New Developments and Rulings about Dry Needling by U.S. State Boards

 

Dry Needling Map Feb  2017

Not all states have issued formal statements or opinions, such as Connecticut, Illinois, Indiana, Minnesota, and Rhode Island, but there is nothing in their Physical Therapy Practice Acts that would prohibit dry needling. Most physical therapy practice acts are silent on the practice of dry needling. Only the physical therapy statutes of Hawaii do not allow physical therapists to penetrate the skin.

The Oregon Physical Therapy Board issued the following statement:  “dry needling of trigger points is likely within the physical therapist scope of practice…“, but also “in the interest of public safety, until specific training and education parameters can be determined, the Board strongly advises its licensees to not perform dry needling of trigger points at this time.

1984
  • In 1984, the Maryland Board of Physical Therapy Examiners was the first physical therapy board in the US that approved dry needling by physical therapists.
1992
  • In 1992, the New York Board of Education concluded that dry needling would not be allowed by physical therapists.
1993
  • In 1993, the Maryland Board of Physical Therapy Examiners approved trigger point injections by physical therapists and during the past 20 years, Maryland has been the only jurisdiction in the US allowing physical therapists to use trigger point injections. There are rumors that the Maryland Board of Physical Therapy Examiners is reconsidering this option and may revoke the privilege, although there have been no reports of adverse events. Very few physical therapists are employing trigger point injections.
1999
  • In 1999, the New Mexico Physical Therapy determined that dry needling is within the scope of physical therapy practice. In March 2000, the Board reiterated its position following an inquiry by the New Mexico Board of Medicine.
2001/2002
  • ph_news-map-rulings2002In 2001 and 2002, state boards of Tennessee and North Carolina ruled that dry needling was not in the scope of physical therapy practice.200
  • In March 2002, the New Hampshire Physical Therapy Governing Board determined that dry needling is within the scope of physical therapy practice.
  • In April 2002, the Virginia Board of Physical Therapy started issuing statements that dry needling appeared to be within the scope of physical therapy practice.
2004
  • In October 2004, the Georgia State Board of Physical Therapy suggested that dry needling would be within the scope of physical therapy practice.
  • In October 2004, the South Carolina Board of Physical Therapy Examiners determined that dry needling is within the scope of physical therapy practice.
  • In December 2004, the Kentucky State Board of Physical Therapy determined that dry needling is within the scope of physical therapy practice.
2005
  • In July 2005, the Director of the Colorado Board of Regulations determined that dry needling is within the scope of physical therapy practice.
2007
  • In January 2007, the Ohio Occupational Therapy, Physical Therapy and Athletics Trainers Board determined that dry needling is within the scope of physical therapy practice.
  • In March 2007, the Virginia Board of Physical Therapy determined that dry needling is within the scope of physical therapy practice, after having been challenged by the Virginia Acupuncture Society in August 2006. Jan Dommerholt, president of Myopain Seminars, testified in favor of dry needling during the Board’s meeting in October 2006.
2008
  • In January 2008, the Texas Board of Physical Therapy Examiners determined that dry needling is within the scope of physical therapy practice.
  • In May 2008, the Alabama Board of Physical Therapy determined that dry needling is within the scope of physical therapy practice.
  • In 2008, the Nevada Board of Physical Therapy Examiners concluded that dry needing is not within the scope of physical therapy practice.
  • In 2008, the Georgia Composite Medical Board, which oversees the practice of acupuncture rewrote their practice act. After the Acupuncture Statutes were modified in 2009 by including a sentence that “dry needling is a technique of acupuncture,” the Medical Board at the request of the acupuncture board began to issue cease and desist orders and the Georgia Attorney General ruled that dry needling would therefore no longer be allowed by physical therapists. Myopain Seminars faculty member Dr. Joseph Donnelly was very instrumental in effectively addressing this issue. In July 2010 the Georgia State Board of Physical Therapy met with the Georgia Composite Medical Board and both boards agreed to collaborate to resolve the dry needling problem. In December 2010, local physical therapist Dr. Herb Silver and his wife Sally contacted their Georgia Representative Edward Lindsey (Republican Whip) and set up a meeting, which was followed by a meeting by Dr. Ruth Maher, Dr. Barney Poole, Dr. Donnelly and Dr. Silver with Representative Sharon Cooper, Chair of the Health and Human Services Committee and Chief Sponsor of the re-write of the Medical Practice Act. Subsequently, Dr. Silver testified before the Senate Committee chaired by Representative Sharon Cooper. ThAT testimony along with all the prior efforts by the Physical Therapy Association of Georgia resulted in the introduction of legislation (House Bill 145) by Representatives Cooper and Lindsey stating that dry needling is also an intervention used by physical therapists. In February 2011, the Bill passed the House of Representatives and was moved to the Senate, which approved the Bill in April 2011. On May 12, 2011 the Governor of Georgia signed the Bill into law effective July 1, 2011. Georgia became the only state in the United States where dry needling is part of the Physical Therapy Statutes.
