Dry needling and legal issues

DR. SUBHANJAN DAS, PTSubhanjan_82@yahoo.co.in

+91 8967549104Dry Needling Instructor

MPT (Musculoskeletal & Sports)Assoc. Prof., BIMLS, Burdwan

Also in the serieshttp://www.slideshare.net/SubhanjanDas/introduction-to-dry-nee

dling

http://www.slideshare.net/SubhanjanDas/2-brief-hisory-of-needling

http://www.slideshare.net/SubhanjanDas/3-superficial-dry-needling

http://www.slideshare.net/SubhanjanDas/4-indications-of-dry-needling

http://www.slideshare.net/SubhanjanDas/6-dangers-of-dry-needling

http://www.slideshare.net/SubhanjanDas/7-physiologic-background-of-dry-needling

http://www.slideshare.net/SubhanjanDas/8-dn-vs-acupuncture

http://www.slideshare.net/SubhanjanDas/9-electroacupuncture

http://www.slideshare.net/SubhanjanDas/10-legalities-involved-in-dry-needling

Issue: is it within the scope of physiotherapy?Dry needling is practiced by physical

therapists in many countries, including South Africa, Bangladesh, the Netherlands, Spain, Switzerland, Canada, Chile, Ireland, the United Kingdom, Australia and New Zealand1

Issue: is it within the scope of physiotherapy?Of the approximately 9,000 physical

therapists in South Africa, over 75% are estimated to employ the technique at least once daily2

Issue: is it within the scope of physiotherapy?In the United States 33 states allow dry

needling by physiotherapists, 4 states ( California, Hawaii, New York, and Florida) prohibit practice of dry needling, in fact they do not allow physical therapists to penetrate the skin1,3.

Rest of the states do not have clear guidelines regarding physical therapists practising DN.

Issue: is it within the scope of PT?As DN is a comparatively new modality, many

authorities are in the process of recognizing DN, example, Arizona State Board of Physical Therapy allowed PTs to perform DN only in 22 Oct 20134!

HISTORICAL PERSPECTIVEIn the initial days of spinal manipultion Dr.

Janet Travel discouraged Stanley Paris from manipulation by saying, “Manipulation is a diagnostic and therapeutic tool to be reserved for physicians only.”5

Scenario in IndiaNo clinical practice guideline exists

regarding physiotherapy. The D&C act 1940 prevents PT’s to

administer prescription drugs. Dry needling does not use any drug.

Lidocaine or corticosteroids, sometimes injected to the trigger point can not be independently administered by a physio.

Who can perform acupuncture?Various organizations run acupuncture courses,

e.g. Singhania university (UGC & AICTE approved)has a certificate course where the eligibility is 10th pass. The web is full of certificate, diploma, degree and even MD courses. There is need for definitive guidelines.

Final wordPhysiotherpists in India can legally perform

needling within present system.It is highly unlikely that this locus standi will

change in future.

1. http://en.wikipedia.org/wiki/Dry_needling2. Dommerholt et. al, Trigger point dry needling,

The Journal of Manual & Manipulative Therapy Vol. 14 No. 4 (2006), E70 - E87

3. Hawaii Revised Statutes. Chapter 461J; Physical Therapy Practice Act. Article §461J-2.5 Prohibited practices, 2006.

4. http://www.ptboard.az.gov/docmgt/docs/dryneedlingbyPT.pdf

5. Paris SV. In the best interests of the patient. Phys Ther 2006;86:1541-1553.