Acupuncture Fail: Arizona Allows Physical Therapists to Practice Dry Needling with Only 16 Hours of Training!

On October 22, 2013 the field of acupuncture took a major blow in Arizona. The state’s Board of Physical Therapy, which had been reviewing the use of dry needling, ruled unanimously that the practice falls within the “definition of physical therapy.” Physical therapists will be allowed to continue to administer the treatment with a mere 16 hours of training.

Currently, the Arizona Acupuncture Board of Examiners requires acupuncturists to complete 1,850 hours of training, which includes 800 hours of clinical training, and a clean needle technique course, graduate from a Board approved program in traditional Chinese medicine and acupuncture, and receive certification by the NCCAOM or pass the NCCAOM exams to obtain a license. This is in sharp contrast to the minimal requirements for physical therapists to administer dry needling.

Dry needling involves the insertion of acupuncture needles into myofascial trigger points to alleviate muscle pain and impaired movement. Proponents of dry needling often argue that it is not acupuncture in an attempt to get around licensure requirements.

dry needling vs acupuncture

According to Arizona statute 32-3901, “acupuncture means puncturing the skin by thin, solid needles to reach subcutaneous structures, stimulating the needles to affect a positive therapeutic response at a distant site and the use of adjunctive therapies.” Dry needling is clearly acupuncture under this definition.

The American Association of Acupuncture and Oriental Medicine (AAAOM) previously released a statement reading, “The American Association of Acupuncture and Oriental Medicine Blue Ribbon Panel on Inter-professional Standards has determined that dry needling and any of its alternative designations, including intramuscular manual therapy, trigger point needling, functional dry needling, intramuscular stimulation or any other method by which a needle is inserted to effect therapeutic change, is, by definition, the practice of acupuncture.”

While the Board noted it will consider additional training requirements for practitioners of dry needling in the future, this does not benefit patients in the present. A physical therapist with 16 hours of training puts an individual’s safety at risk. The lack of training also reduces the likelihood of a treatment being effective. This tarnishes the credibility of acupuncture and does nothing to preserve the value of licensed acupuncturists.

Weekly Cup of Qi addressed this very topic when we referred to a 2006 case study published in Motion that examined an incidence where a “practitioner” caused a pneumothorax, or collapsed lung, in a patient while dry needling trigger points. The authors of the study concluded, “while acupuncture is generally considered a safe procedure with low risk of serious complications, such risks are directly related to the amount of training the practitioner has undergone and decrease with increased hours of required training.”

In the same article, we discussed a review of liability claims related to the incident by Guild Insurance Limited, a company that provides malpractice insurance for physical therapists. Guild Insurance Limited found that in a one year time period, the cases of pneumothorax due to dry needling had seen an increase. This increase was correlated with the increase in physical therapists practicing dry needling over the same time span.

With solid evidence that dry needling is potentially dangerous when a practitioner is not qualified, it’s more important than ever for the general public to be educated about the differences in training among practitioners. The beauty of acupuncture is the lack of side effects and the safety of treatment in the hands of a fully qualified and licensed acupuncturist. This does not hold true when performed by a physical therapist with 16 hours of education. 16 hours is certainly not enough time to understand the nuances of needling techniques, the tenants of traditional Chinese medicine, safety protocols, and diagnostic criteria.

Traditional Chinese medicine is just that: medicine. Medical doctors go through rigorous training and must successfully graduate from medical school. Why is it acceptable for physical therapists to practice a form of medicine without having to adhere to training requirements? It is not only hypocritical, but an issue of public safety.

Don’t fall trap to undertrained practitioners. If you are interested in acupuncture treatments, visit to find a licensed acupuncturist in your area. We fully vet all of our providers before adding them to the directory. The service connects patients with only fully trained and licensed practitioners. Don’t take chances with your health. Instead, experience the full array of benefits REAL acupuncture has to offer.

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