2009
  • ph_news-map-rulings2009In July 2009, the Oregon Board of Physical Therapy approved dry needling, but was immediately challenged by the Medical Board of Oregon and its Acupuncture Committee, “who voted that dry needling is the practice of acupuncture.” In response, the PT Board issued a statement that “upon further discussion and consideration, the Physical Therapy Licensing Board believes that the dry needling of trigger points is likely within the physical therapist scope of practice (excluding PTAs). The Board acknowledges that the dry needling of trigger points is an advanced intervention requiring post physical therapy graduate training and education.” The PT Board concluded its statement with “in the interest of public safety, until specific training and education parameters can be determined, the Board strongly advises its licensees to not perform dry needling of trigger points at this time.”
  • In July 2009, the Wisconsin Physical Therapy Affiliated Credentialing Board determined trigger point dry needling as within the scope of practice of physical therapy provided that the licensed physical therapist is properly educated and trained.
  • In August 2009, the Wyoming Board of Physical Therapy announced that the Physical Therapy Practice Act does not preclude dry needling with the proper credentials.
  • In August 2009, the Board of Idaho did not approve dry needling, “based upon the fact that trigger point dry needling is an invasive procedure, and invasive procedures are not within the physical therapy scope of practice,” even though invasive electromyography and nerve conduction studies can be performed by Idaho physical therapists.
  • In September 2009, the New Jersey State Board of Physical Therapy Examiners determined that dry needling is within the scope of physical therapy practice. The decision of the New Jersey Board has been challenged by the acupuncture lobby.
  • In October 2009, the Delaware Board of Physical Therapy elected not to issue an opinion about dry needling.
  • In November 2009, the District of Columbia Board of Physical Therapy approved dry needling to be within the scope of physical therapy practice. The American Association of Acupuncture and Oriental Medicine (AAAOM) prepared a letter to the District of Columbia Medical Board objecting to dry needling by physical therapists. The DC Board of Physical therapy issued a “Policy Statement: Guidance On Dry Needling In The Practice Of Physical Therapy” on May 17, 2010.
  • In 2009, the Maryland Acupuncture Board approached the Board of Physical Therapy Examiners questioning the PT Board’s decision to allow dry needling by PTs. The PT Board invited Dr, Jan Dommerholt to present a lecture of dry needling to the combined Acupuncture and PT Boards. Although the members of the Acupuncture Board had only a few questions following the presentation, a few months later, the Acupuncture Board requested a legal opinion of the Maryland Attorney General. In August 2012, the Attorney General issued his Opinion supporting dry needling by physical therapists (see below). The Attorney General did require the PT Board to develop regulations for dry needling. The PT Board has worked diligently on developing such regulations, but that process has not yet been completed (January 2016).
2010
  • ph_news-apta-portland-2010In August 2010, dry needling by physical therapists was approved in Illinois. In June 011, the Illinois Acupuncture Federation issued a position statement opposing dry needling by physical therapists.2
  • In September 2010, the North Carolina Board of Physical Therapy Examiners reversed its 2002 decision and determined that dry needling is within the scope of physical therapy. In December 2011, an initial ruling was finalized.
  • In September 2010, the South Dakota Board of Medical and Osteopathic Examiners voted against dry needling, however, in December 2010, the Board agreed to develop an Advisory Position on Dry Needling.
2011
  • In January 2011, the Utah Division of Occupational and Professional Licensing concluded that “the performance of trigger point dry needling is outside the scope of practice of a physical therapist in the State of Utah.” The Bureau Manager continued with “Utah Code 5B-24b-102 (11)(b) prohibits physical therapists from performing acupuncture. The Division’s research regarding the practice of trigger point dry needling confirms that it is the practice of acupuncture. Therefore, the Division finds that it is outside the scope of practice of physical therapists in Utah.” On February 1, 2011 we submitted a reply (pdf) to the Utah Division of Occupational and Professional Licensing.
  • In May 2011, the Montana Board of Physical Therapy determined that dry needling is within the scope of physical therapy practice, which continues to be challenged by acupuncture lobbyists (January 2016).
