Dry needling is an acupuncture style that has been gaining popularity in the last few years. It is a type of acupuncture that has been used by physical therapists and Chiropractors as a method of treating musculoskeletal problems primarily related to trigger points. Dry needling involves the precise insertion of acupuncture needles into small knots of muscle called trigger points. Trigger points are often found within tight or spasmed bands of muscle and often refer pain to areas not necessarily located at or near the trigger point. When a needle is inserted at the right location and the correct manipulation method is used a noticeable twitch or release of the muscle can occur. The mechanism of this is not totally understood by modern science, but has been explained in acupuncture texts for thousands of years.
Is Dry Needling Acupuncture?
In short yes, dry needling is a single style of Chinese acupuncture that has been taught, practiced, studied, and written about since the Han Dynasty (206 BC–220 AD). There is nothing new about dry needling other than interest. Currently, as acupuncture has become popular because of its effectiveness, there is more scientific research concerning its effect on the musculoskeletal system. Simply put, dry needling is one of many different acupuncture styles that many acupuncturists do. An acupuncturist will typically modify or gear the type of acupuncture they perform based on the patient’s chief complaint and diagnosis. Insomnia or infertility are very different than chronic neck pain or a pulled hamstring and thus require a different method of treatment.
The term “Dry Needling” was coined as a way for Physical Therapists and Chiropractors to get around acupuncture licensing requirements. The education requirements to have an acupuncture license and to perform dry needling are quite different.
So, why see an acupuncturist instead of another practitioner?
It simply boils down to experience and safety. In the last few years the majority of injuries and adverse reactions to treatments have been experienced from being treated by Chiropractors and Physical Therapists and not acupuncturists. The injuries reported have been everything form nerve damage to collapsed lungs. These practitioners truly mean well and are trying to help their patients, but they are simply undereducated in the process of acupuncture/dry needling. This has lead to states like Washington to ban Physical Therapists from doing dry needling and requiring an acupuncture license to perform it. Additionally, The Food and Drug Administration (FDA) classified acupuncture needles as Class II medical devices subject to strict regulations under the federal Food, Drug, and Cosmetic Act (FDCA) and FDA’s regulations. Individuals purchasing or receiving acupuncture needles who are not licensed by law to practice acupuncture are directly violating both civil and criminal provisions of the FDCA intended to protect public safety. 21 U.S.C. § 331(a)–(c), (g).
The FDA's own website says, "The patient(s) expected that her health care provider be appropriately licensed in safety inserting needles into the tissues of the body. It is unknown where this practitioner was trained. An acupuncture practice act exists to maintain the highest credentials and skills needed to use acupuncture needles as regulated by the fda and licensed by (b)(6). This practice act is being bypassed by physical therapists and chiropractors with training that may be as little as 54 hours in (b)(6) in a continuing education course with non educational standards, no state registration, no board exams and no clinical time."
Lastly, with regard to insurance and Medicare, since “dry needling” is acupuncture, it is not a covered service. Use of acupuncture needles is not a covered service, whether an acupuncturist or any other provider renders the service. 42 U.S.C. § 1395y(a)(1). Its billing under Current Procedural Terminology (CPT) codes 97112 (neuromuscular reeducation) or 97140 (manual therapy techniques) is a misrepresentation of the actual service rendered and is considered fraud by Medicare. 31 U.S.C. §§ 3729–3733.