VTAA Position on Dry Needling

The Vermont Acupuncture Association (VTAA) opposes the illegal and unsafe
practice of acupuncture. “Dry needling” is a pseudonym for acupuncture that has
been adopted by physical therapists, chiropractors, and other health providers
who lack the legal ability to practice acupuncture within their scope of practice.
This strategy allows these groups to skirt safety, testing, and certification
standards put into place for the practice of acupuncture. Dry Needling is a style of
needling treatment within the greater field of acupuncture. The practice of
“acupuncture” includes any insertion of an acupuncture needle for a therapeutic
purpose. Acupuncture training has always included both traditional and modern
medical understandings.

Anatomically, “trigger points” and “acupuncture points” are synonymous, and
acupuncture has targeted trigger points for over 2,000 years. “Dry needling” is
indistinguishable from acupuncture since it uses the same FDA-regulated medical
device specifically defined as an “acupuncture needle,” treats the same
anatomical points, and is intended to achieve the same therapeutic purposes as acupuncture.

The US Food and Drug Administration (FDA) defines the acupuncture needle as a
Class II medical device, and has explicitly stated that the sale of acupuncture
needles “must be clearly restricted to qualified practitioners of acupuncture as
determined by the States.” As “dry needling” is acupuncture, it presents the
same inherent risks including but not limited to perforation of the lungs and
other internal organs, nerve damage, and infection. Recent reports of serious and
potentially life-threatening injuries associated with “dry needling” include
pneumothoraces and spinal cord injury. These and other injuries support the
statement that “dry needling” presents a substantial threat to public safety when
performed without adequate education, training, and independent competency
examination. Adequate training and competency testing are essential to public safety.

In addition to biomedical training, licensed acupuncturists receive at least 1365
hours of acupuncture-specific training, including 705 hours of acupuncture specific
didactic material and 660 hours of supervised clinical training. The
American Academy of Medical Acupuncture (AAMA) has set the industry
standard for a physician to practice entry-level acupuncture at 300 hours of
postdoctoral training with passage of an examination by an independent
testing board. This standard presumes extensive, pre-requisite training in
invasive procedures [including underlying structures, contraindications for skin

puncture, clean needle technique, anticipated range of patient responses to
invasive technique, etc.], the differential diagnosis of presenting conditions,
clinical infection-control procedures in the context of invasive medicine,
management of acute office and medical emergencies, and advanced knowledge
of human physiology and evidence based medicine. The AAMA expects that
physicians choosing to incorporate acupuncture into practice will pursue lifelong
learning, including formal and self-directed programs. The VTAA supports other
professionals practicing acupuncture with these standards and strongly
welcomes such collaboration.

In contrast, there are no independent, agency-accredited training programs for
“dry needling,” no standardized curriculum, no means of assessing the competence of instructors in the field, and no independently administered competency examinations.
Neither physical therapy nor chiropractic entry-level training includes any
meaningful preparation for the practice of invasive therapeutic modalities such
as the insertion of acupuncture needles. Training in these programs is generally
limited to external therapeutic modalities. However, physical therapists and
others have begun inserting acupuncture needles and practicing acupuncture
with 12-24 hours of classroom time and little to no hands-on training or
supervision. This is being done under the name “dry needling.”

January 16, 2017

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