  • In May 2011, the Oregon Board of Chiropractic Examiners approved dry needling for Oregon chiropractic physicians. In July 2011, the Oregon Association of Acupuncture and Oriental Medicine filed a Petition for a Judicial Review with the Court of Appeals in Oregon, which lead to the decision of the Oregon Appeals Court Commissioner to stay the dry needling rule. The Oregon Chiropractic Board shared that “Chiropractic physicians who have been certified (by the OBCE) should cease all practice of dry needling. The OBCE may not certify any new chiropractic physicians during the period of the Stay. […..] The OBCE’s dry needling rule is no longer in effect pending a full proceeding and argument before the Oregon Court of Appeals. This could be a lengthy process that could take up to a year.” On July 17, 2013,  the Court of Appeals of the State of Oregon concluded that dry needling is not within the practice of chiropractic in Oregon. This ruling did not implicate dry needling by physical therapists in Oregon.
  • In May 2011, the Louisiana Board of Physical Therapy issued standards of practice for the utilization of dry needling techniques, which formally established dry needling as a physical therapy treatment.
  • In June 2011, the Nebraska Board of Physical Therapy decided that “a Nebraska licensed physical therapist may perform dry needling as long as he/she can competently perform such a procedure. This does not include physical therapy assistants.”
  • In August 2011, the Tennessee Board of Physical Therapy reversed its 2002 decision and approved dry needling by physical therapists.
  • In September 2011, the State Board of Physical Therapy of the Commonwealth of Pennsylvania issued a statement that “dry needling is not legal to perform as a physical therapist in the Commonwealth of Pennsylvania.” The President of the Pennsylvania Physical Therapy Association opposed the ruling in October 2011, as the PT Board has no legal authority to issue such advisory opinions or pre-approve conduct.
2012
  • ph_news-chart-statesIn February 2012, the Vermont Office of Professional Regulation issued a statement that dry needling is within the scope of physical therapy in that state.
  • In March 2012, the Nevada Board of Physical Therapy Examiners reversed its 2008 decision, and approved dry needling by physical therapists.
  • In April 2012, the Alaska PhysicalTherapy and Occupational Therapy Board approved dry needling by physical therapists.
  • In May 2012, the NC Board of Physical Therapy Examiners lowered the requirements for dry needling to 54 hours of education. Myopain Seminars has always met and continues to meet the requirements of the NC Board.
  • In June 2012, the Iowa Board of Physical & Occupational Therapy replied to an inquiry by Dr. Jan Dommerholt that “It has been the consensus of the Board that dry needling does not appear to be prohibited by the law or administrative rules. However, dry needling is an advanced skill that requires additional training beyond entry-level education and should only be performed by PTs who have completed additional education and demonstrated knowledge, skill, ability and competency in the performance of the procedure. If the Board determines that a PT is performing dry needling outside their training or expertise it could result in the licensee being disciplined by the Board. The Board has not issued an official opinion or policy statement on the performance of dry needling by Iowa licensed PTs.”
  • In July 2012 the West Virginia Board of Physical Therapy issued its “Opinion regarding Dry Needling Therapy” and concluded that dry needling is within the scope of practice of “physical therapy” …
  • In July 2012, the Mississippi Board of Physical Therapy issued “Requirement for Physical Therapists to Perform Intramuscular Manual Therapy.” The decision to include dry needling in the scope of physical therapy practice was challenged by the Mississippi Council of Advisors in Acupuncture. Dr. Jan Dommerholt testified at the PT Board’s meeting on behalf of the American Physical Therapy Association. The Mississippi Council of Advisors in Acupuncture and the Mississippi State Board of Medical Licensure approached the Mississippi Attorney General questioning the authority of the State Board of Physical Therapy to include dry needling within the scope of practice of physical therapy. In September 2012, the Mississippi Attorney General issued a legal opinion that “the Physical Therapy Board acted within the scope of its authority when promulgating the proposed rule including the use of needles for therapeutic treatment as a technique within the scope of the statutory definition of the practice of physical therapy. It is also the opinion of this office that the statutes regarding the definitions of acupuncture and the unlicensed practice of acupuncture can not be used to interfere with or limit physical therapists who are performing IMT or dry needling under the licensing authority of the Physical Therapy Board” (see below). In September 2012, another hearing was conducted at the offices of the Mississippi State Board of Medical Licensure. Once again, Dr. Jan Dommerholt testified on behalf of the American Physical Therapy Association. Following that meeting, the Mississippi State Board of Medical Licensure requested a reconsideration of the Attorney General. In October 2012, the Mississippi Attorney General issued a reconsideration and confirmed the previously expressed legal opinion that “the PT Board acted within its scope of authority” (see below).
