Physical therapists’ dry needling ignites turf war with acupuncturists

PHOENIX — Golf instructor Chuck McDevitt had tried everything, physical therapy, exercise, acupuncture, to alleviate pain in his knees and back.

At the suggestion of his physical therapist, Sean Flannagan, he decided to try dry needling, a pain-relief technique that uses ultrathin needles to poke into and stimulate muscle tissue.

“I 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 — not a lack of energy flow.”

While the technique has been approved by the state board that oversees physical therapists, it has ignited a turf war with acupuncturists who said physical therapists don’t have enough training to use needles.

“This culture of casualness around acupuncture is hurting people,” said Lloyd Wright, an acupuncturist and traditional Chinese medicine practitioner with Stellar Physical Medicine in Scottsdale.

But 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 using needles.

“They want the public to believe they’re the experts on needling,” he said. “No one profession owns any modality. They share.”

The 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 didn’t have the authority under state law to set any training standards.

“It’s 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.

Rep. 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.

“All the board can do is follow the language as it’s written,” Boyer said. “The board believes they’re within their duties by adhering to the rule of law.”

The 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.

While 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 degree.

“For me to even sit in these courses, I had to have bachelor’s and doctorate degrees,” Flannagan said.

He said acupuncturists and physical therapists look at the body in different ways and that patients will choose which route is best for them.

“It’s kind of a one-way turf battle,” Flannagan said. “We don’t want to restrict acupuncture at all.”