Wednesday, April 27, 2016

Dr. Zhu Position Statement on Dry Needling by Physical Therapists in Tennessee

Chongbin Zhu, Ph.D., M.D. L.Ac
Associate Professor
Acupuncture Division
Vanderbilt Center for Integrative Health
I am writing this letter to discuss the issue regarding the practice of acupuncture and so-called “dry needling” .
Let’s look at the definition of “acupuncture” and “dry needling” .
Officially, in the website of National Institute of Health, it is stated that “ The term "acupuncture" describes a family of procedures involving the stimulation of anatomical points on the body using a variety of techniques. The acupuncture technique that has been most often studied scientifically involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation. (
Dry Needling is a general term for a therapeutic treatment procedure that involves multiple advances of a filament needle into the muscle in the area of the body which produces pain and typically contains a 'Trigger Point’. “
Depending on the brand, we highly recommend using Seirin brand filament needles,…” (
By the definitions, is there any significant difference between the two? The answer is obviously no. The tools used are the same (the Seirin brand filament needles were actually labeled as “acupuncture needles”. When using a needle to penetrate the skin, regardless in the “trigger points” or traditional acupoints, it already falls into the scope of acupuncture.
In traditional acupuncture theories, meridians are the basic systems to guide the acupuncture treatment. There are 14 regular meridian systems, but there are countless branches of those systems covering all aspects of human body. There are classical acupoints distributed along the meridian systems, there are acupoints that do not go along the meridians called “extra acupoints outside the meridians”, and there are also countless acupoints called “A’Shi” points representing the places or area where the pain and discomfort are produced. These “extra acupoints” and “A’shi” points are literally “Trigger Points”, not to mention that most of the classical acupoints are also “Trigger points” . Therefore, no matter it is called “dry needling” or other names, or whether using or not using traditional meridian theory, there’s no difference of the two practice—they are all the techniques from acupuncture. In fact, the originators and proponents of dry needling acknowledged the origin and inspiration of this technique to be acupuncture.
Recent studies also demonstrated that the trigger points are not distinct from acupoints. In 1983, Janet Travell et al. described trigger point locations as 92% in correspondence with known acupuncture points. In 2006, Peter T. Dorsher, acupuncturist at the Mayo Clinic, concludes that the two point systems are in over 90% agreement. In 2009, Dorsher and Fleckenstein conclude that the strong (up to 91%) consistency of the distributions of trigger point regions’ referred pain patterns to acupuncture meridians provides evidence that trigger points most likely represent the same physiological phenomenon as acupuncture points in the treatment of pain disorders. An article in Acupuncture Today (May 2011, p. 3, “Scope and Standards for Acupuncture: Dry Needling?”) further corroborates the 92% correspondence of trigger points to acupuncture points. The North Carolina Acupuncture Licensing Board has published a position statement asserting that dry needling is acupuncture and thus is covered by the North Carolina Acupuncture Licensing law, and is not within the present scope of practice of Physical Therapists, and Physical Therapists are not among the professions exempt from the law.
In acupuncture field, it requires3-8 years post-graduate training before one can goes to practice. It specifically required the technique of the needling to be enhanced to the level that does not generate any harm or any unwanted effect. There are a variety of techniques in acupuncture needling, each of which may result in different effect. Doing it without such knowledge, it most likely will do harm than benefit. One can not simply insert a needle to treat a condition without sufficient training.
Please let me know should you have any further questions.
Chongbin Zhu, Ph.D., M.D., L.Ac

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