  • In August 2012, the Indiana Physical Therapy Committee declared that “Indiana does not take a position on dry needling and does not offer a certification for this practice. The current Indiana statute is open and does not specifically state whether of not it is appropriate. The statue is up to interpretation and any PT who is interested in needling should consult their legal counsel. If someone was brought before the Committee for an incident resulting from using needling, the Committee would ask them what their qualifications were and determine if they were adequately educated in needling.”
2013
  • In May 2013, the North Dakota Physical Therapy Board approved dry needling to be within the scope of physical therapy practice.
  • In August 2013, the North Carolina Board of Acupuncture issued Cease & Desist letters to a number of physical therapists in that state who use dry needling techniques, even though the acupuncture board has no jurisdiction over physical therapists and physical therapy practice.
  • In August 2013, the Acupuncture Center (consisting of the Midwest College of Oriental Medicine and the Wisconsin Society of Certified Acupuncturists filed a lawsuit in the Circuit Court of Racine County in Wisconsin versus the Wisconsin Department of Safety and Professional Services, the Wisconsin Physical Therapy Examining Board, and the Wisconsin Joint Committee for Review of Administrative Rules demanding that the Defendants “formulate and publicize a rule prohibiting the therapeutic insertion of solid filiform needles into patients ….” The lawsuit was found to have no validity and was dismissed.
2014
  • On April 1, 2014, Utah Governor Gary R. Herbert signed new legislation specifying that dry needling is included in the scope of practice for licensed physical therapists (PTs) in Utah. The amended statutes require 54 hour “in-person” instructional hours, at least 300 total course hours with 250 supervised patient treatment sessions. Furthermore, the amendment stipulates that the physical therapist has to be practicing for 2 years prior to performing “trigger point dry needling.”
  • On April 25, 2014, the Illinois Department of Financial and Professional Regulation (IDFPR) released an informal opinion on April 25, 2014, asserting that dry needling would not be within the scope of practice of licensed physical therapists in the state of Illinois.  The rationale was because all procedures listed in the physical therapy practice act are non-invasive. There is an ongoing debate on this topic.  As this concerns an informal opinion, there are no consequences for the utilization of dry needling in Illinois. The APTA drafted a reply (PDF).
  • Also on April 25, 2014, Arizona Governor Jan Brewer signed into law SB 1154, legislation that amends the Arizona physical therapy statute to specifically add dry needling to the physical therapist scope of practice.
  • On June 19, 2014, the Tennessee Attorney General issued an opinion (PDF) that dry needling is not in the scope of physical therapy practice in the state of Tennessee. The Attorney General suggested that a change in legislation would be required (see below).
  • On August 12, 2014, Delaware Governor Jack Markell signed a newly revised PT licensing law that includes dry needling.
  • On October 10, 2014, the Honorable Laura C. Inveen, judge at the Superior Court for the State of Washington, County of King, ruled that dry needling is considered the practice of medicine in Washington State and outside the scope of physical therapy practice. Kinetacore, a continuing education company based in Colorado, was enjoined from holding any workshops, classes or similar trainings in the State of Washington by physical therapists. The ruling was the outcome of a lawsuit filed by the State of Washington ex rel South Sound Acupuncture Association, a State of Washington non-profit corporation, vs. Kinetacore, a Colorado LLC doing business in the State of Washington, Edo Zylstra, CEO and owner of Kinetacore, Kerry Maywhort, a Kinetacore instructor, Emerald City Physical Therapy Services, LLC doing business as Salmopn Bay Physical Therapy. LLC, a limited liability company, John Does 1-10 and Jane Does 1-10, No. 13-2-04894-9 SEA. The APTA issued a formal response to the ruling (PDF).
2015
  • On January 15, 2015, the North Carolina Rules Review Commission objected to Rule 21 NCAC 48C 0104 which is the Physical Therapy Board’s proposed rule on dry needling due to a “lack of statutory authority.” According to the North Carolina Board of Physical Therapy Examiners, “…. the Board’s Position Statement on Intramuscular Manual Therapy and Dry Needling is not considered to be a rule, and physical therapists must therefore comply with 21 NCAC 48C .0101(a).” Furthermore, the NC PT Board issued a statement that “….. based on an Advisory Letter from the Attorney General’s Office submitted to the Acupuncture Licensing Board in 2011, and the opinion of the RRC Staff Counsel reviewing the NCBPTE rules for statutory compliance, dry needling is within the scope of practice of physical therapy.”  In summary, this means that while dry needling is legally within the scope of physical therapy practice, any previously issued rules regarding minimal educational requirements are no longer valid. In other words, there are no regulations anymore  to set the specific requirements for engaging in dry needling. The Board believes that physical therapists can continue to perform dry needling so long as they possess the requisite education and training required by N.C.G.S. § 90-270.24(4).
