State Forces Physical Therapists to Wind Down ‘Dry Needling’ Treatment

Lilo H. Stainton | May 30, 2017 | Health Care
Therapists’ decade-long practice to end; acupuncturists, other professionals accused them of performing ‘unlicensed acupuncture’

dry needling
Hundreds of New Jersey physical therapists now offering “dry needling” will no longer be able to treat their patients using this pain-relief technique come September, ending a nearly decade-long practice and easing concerns among acupuncturists who felt it infringed on their own profession.

The state board that regulates physical therapists notified providers last week that they could no longer accept new dry needling patients after July and would need to suspend their use of the practice entirely by the end of August.

Some physical therapists have been providing dry needling for years, emboldened by a previous ruling by the panel, the New Jersey State Board of Physical Therapy Examiners, which suggested the procedure was within their purview.

But an opinion issued in February by the state Attorney General’s office made clear that dry needling was not part of the legal “scope of practice” for physical therapists, whose work traditionally involves non-invasive procedures.

The state physical therapy board — which operates under the Division of Consumer Affairs, a program of the AG’s office — had requested state permission to allow providers to phase out their use of the treatment through January 2018, when the licensing period for the profession ends. Instead, state officials said they must wind it up by September.

A representative for the American Physical Therapy Association of New Jersey said the group respected the decision and appreciated the grace period it allowed them to help patients transition to other care.

“Hundreds of physical therapists have provided this treatment safely and effectively for nearly eight years in New Jersey without any reported incident prior to the Attorney General’s opinion,” added Paul Vidal, a physical therapist who is the association’s president. “We will do what we can to support our patients and the profession.”

The president of the New Jersey Association of Acupuncture and Oriental Medicine, acupuncturist Jason Sargis, said, “The acupuncture community commends the [physical therapy] board for complying with the rule of law and agreeing to properly regulate its licensees.”

Dry needling involves the use of acupuncture-like needles to pierce the skin slightly and stimulate certain “trigger points” of muscles; acupuncture uses similar needles to activate nerve impulses to reduce pain or address other conditions, including complex issues like depression, addiction, and obesity.

Acupuncturists, who are licensed and regulated separately, insist that 95 percent of the time the needles are being used in the same places on the body, and have accused physical therapists of performing “unlicensed acupuncture.” There are just over 1,000 licensed acupuncturists in New Jersey; Sargis said these providers, also trained in dry needling, were available to treat patients currently seeing physical therapists.

Non-addictive option

Only a small segment of the state’s 11,000 licensed physical therapists was offering dry needling, which they call “another tool in the toolbox” for their profession. Physical therapists claim they are not trying to infringe on other providers’ territory, but are looking to help patients who are frustrated with pain. In particular, they said it offered an important non-addictive option for pain relief at a time when the public is seeking alternatives to opiates.

“We are grateful that patients were able to receive this non-narcotic form of pain relief during a grace period after the New Jersey Attorney General’s opinion and will continue examining ways to make sure they have access to qualified healthcare providers and treatment when making their pain management decisions,” Vidal, APTANJ president, said.

Dry needling has grown in popularity in recent years although the professionals involved have tried for some time to resolve the dispute over its use. The disagreement was exacerbated in 2012 when a Colorado company led a series of dry-needling courses in New Jersey that were tailored to physical therapists.

Acupuncturists, others complained

That prompted acupuncturists and other professional societies to complain to the Division of Consumer Affairs, urging it to rein in use of the procedure. The ruling in February from the AG’s office appeared to have settled the dispute; the only question seemed to be how long physical therapists would have to phase out the practice.

Sargis, with the acupuncture association, said the recent letter to physical therapists “finally puts to rest” the argument over dry needling, making it clear the procedure is off-limits to physical therapists. “Unfortunately, the [past] misinterpretation of the current statutes by the PT board led a group of PTs to offer dry needling to their patients with minimal training,” he added.

As the dispute evolved over the years, physical therapists also tried to expand the scope of work through legislative change. But proposals that included dry needling were blocked by other provider organizations concerned in part that physical therapists would infringe on their territory.

On Thursday the Senate passed the latest version of this effort, (S-1315), a bill that would update the 1983 licensing act for physical therapists; a companion measure is making its way through the Assembly. Among other things, it further defines the role of physical therapist assistants, expands the schedule for licensing exams, and expands their scope of work to include balance disorders and certain types of wound care — but not dry needling.