Dry Needling Is Illegal: The Facts You Need to Know To Stay Safe
Written By Dr. Kristen Burris, DAcCHM Doctor of Acupuncture With a Specialization in Chinese Herbal Medicine
Dry needling has created quite a stir in the medical community and for good reasons. The practice is largely utilized by physical therapists and chiropractors, who admired and revered the effects of acupuncture for musculoskeletal injury and pain. However, these providers didn’t want to hire an acupuncturist in their practice either because they couldn’t afford it or because they wanted an add additional billing practices for their own patients. They also didn’t want to have to go back to school for 5-6 ½ mor years. But, to be properly licensed in acupuncture, the schooling is thorough and advanced; with many years of training and the need to pass difficult board exams. This takes years to accomplish. To give examples, the providers at Eagle Acupuncture have the most advanced training in acupuncture with over 5,000 hours of training having a dual board certified in both acupuncture and Traditional Chinese medicine. Physical therapists or chiropractors or even physicians, who learn dry needling, take an acupuncture needle, also known now as filiform needle, and insert it into a patient after only one weekend of training = 27 hours total. It sounds criminal, doesn’t it? This is why dry needling is illegal in five states and counting. The number of states revoking the right to dry needling is increasing.
Yes, you read that correctly. Dr. Kristen Burris has 5,000 hours of training in TCM and acupuncture and is dual board certified. Mr. Tony Burris has 3,800 hours of training in TCM and acupuncture and over 1,000 hours of training in physical medicine of the Taoist arts. Physical therapists and chiropractors take an acupuncture needle and insert it into patients and call it “dry needling” because it has no wet medicine inside it, the way hypodermic needles do) after only 27 hours of training. No board exam. No regulatory license. No degree. No college. Just a certificate from a typed piece of paper that supposedly qualifies them to put needles in a person’s body for a therapeutic effect: another definition of acupuncture.
You can imagine the pain, injury, and tragedies that can occur by accidentally puncturing lungs, organs, veins, arteries and nerves. Many adverse events have been reported, and several states have made dry needling illegal, where acupuncture is legal in all 52 states.
Here are the states where dry needling, even if a provider is certified in dry needling, is illegal:
California
Hawaii
New York
Oregon
Washington
Many providers will attempt to make distinctions between dry needling and acupuncture, but they are often not acupuncturists themselves, so they erroneously mislead the public in their published statements. Knowingly or not, they are spreading false information.
Dry needling is an invasive, physical therapy modality where the provider inserts acupuncture needles or filiform needles deep and blindly into the body to attempt to penetrate trigger points to treat myofascial dysfunction and pain. Many claim it is unlike acupuncture, because the provider doesn’t know how to balance the body’s energy flow or Qi. But here is the irony, just because the provider isn’t educated and knowledgeable, doesn’t mean they aren’t affecting a patient’s “energy” or “Qi” in a patient’s body. They are. They just are uneducated about how, when or where to do it. They don’t know how to combine points and in fact, they don’t know acupuncture point locations at all.
Acupuncturists have been treating motor points for decades. This is not new. Dry needling is a new name, but the treatment process is acupuncture. It is simply an uneducated, unregulated, unlicensed, form of acupuncture called dry needling. Do not allow anyone to mislead you into thinking otherwise, as that is not factual information. Providers who learn dry needling, may not even know that they don’t know this information. They profess it is not acupuncture, but that is because other physical therapists, who taught them dry needling, educated them poorly about the foundations of acupuncture, sports medicine and motor points. Taking a filiform needle and inserting it into the body for a therapeutic effect and or pain relief is a definition of acupuncture.
However, not all acupuncturists are trained in this form of musculoskeletal acupuncture. Yet, Dr. Kristen Burris DAcCHM and Mr. Tony Burris, L.Ac. at Eagle Acupuncture are trained in sport medicine acupuncture and motor points. They both studied musculoskeletal and sports injury acupuncture from Mr. Matt Callison, L.Ac. who has nearly 30 years experience as a renowned teacher educating student about sports medicine, acupuncture and cadaver dissection. He is the author of the book Motor Points and Acupuncture Meridian Charts, and Motor Points Index (MPI) Reference Guide. He is considered an expert in Motor Point acupuncture. They spent years under his training to learn this aspect of acupuncture. Not one weekend. Sound like dry needling? Yes, it does.
