Brazil
On September 12, 2016, Brazil’s Federal Council of Physical Therapy and Occupational Therapy (COFFITO) unanimously declared that dry needling falls within the scope of physical therapy practice, as per Resolution No. 481/2016.
It did not take long for the Brazilian Medical College of Acupuncture (CMA) to file a lawsuit against the Council with the Federal Regional Court of the 1st Region (TRF1).
On October 16, 2019, the Courts reached a verdict and annulled Resolution No. 481/2016 and the resolutions derived from it. According to the Court’s Ruling, “dry needling is a practice derived from acupuncture, consisting of the insertion of a physical material to treat inflammation and other conditions. It has been described as a defective term often used to refer to acupuncture based on musculoskeletal anatomy and myofascial physiology—more appropriately termed “myofascial trigger point acupuncture.”
As a side note, in a recent webinar for members of the International Acupuncture and Dry Needling Association of Physiotherapists (IADAPT https://iadapt.physio/), I noted that, from a physical therapy perspective, dry needling originated in the medical practice of trigger point injections. However, from an acupuncture perspective, dry needling is no different from needling Ashi points, which was already recommended in the Ling Shu, translated as “Spiritual Pivot.” This cardinal acupuncture source is part of the Huangdi Neijing, or Yellow Emperor’s Inner Canon, likely compiled between the 2nd and 1st centuries BCE during the Han Dynasty. Ashi needling remains an established practice in acupuncture.
Back to Brazil. The COFFITO appealed the Court’s ruling to the 7th Panel of Judges of Brazil’s Federal Regional Court of the 1st Region, a federal appeals court. The Appeals Court unanimously upheld COFFITO’s appeal and recognized the validity of COFFITO Resolution No. 481/2016.
On April 28, 2026, the Court acknowledged similarities between dry needling and acupuncture. It also recognized the consolidation of a new legal framework through Law No. 15,345/2026, which regulates acupuncture as a plural and multiprofessional field, allowing its practice by healthcare professionals with higher education and specific qualifications. The law was published on January 12, 2026, by the President of the Federative Republic of Brazil, Luiz Inácio Lula da Silva.
In other words, the lower court’s assumption of a medical monopoly was dismissed, and the ruling was overturned.
According to the Appeals Court, “the new legislation established an explicit legal basis addressing the central issue of the case, reinforcing that COFFITO’s progressive stance is aligned with current federal law and with the protection of society through the requirement of technical qualification of professionals.”
As a result, COFFITO’s institutional authority to regulate and supervise the professional practice of Physiotherapy is reaffirmed, including the use of dry needling by properly trained professionals. This represents an important precedent in defense of professional autonomy, legal certainty, the appreciation of Physiotherapy, and the recognition of healthcare as a multiprofessional field.
Source: Case No. 1014957-42.2019.4.01.3400, Judgment Session held on April 28, 2026.