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.
California
On May 6, AB 2497 (Modernization of the California PT Practice Act) was placed on the California Assembly Suspense Calendar. The suspense calendar is a procedural tool used by the California Legislature to manage bills with significant fiscal impact (legislation proposed to cost the state $150,000 or more). It allows the Appropriations Committee to decide the fate of these bills in a single hearing.
Bills are either advanced for a vote or held and effectively “Fail” without a public explanation. On May 14, 2026, the Assembly Appropriations Committee passed the Bill with certain amendments, for now still undefined.
The bill will be heard next on the Assembly Floor in late May.
Netherlands
The Dutch Physiotherapy Quality Council has updated its position statement on dry needling. After reassessment based on the current criteria, the position remains unchanged: dry needling falls within the scope of physiotherapy, but it must be part of an assessable physiotherapy treatment plan. The Physiotherapy Quality Council consulted with Jan Dommerholt, President and CEO of Myopain Seminars.
Within physiotherapy, dry needling is classified as a specialized procedure. Therefore, the advice and recommendations in the brochure Careful Practice in Reserved and Specialized Procedures, as well as the KNGF Recommendations for the Safe Application of Dry Needling, apply and should be consulted beforehand.
Notably, the recommendations were written by physiotherapists Beersma, Eleveld, Leidekker, van Liere, Luitjes, and Timmermans. Most of the authors are affiliated with Myofasciale Pijn Seminars, our partner organization in the Netherlands.
How are position statements established in the Netherlands?
Since 2023, the Quality Council has established position statements based on the Professional Profile of the Physiotherapist and additional criteria. These position statements determine which interventions do or do not belong within the professional scope. With each new or revised decision, the professional standard, Position Statements Regarding the Scope of Physiotherapy, is updated.
Pennsylvania
House Bill 2070, sponsored by Representative John Schlegel, which would allow physical therapists in Pennsylvania to use dry needling, has been in the House Professional Licensure Committee since December 3, 2025.
According to the Bill, “Dry needling” shall mean a physical intervention that uses a filiform needle to stimulate trigger points and diagnose and treat neuromuscular pain and functional movement deficits. The term does not include the stimulation of auricular or any other points based upon areas of oriental medicine or the practice of acupuncture under the act of February 14, 1986 (P.L.2, No.2), known as the “Acupuncture Licensure Act.”