Commonly, dry needling targets trigger points deep into the body that often run close to the nerves. The opportunities that a deeply penetrated needle, may trigger or hit nerves accidentally, runs high. These needling accidents often create burning, electrical pain that does not stop once the needle is retracted and pulled out. Nerve damage, irritation, inflammation and immediate pain is to be expected. In fact, most people report dry needling hurts. On the contrary, most people report acupuncture does not hurt. Training matters. Technique matters. Education matters. Licensing matters.
It can take weeks or months to recover fully from nerve damage caused by dry needling. Causing pneumothorax, the puncturing of a lung, is a life-threatening emergency that will affect a person’s lung health and likelihood of recurrence for the rest of their life. Some patients die from it. Proponents will claim this is such a rare occurrence, but studies have shown quite the opposite as published in ERJ Open Research : The best in open access, basic, translational and clinical respiratory research and can be found in NIH the National Library of Medicine (Bontinck et all 2024). Therefore, many legal regulations are involved in limiting the practice of dry needling. And wisely, several states have now banned dry needling. Beyond the safety and risk of dying by dry needling, there are other concerns.
Lack of Regulation: Unlike acupuncture, which require years of training (6 ½ years for DAC and 5 years for LAc) , certifications, licensure and board exams with annual continuing education required to stay in practice. The regulation of dry needling is sadly only 27 hours in Idaho. Even dog groomers are required to receive more education than that.
Scope of Practice: Dry needling grossly encroaches on the scope of practice of acupuncturists. Imagine if a doctor of acupuncture and Chinese herbal medicine, DAcCHM noticed a lot of skin tags and moles on her patient. She decided she wanted to remove these for her patients and call herself a “mole removalist” instead of going back to medical school to become a dermatologist. Imagine the dangers of not sending these skin eruptions to a lab to check for cancer because we have rural areas that many dermatologists just can’t get to. There would be an uproar against this behavior, and no one would stand for it, or at least I hope they wouldn’t. A needle, inserted in the body to alleviate pain, muscle spasm or other ailments, is the definition of acupuncture and has been since it first arrived in this country in 1972. Deep, penetrating needles into motor points is dry needling (it is also advanced acupuncture technique that is learned in the fourth year of training, not in the fourth hour of training). This takes years to master successfully. If a dry needler, gently puts needles in the body and does not in fact, hit a motor point, this is acupuncture and they are not licensed to perform acupuncture. That is illegal. How can a patient differentiate? They can’t. This is dangerous. Now imagine if acupuncturists wanted to twist and crack people’s neck, backs and any other joint in their body and learn this technique in one weekend. Let’s call these providers “bone setters”. But patients say to them, this feels like chiropractic care. No. Not the same. But you are holding my body the same, turning it the same and cracking my bones the same. Not this is bone setting, not chiropractic. It just seems surreal to even give these examples, but this is true encroachment on a complex, sophisticated form of medicine called acupuncture, and we need more awareness.
Safety Hazards: Advocates of dry needling promote its effectiveness in treating musculoskeletal pain, which even bad acupuncture can get good results on occasion, however, opponents are truly concerned about the public’s safety. It takes years to learn how deep one can insert needles safely into the body. It takes years to learn the anatomy, work on actual cadavers, treat students under the supervisor’s wisdom and expertise, then to practice on patients in a supervised environment under licensed acupuncturists for years in a clinical setting. Not one weekend. That is absurd and it is tragic that this has passed in so many states. Puncturing lungs and other vital organs, causing nerve damage, and pain endured by the patient, are real adverse reactions that have been reported numerous times from dry needling. Proper sterilization and clean needle technique are also required training for acupuncturists and create a hazard for dry needling who have lack of education in this regard.
We applaud California, Hawaii, New York, Oregon and Washington for making dry needling illegal. They care about patient safety, encroachment on professional scope of practice and keeping professions held to high ethical standards. We respect all forms of medicine, natural or not, physical or not. We refer to physical therapists and chiropractors and doctors of western medicine. We, however, will never condone the masked performance of acupuncture in any way. This is an ancient form of medicine that when performed properly can be extraordinarily successful at treating sports injury, work injury, car injury, weekend warrior injury, accidents and pain from all types of diseases and injuries. If you ever hear the words “you need dry needling” consider your options and we urge you to opt for acupuncture instead.
Bontinck JSB, Lyphout C, Malfait TLA. Pneumothorax as a complication of dry needling technique. ERJ Open Res. 2024 Apr 15;10(2):00156-2024. doi: 10.1183/23120541.00156-2024. PMID: 38623313; PMCID: PMC11017104.