  • Maryland Senate Testimony 2015On March 10, 2015, Maryland House Bill HB 979 was withdrawn. HB 979 and Senate Bill 580 would require that PTs receive education & training specific to dry needling that are equal to the requirement for physicians who perform the entire scope of acupuncture practice – at least 200 hours! It would also require that such education and training standards for physical therapists be formulated in conjunction with acupuncturists. Many physical therapists, physicians and patients joined the APTA of Maryland for the Senate Committee hearing in spite of a major snowstorm.
  • On March 16, 2015, the House of Tennessee passed House Bill 25, which cleared the way for physical therapists in TN to start using dry needling again in clinical practice.  The bill also clarifies that the Physical Therapy board will be required to establish minimum competency requirements for a physical therapist to practice dry needling. The bill also redefined “dry needling” to clarify that the practice is for the management, instead of evaluation and management of neuromusculoskeletal conditions, pain, and movement impairments.  On March 23, 2015, the Senate of Tennessee passed the legislation.  On April 9, 2015, Governor Bill Haslam signed the bill into law effective July 1, 2015
  • On March 31, 2015, a Washington State Senate Committee killed a proposed bill HB 1042, which would have prevented physical therapists from using dry needling in Washington State.
  • On June 12, 2015, the Vermont Acupuncture Association filed a complaint with the Vermont Office of Professional Regulation, alleging that eleven Vermont physical therapists would have engaged in the unauthorized practice of acupuncture by using trigger point dry needling.  On June 22, 2015, the Office of Regulation replied pointing out that “under the existing law, the OPR believes that physical therapists reasonably may practice TDN if appropriately trained and experienced, and if the therapy is reasonably indicated for the relief of an impairment of physical movement.”
  • On August 17, 2015, the Iowa Association of Oriental Medicine and Acupuncture filed a Petition for Declaratory Order pursuant to Iowa Code § 17A.9 and 645 IAC Chapter 8. The Petition requests a Declaratory Order from the Iowa Board of Physical & Occupational Therapy regarding dry needling.
  • On September 2, 2015, the North Carolina Acupuncture Licensing Board filed a lawsuit in Wake County Superior Court against the North Carolina Board of Physical Therapy Examiners to “protect the public from the unlicensed practice of acupuncture by physical therapists offering “dry needling.” The complaint  seeks judicial confirmation that the practice known commonly as “dry needling” is acupuncture.
  • On October 7, 2015, attorneys for the North Carolina chapter of the APTA (NCPTA) have filed a federal antitrust lawsuit (Henry v. NC Acupuncture Licensure Board) against the North Carolina Acupuncture Licensure Board (NCALB). The landmark lawsuit asserts federal antitrust and due process claims against the NCALB and its members. It seeks an injunction blocking the NC Acupuncture Board from taking action against physical therapists, recovery of three times the physical therapists’ lost profits, and payment of attorneys’ fees. A copy of the 44-page lawsuit can be accessed here.  The plaintiffs in the case are four licensed physical therapists. Two of the four PT plaintiffs received cease & desist letters from the NCALB in 2013; the other two PT plaintiffs do not currently perform dry needling and want to be able to do so in the future, but are afraid of entering the market due to fear of the NCALB taking action against them. In addition there are two patient plaintiffs who currently receive and are benefitting from dry needling treatment performed by their NC physical therapists.  The Henry lawsuit has legal support in a 2015 decision by the US Supreme Court holding that state licensing boards controlled by market participants, such as the NCALB, are not exempt from antitrust claims unless their conduct is actively supervised by the state. The NCPTA lawsuit is the first in the country to bring this type of antitrust violation claim on behalf of PTs since the Supreme Court decision.
  • On December 8, 2015, the NC Acupuncture Board filed an “Amended Verified Complaint for Declaratory Judgment and for Permanent Injunction” against the NC Board of Physical Therapy Examiners and against three NC licensed physical therapists and a physical therapy practice.
