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Law clears way for regulation of dry needling in physical therapy

A patient receives a dry needling treatment. (Cronkite News Service Photo by Rachel Leingang)

A patient receives a dry needling treatment. (Cronkite News Service Photo by Rachel Leingang)

A new law clears the way for dry needling, the use of thin needles to stimulate tight muscles, to be regulated as part of accepted physical therapy practice in Arizona.

The battle over the legislation, signed into law last week by Gov. Jan Brewer, pitted physical therapists against acupuncturists who said more training is needed to use needles on patients.

Last October, the Arizona Board of Physical Therapy approved dry needling as within the scope of practice for physical therapists but said the panel didn’t have the power to make any rules or regulations for the practice. The bill exempts the board from any standard rulemaking procedures and allows them to come up with standards for dry needling.

“Even though they don’t have to follow the normal steps, they’re still going to do a public process,” said Charles Brown, executive director for the board. “They’ll seek public input on their plan, which would include the various professions involved.”

SB 1154, authored by Sen. Kelli Ward, R-Lake Havasu City, requires the physical therapy board to make rules and standards for the practice by July 1, 2015. The board will also be allowed to take disciplinary action against physical therapists who don’t follow the rules.

Sean Flannagan, a physical therapist who practices dry needling, said he thinks the law is a great move for the profession and for consumers.

“I think our Legislature did a really good job in being fair, and that’s what this whole thing was about – to be fair and allow people to have a choice between traditional Chinese medicine and Western-based sciences,” he said.

The Arizona Board of Acupuncture Examiners wrote a letter urging Brewer to veto the bill, saying the physical therapy board needed to follow proper procedures and set up a minimum protocol for education, something the group said the bill doesn’t do.

“My Board believes that there are significant public health implications of having a health care professional such as physical therapists engage in an invasive practice without clear demonstration that public health and safety is protected,” John Rhodes, the board’s chairman, wrote in the letter.

The Coalition for Arizona Acupuncture Safety also wrote a letter to Brewer to encourage her to veto the bill, citing similar concerns about procedures and education.

The coalition’s co-chair, acupuncturist Lloyd Wright, said the bill’s definition of dry needling as a “skilled intervention performed by a physical therapist” is troubling because he thinks dry needling and acupuncture are the same.

“We were very puzzled as to why we need to have separate definitions for the same procedures,” Wright said. “Does the public know the difference? Do they know that there is practically no difference? These are all big question marks. Right now, we are loaded with question marks.”

Flannagan said that argument doesn’t really apply – the physical therapy board can only regulate and define physical therapy.

“I think the acupuncture community as a whole missed a big opportunity had they not resisted the physical therapists but embraced them,” Flannagan said. “I think needling could’ve been more accepted.”

Pete Gonzalez, executive director of the acupuncture board, said there’s been a misconception throughout the process that acupuncturists want to regulate dry needling.

“It’s not our job to regulate physical therapy; that’s the physical therapy board’s job. We’re just asking them to do it,” Gonzalez said. “What we’re saying is that the physical therapy board needs to do that so that the public clearly understands who’s responsible and knows exactly what’s being performed on them.”

Brown said the physical therapy board will welcome any input while it works to make dry needling rules.

“It’s just part of our process,” he said. “Someone being involved is not an issue, whether they’re for or against it, it’s important that they get involved. The board just wants the best product while protecting the public.”

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