A Legal Battle to Protect Acupuncture Profession

Dry Needling: Averting a Crisis for the Profession
By John Amaro

Acupuncture Today

To date, there have been a multitude of articles published nationally in opposition to what may very well be perceived as the number-one threat to the existence of the acupuncture profession – what is known as "dry needling." Dry needling is being practiced by hundreds of physical therapists across the nation and in every state.

It has achieved a great deal of notoriety and popularity within the PT community, and in particular the general public, who have embraced it and are actively seeking the services of those who utilize this procedure.

When practiced by a physical therapist, the procedure is more often than not covered through medical insurance plans and may command as much or more than $200 per treatment. Unfortunately, the practice of acupuncture by licensed and state board-regulated LAc's does not fall within the same financial parameters the PT is receiving by billing for trigger-point therapy or other similar codes.

The entire acupuncture profession, from the individual practitioner to the national organizations, have launched direct and impassioned protests against this practice. Acupuncture organizations have stated emphatically that the PT who is inserting acupuncture needles into the skin to deactivate trigger points is infringing upon the practice acts of state board-licensed and regulated acupuncturists, as the procedure is clearly acupuncture.

Physical therapists, on the other hand, respond by saying that they are not using any belief system, academia or philosophy of Traditional Chinese Medicine or any particular thought process that deals with what is commonly known as the practice of acupuncture, regardless of what Asian country it may have been developed in. They explain their procedure as simply isolating trigger points, as described by Travell, Simons, and others as far back as 1947 and expounded upon in the mid-1960s. They go on to say that what they are doing is absolutely not acupuncture.

Trigger points are hyperirritable spots in skeletal muscle which are painful on deep palpation and can give rise to referred pain and motor dysfunction. They are found in palpable, taut bands of skeletal muscle and are responsible for a host of maladies affecting especially the musculoskeletal system, from pain in a body area to dysfunction of the area. Acupuncturists counter that this is what we refer to as "Ah Shi," "Ah So" points, which is a classic method of acupuncture known universally.

Palpating the area of pain, which may be known as "Surround the Dragon," will elicit specific tender points that may be needled by the acupuncturist in a classically and globally utilized approach. The physical therapist utilizes the identical approach by palpating and finding the trigger points, which are exquisitely tender; and then inserting an acupuncture needle into the area in what is described by them as "dry needling."

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