2016
  • On January 14, 2016, the Iowa Board of Physical & Occupational Therapy issued a Ruling on the Petition for Declaratory Order and concluded that dry needling is within the scope of physical therapy practice as defined in Iowa Code section 148A.1(1)(b).
  • On April 15, 2016, the Attorney General of Washington State concluded that “The definition of the practice of physical therapy indicates that the legislature did not intend to include dry needling within the scope of practice. We have been informed of many reasons for including dry needling in the practice of physical therapy and arguments to the contrary, but our role is not to resolve such public policy disputes. We conclude only that RCW 18.74, as currently written and implemented, does not encompass dry needling in the practice of physical therapy.”
  • On April 26, 2016, Louis A. Bledsoe, III, Special Superior Court Judge for Complex Business Cases in the State of North Carolina dismissed all of the Acupuncture Board’s claims against the Physical Therapy Board and several NCPTA members. The Court’s thorough and well-reasoned decision can be found at this link. Days after its lawsuit was dismissed in full, the Acupuncture Board started more legal proceedings with the Physical Therapy Board. The new proceedings have the same purpose as the now-dismissed lawsuit: trying to prevent North Carolina patients from receiving the safe, effective treatment that those patients choose.
  • On May 9, 2016, the Attorney General of Texas, Mr. Ken Paxton, issued a ruling that “A court would likely conclude that the Board of Physical Therapy Examiners has authority to determine that trigger point dry needling is within the scope of practice of physical therapy.”  The opinion was requested by Mr. Allen Cline, the Chairman of the Texas State Board of Acupuncture Examiners. A copy of the legal opinion is available here.
  • On May 13, 2016, Kansas Governor Sam Brownback signed legislation affecting the use of dry needling by physical therapists. The legislation clarifies that dry needling is within the scope of practice of physical therapy in Kansas. The new dry needling provisions in the physical therapy practice act will take effect July 1, 2016. Kansas is now working on developing rules and regulations for dry needling.
  • On July 8, 2016, the Attorney General of Nebraska, Mr. Douglas Peterson, issued a ruling that “If dry needling is defined using the descriptions provided to this office by the Board of Physical Therapy and the APTA, it is our opinion that a reasonable legal argument can be made that dry needling is a “mechanical modality” or a “physical agent or modality” and, therefore, falls within the statutory definition of physical therapy.”  In addition, it was opinioned that dry needling was not within the scope of practice for OTs and Athletic Trainers. A copy of the legal opinion is available here.
2017
  • On January 30, 2017, the United States District Court for the Middle District of North Carolina issued its Opinion and Order in the case of Henry et al. v. the North Carolina Acupuncture Licensing Board et al. Henry et al. v. the North Carolina Acupuncture Licensing Board et al, is an antitrust lawsuit arguing that the North Carolina Acupuncture Licensing Board (NCALB) is violating antitrust law and due process rights in its actions to prevent PTs from practicing the skilled intervention of dry needling. The court ruled “that Plaintiffs have satisfied their obligation, at this stage, to plausibly allege an impact on interstate commerce.”  Furthermore, the court ruled “that Plaintiffs have sufficiently alleged injury in fact” and the court agreesd “with Plaintiffs and finds that the Amended Complaint adequately alleges “the type of injuries the antitrust laws were intended to prevent.” The court also found evidence of conspiracy by the North Carolina Acupuncture Licensing Board and the North Carolina Association of Acupuncture and Oriental Medicine. As far as we know, this is the first Federal ruling in favor of dry needling by physical therapists in the United States, which could have far-reaching implications for acupuncturists in other states who are still attempting to stop the practice of dry needling by physical therapists. A copy of the legal opinion is available here.
  • On February 9, 2017, the Attorney General of New Jersey issued a statement that physical therapists are not authorized to engage in the practice of dry needling. A copy of the legal opinion is available here.
  • On April 14, 2017, the Kansas Board of Healing Arts approved the Dry Needling Regulations for Physical Therapists in the state of Kansas.

The Florida Physical Therapy Statutes continue to be rather confusing on the issue of dry needling and include language that physical therapists are allowed to practice acupuncture as long as they do not penetrate the skin. The Florida statutes do not offer any suggestions how to accomplish this. Whether this language applies to physical therapists using dry needling has not been considered.

Legal Opinons by Attorney Generals

Whether physical therapists in the United States are legally allowed to use dry needling in their clinical practices continues to be a question that is being raised. In recent years, the Attorneys General of several states have been approached to render a legal opinion.  Below are the legal opinions (PDF) of the Attorneys General of: