Introduction
On April 22, 2025, the Oregon House of Representatives passed House Bill 3824 with 52 in favor, two against, and six not voting. The Bill’s Digest states, “Authorizes a physical therapist to prescribe durable medical equipment. Authorizes a physical therapist to administer vaccines to specified individuals. Allows a physical therapist to sign and date a certificate for a disabled person parking permit application. Exempts a physical therapist from the requirement to obtain a license to use sonographic equipment if the sonographic equipment is used for physical therapy purposes. Changes membership requirements for members of the Oregon Board of Physical Therapy.” The bill does expand the definition of the Practice of Physical Therapy to include “therapeutic exercise, needle insertion, patient-related instruction, therapeutic massage, airway clearance techniques, integumentary protection and repair techniques, debridement and wound care, physical agents and modalities, mechanical and electrotherapeutic modalities, manual therapy including soft tissue and joint mobilization and manipulation, functional training in self-care and home, community or work integration or reintegration, prescription application and, as appropriate, fabrication of assistive, adaptive, orthotic, prosthetic, protective or supportive devices and equipment” (Section 9, 9(b). In other words, House Bill 3824 would allow physical therapists in Oregon to administer vaccines and include dry needling in the treatment of their patients.
Opposition
As expected, initially, about 50 acupuncturists submitted opposing testimonials and letters to the Oregon House of Representatives, sharing many unsupported assumptions, opinions, and claims. One acupuncturist expressed opposition to “this measure because it allows PTs to perform dry needling without proper acupuncture training. This puts the public at risk for pneumothorax, muscle fiber tears, organs being punctured, fascial tears, risk of infection, and increased pain.”
Acupuncturist WS reported that “over the years, I have personally treated patients who experienced pain, nerve damage, and complications after receiving dry needling from inadequately trained practitioners. These are not hypothetical risks. They are real people who walked through my clinic doors, frightened and in pain, because someone inserted a needle too deeply or without proper anatomical understanding.” This is curious as dry needling by physical therapists has not been legal in Oregon for many years, but perhaps these patients traveled from other states…..
Acupuncturist JP wrote “If you look at the literature, injuries such as pneumothorax have occurred when people untrained in acupuncture (PT’s, chiropractors, etc) have performed “dry needling”. For the public’s safety, it is best to oppose this bill and let those trained and licensed in this modality perform this treatment on patients.” Acupuncturist AW claimed that “needle insertion is acupuncture and requires extensive education — over 2,500 hours — not a short weekend course.”
It may be hard to believe that acupuncturists in Oregon have such difficulty accepting that it is in the best interest of any healthcare delivery system to have substantial overlap in practice. Just in case, you are questioning whether these claims were made, listen to a “live” testimony, full of unsubstantiated claims based on assumptions, hearsay, and anxiety about non-acupuncture professions using a filament needle:
This erroneous testimony suggests that physical therapists would not receive adequate training to use dry needling safely, which contradicts objective studies, such as the “Dry Needling Competency Update: Report Memo 2024,″ released on October 24, 2024, by the Healthcare Regulatory Research Institute (HRRI), in partnership with the Federation of State Boards of Physical Therapists (FSBPT) and the Human Resources Research Organization (HumRRO) (Harris, J. L., Caramagno, J., Bryant, E., Adrian, L., & Woolf, R. (2024). Dry Needling Competency Update: Report Memo 2024. Alexandria, Human Resources Research Organization).
Similar unsubstantiated claims have been dismissed across the United States, such as by the North Carolina Supreme Court, the Florida Administrative Court, and the Maryland Attorney General, among many others.
Physical therapist Dr. Jennifer Crane testified that in 2015, the Chinese Olympic Committee recruited her to work with Chinese Olympic athletes in preparation for the Rio Olympics. The Committee recognized that dry needling distinctly differs from acupuncture and wanted their athletes to benefit from diverse treatment options. She shared that she worked alongside their acupuncturists and TCM doctors as a valued team member, not as their competition. They never referred to dry needling practice as acupuncture; they had a distinct word for it, which was paired with the Mandarin word for physical therapist. They never questioned her competence or safety; they assigned her to work exclusively with their top gold medal contenders. She concluded her testimony with “my hope in sharing this story is that if traditional Chinese medicine practitioners in China, the birthplace of acupuncture, can recognize the distinct value of dry needling as performed by physical therapists, we in Oregon can, too.”
False and Misleading Statements
Another acupuncturist claimed that “a 2014 survey of 20,000 dry needling sessions found that over one-third caused adverse effects, including major complications like pneumothorax and nerve injuries.” Interestingly, the author cited “Brady S, et al. Adverse events following trigger point dry needling: a prospective survey of 20,000 treatments. PM&R. 2014;6(9):847–852.”
While this may sound convincing at first glance, I want to emphasize that this reference does not exist and is entirely fictitious.
Page 847 of issue 9 in volume 6 (2014) of the PM&R journal is in the middle of an article entitled “Neuromuscular Ultrasound Application to the Electrodiagnostic Evaluation of Quadrilateral Space Syndrome,” written by Chen, Onishi, Zhao, and Chang (PM&R. 2014;6(9):845-848).
In case you were wondering, there is an adverse events study by Brady (et al.), which she co-authored with McEvoy, Dommerholt, and Doody. This study of 7,629 dry needling treatments was published in the Journal of Manual and Manipulative Therapy in 2014, and showed that the risk of a serious adverse event was less than 0.04%!
As a side note, according to ORS 171.764 – False statement or misrepresentation by lobbyist or public official, “No lobbyist or public official shall make any false statement or misrepresentation to any legislative or executive official or, knowing a document to contain a false statement, cause a copy of such document to be received by a legislative or executive official without notifying such official in writing of the truth as prescribed in subsection (2) of this section.”
Several acupuncturists, including acupuncturist WS, reported the same false statements and repeated the non-existent Brady et al. reference and added some additional misleading references, such as “Other studies document similar outcomes, including hospitalizations, nerve palsies, and even bilateral pneumothorax” (Majchrzycki et al., 2022; Şahin et al., 2020). Majchrzycki contributed to only one dry needling paper in 2022 as the fifth listed author:
Trybulski, R., Kużdżał, A., Kiljański, M., Gałęziok, K., Matuszczyk, F., Kawczyński, A., & Clemente, F. M. (2024). Adverse reactions to dry needling therapy: Insights from Polish physiotherapy practice. Journal of Clinical Medicine, 13(7032). https://doi.org/10.3390/jcm13237032
Interestingly, that paper reports “Severe adverse effects were extremely rare in clinical practice: pneumothorax and shock were each reported by 3% of respondents, nerve palsy by 14%, infection by 2%, and hospitalization by 1%. In conclusion, this study suggests that most adverse effects are mild, typically involving bleeding and slight pain during or after treatment.” Given that the survey was of 102 Polish physical therapists, one person was hospitalized, most likely for a pneumothorax, which was reported in 3% of respondents.
The second reference (Şahın N, et al. A Rare Complication Caused by Dry Needling: Bilateral Pneumothorax. JournalAgent. 2020) could not be retrieved either. When searching for this reference, JournalAgent brought up a different paper: Koczaci, N., Yalçin, N. C., Özkaya, M., Kirpat, Ö., & Çelik, A. (2017). A rare complication caused by dry needling method: tension pneumothorax. Respiratory Case Reports, 6(3), 145–148. Amazingly, quite a few of the opposing acupuncturists cited the same non-existent references in support of their claims, which strongly suggests that they were following a template without having any knowledge of the claims they submitted.
There is no question about serious adverse events associated with dry needling and acupuncture. Sadly, the opposing acupuncturists seem to imply that adverse events are unique to dry needling by physical therapists. Still, they have been reported in acupuncture practice as well (Ernst, E., & White, A. R. (2000). Acupuncture may be associated with serious adverse events. BMJ, 320(7233), 513–514; McDowell, J. M., & Johnson, G. M. (2014). Acupuncture needling styles and reports of associated adverse reactions to acupuncture. Medical Acupuncture, 26, 271–278). In both fields, serious adverse events are rare.
In contrast to the opposing acupuncture testimonials submitted to the Oregon House of Representatives, Dr. Linh Taylor, DTCM, LAC, CMTPT/DNAc responded,
“I agree that physical therapists and chiropractors shouldn’t needle patients without proper training. However, instead of banning these professions from doing it, risking improper conduct, let’s reinforce quality and proper training to keep our patients safe. Some of the incidents listed sound horrendous. This is absolutely not my experience with dry needling training with Myopain Seminars. I was trained with PTs and by PTs and acupuncturists. The dry needling training I received placed safety, precautions, and red flags above all else. Each muscle was taught one by one, practiced under strict supervision, and you have to pass both written and practice exams in order to treat the public. I learned more needling techniques, safety, and anatomy in one year with Myopain Seminars than I did in 4 years in acupuncture school.
At the end of the day, acupuncture or dry needling, orange or tangerine, the best medicine is the medicine that works. Acupuncture works. Dry needling works. Physical therapy works. Chiropractic works. Does it work for everyone? Probably not, but that’s more reason for all of us to work together and train together to bring the best outcome to our patients, family, and our own health.”
Senate Committee on Health Care
On May 6, the Oregon Senate Committee on Health Care started considering the bill. The final count of opposing and supporting testimonials submitted to the Committee was 598 opposed and 626 in support. The bill is scheduled for further consideration on May 20, 2025.
As usual, Myopain Seminars will keep you up-to-date on all dry needling legislative updates in the country.
