ó Golf instructor Chuck McDevitt had tried everything ó
physical therapy, exercise, acupuncture ó to alleviate pain
in his knees and back.
suggestion of his physical therapist, Sean Flannagan, he
decided to try dry needling, a pain-relief technique that uses
ultra-thin needles to poke into and stimulate muscle tissue.
had acupuncture before that was supposed to heal something in
my back," McDevitt said. "But I needed spinal
manipulation, and I needed some dry needling that actually
addressed some of the muscle restrictions that I had ó not a
lack of energy flow."
the technique has been approved by the state board that
oversees physical therapists, it has ignited a turf war with
acupuncturists who say physical therapists donít have enough
training to use needles.
culture of casualness around acupuncture is hurting
people," said Lloyd Wright, an acupuncturist and
traditional Chinese medicine practitioner with Stellar
Physical Medicine in Scottsdale, Ariz.
Flannagan, who has been using dry needling to treat pain for
five years, said safety concerns are just a way for
acupuncturists to attempt to shut out physical therapists from
want the public to believe theyíre the experts on
needling," he said. "No one profession owns any
modality. They share."
Arizona Physical Therapy Board started investigating the
practice of dry needling in 2012 and determined late last year
that it falls within the scope of practice for physical
therapists. But the board decided that it didnít have the
authority under state law to set any training standards.
going to be up to the Legislature to determine if they want to
alter the laws to see if they want to add that
authority," said Charles Brown, executive director for
the board. "If they want this technique to be singled out
for initial competency requirement, they can give that to the
board. Or they can leave the laws alone, and it would be the
status quo that itís a technique within the scope of
Paul Boyer, R-Phoenix, vice chairman of the House Health
Committee, said board members worked with legal advisers to
determine if they could set these standards.
the board can do is follow the language as itís
written," Boyer said. "The board believes theyíre
within their duties by adhering to the rule of law."
House Health Committee will be having meetings for various
stakeholders on the dry needling issue in coming weeks and
determine a course of action, he said.
Wright said he would like to see some standards set for dry
needling, Flannagan said his training already sets standards,
including the type of sanitary practices dry needling
requires. Flannagan took additional training courses on dry
needling after finishing his Doctor of Physical Therapy
me to even sit in these courses, I had to have bachelorís
and doctorate degrees," Flannagan said.
acupuncturists and physical therapists look at the body in
different ways and that patients will choose which route is
best for them.
kind of a one-way turf battle," Flannagan said. "We
donít want to restrict acupuncture at all."
said the Physical Therapy Board would investigate individual
claims from patients to make sure physical therapists are
meeting a standard of care and would follow up with
enforcement if needed. But the board hasnít received any
patient complaints about dry needling, he said.
the complaints weíve received have been from sources other
than patients," he said.
said his primary concern is the patient, and ensuring a safe
and effective practice. He said the board should set a minimum
standard of training for dry needling by involving industry
experts, including acupuncturists, in the process.
need at least 1,850 hours of training, including 800 hours of
clinical experience, in order to practice, according to the
Arizona Acupuncture Board of Examiners.
in needles is an invasive procedure," Wright said.
"When you venture into piercing the skin, itís a whole
said lawmakers would move forward with legislation on dry
needling if the stakeholder meetings determine itís
necessary. Heís already met with physical therapists and
plans to meet with acupuncturists soon.
hope is they can come to a consensus on their own," he
McDevitt, the controversy over dry needling is more than just
a turf war and what may happen in the Arizona Legislature: Itís
about selecting the right treatment so he can continue
teaching and playing golf.
donít want someone telling me whatís best for my family or
myself," he said.
NEEDLING VS. ACUPUNCTURE:
of dry needling, according to Arizona Physical Therapy
Association: a skilled intervention performed by a physical
therapist (PT) that uses a thin filiform needle to penetrate
the skin and stimulate underlying neural, muscular and
connective tissues for the evaluation and management of
neuromusculoskeletal pain and movement impairments
of acupuncture, according to Arizona Acupuncture Board of
Examiners: puncturing the skin by thin, solid needles to reach
subcutaneous structures, stimulating the needles to affect a
positive therapeutic response at a distant site and the use of