, as a result of lack of education or ignorance, cause substantial medical injury.
Acupuncture, like Western Medicine is a complex subject. It cannot be mastered in a weekend or in a
month. All AAMA members in addition to four (4) years of medical school (MD or DO), must have 300
hours of didactic and clinical acupuncture education and training. A non-physician must have in excess
of 2,000 hours of clinical and didactic education and training before they can become certified to treat
patients in most states.
Dry needling is the use of solid needles (contrasted with the use of hollow hypodermic needles that are
used for injections) to treat muscle pain by stimulating and breaking muscular knots and bands. Unlike
trigger point injections used for the same purpose, no anesthetics are used in dry needling. There is
controversy regarding the definition of dry needling. Licensed medical physicians and licensed
acupuncturists consider dry needling as Western Style Acupuncture or Trigger Point Acupuncture
whereby the insertion sites are determined by tender painful areas and tight muscles. These sites may be
treated alone or in combination with known acupuncture points. Other practitioners take the position that
dry needling is different from acupuncture in that it is not a holistic procedure and does not use meridians
or other Eastern medicine paradigms to determine the insertion sites.
Dry needling is an invasive procedure. Needle length can range up to 4 inches in order to reach the
affected muscles. The patient can develop painful bruises after the procedure and adverse sequelae may
include hematoma, pneumothorax, nerve injury, vascular injury and infection. Post procedure analgesic
medications may be necessary (usually over the counter medications are sufficient).
There has been controversy in the United States as to who is qualified to practice dry needling. Since it is
an invasive procedure using needles, many take the position that it should only be performed by licensed
acupuncturists or licensed medical physicians (M.D. or D.O.). In Illinois, this sentiment was echoed by a
decision to reverse legislation permitting physical therapists to perform dry needling. These and other
practitioners were performing this procedure who are not trained nor do they otherwise routinely use
needles in their practices.
The AAMA recognizes dry needling as an invasive procedure using acupuncture needles that has
associated medical risks. Therefore, the AAMA maintains that this procedure should be performed only
by practitioners with extensive training and familiarity with routine use of needles in their practice and
who are duly licensed to perform these procedures, such as licensed medical physicians or licensed
acupuncturists.
December 9, 2014
Adopted unanimously
Board of Directors of AAMA