My Dry Needling Blog: Why Do I Care What They Say?

Why Do I Care What They Say?

Everyday I see a comment like these:

"While both carry risk, acupuncturists have vastly more needle safety and treatment supervision in their significantly longer training. The two professions shouldn’t be equated when it comes to needling safety." - By an acupuncturist 11/9/18.

"Dry needling looks like acupuncture because it is acupuncture. It’s orthopedic acupuncture/trigger point acupuncture—one style out of the many styles of acupuncture. Physical therapists are trying to evade the same training and regulations that acupuncturists go through (my masters degree alone was 4.5 years) by taking weekend crash courses and labeling the process with biomedical terms. Some of them truly believe they are doing something different, bless their hearts. They have better lobbying power and are more organized as a field which is why this wasn’t put to bed like it should have been a decade ago." - By an acupuncturist responding to an article about the recent fight in New Jersey about allowing physical therapists to renew their right to use dry needling. New Jersey PT's had been dry needling since 2009 until the acupuncture association challenged them and a ban went in place in 2017.

I've been going about my business being a physical therapist for nearly 20 years. When I started using dry needling as a treatment technique 9 years ago and for the past 9 years I have felt beaten up by the acupuncture community. The issue of us using needles to help with our clients pain syndromes has not yet become accepted by a seemingly majority of the acupuncture community. As stated in my previous blogs, there has been ongoing legal battles across the nation, trying to prevent physical therapists from performing dry needling. They continue to claim superiority of education as measured in a certain number education hours, not in terms of clinical working hours, mind you. They continue to tell the public that physical therapists are unsafe with needles and that acupuncturists are impeccably safe with needles. Research shows that no profession (MD, Surgeon, Nurse, PT, Acupuncturist, Chiropractor, Fitness Instructor, Massage Therapist, Sports Coach....) is immune to mistakes, injuries, mis-judgements.

So, why do I care what they say? Easy, they have been loudly discrediting my profession, they have been spending unquantifiable and unjustifiable amounts of money getting the word out that we are uneducated, unsafe, and illegal because we use the technique of dry needling. Over the past 9 years, I have been nervous to speak out against the rhetoric that I hear verbally and see in print everyday. I have quietly, and effectively gone about my job as a physical therapist. Yes, I use dry needling. Yes, I help clients with their pain. No, I do not discredit or disrespect the acupuncture profession. I have given up trying to compare/contrast dry needling and acupuncture because I just don't really wish to take time in my day to talk about acupuncture. The scars of being battered are starting to run deep. I will always tell people to find the providers that help them get better, no matter who the provider is. I tell clients it is better to try a variety of things if they can avoid costlier options like pain medications, injections, and surgery.

So, why do I care what they say? Many physical therapists are a lot like me. They quietly go about their daily business of helping people feel better, move better, and improve their function. PT's generally are not marketing machines. They don't have new clients walking in everyday for pain relief, like a chiropractor might. In many states PT's can't even see clients unless a doctor makes a referral. Over the past 10 years, PT's like myself have been keeping their skills of dry needling under wraps and only promoted within their websites and through word of mouth. They have been scared of putting these skills out publicly, because of fear of backlash and being insulted. Across the nation, PT's have not been taken seriously as people who can really help pain. Yes, those of us that do dry needling, are excited to be able to reduce people's pain effectively and efficiently. We have not had the luxury of being able to promote dry needling. Instead, due to lack of public awareness of this technique, we still must approach each patient individually and offer or advise trying dry needling for their neuromuscular pain. We must still be asked how it differs from acupuncture. With all of the negativity that surrounds the topic of dry needling vs acupuncture, it is hard to inform without bias. In my clinic, I have taken the stance of just describing what dry needling is and if they need further information on acupuncture I try to point them in a good direction to research it. I try not to compare or contrast.

So, why do I care what they say? Dry needling, in my experience, is a very effective method of quickly changing pain symptoms. Clients typically do not need extensive physical therapy plans of care involving dry needling. It is an extremely cost effective way of targeting pain compared to medications, injections, and surgery. Steroid injections have about a 5% chance of providing any long term pain relief and there are certainly risks attached to having such injections. Less than 6% of back pain patients that see an MD will ever be referred to physical therapy or other holistic practitioners for treatment options. More commonly, they will be offered pain medications, MRIs, and injections. We are well aware that there is a pain and opioid epidemic across our nation. In 2016, 42,000 Americans died from opioid overdoses. Yes, 42,000 Americans died from opioid overdoses, recently.

So, why do I care what they say? If acupuncturists do not want physical therapists to fight the fight against pain, who can we rely on? The acupuncturists? No. There are roughly 32,000 active acupuncture practitioners in the United States and most (>70%) of them practice in California, New York, Florida, and Colorado. Did I mention 42,000 Americans died from opioid overdoses in 2016? I will not go into my opinion of physical therapists not being able to provide dry needling in NY and California due to the strength of the acupuncture associations. It's ridiculous. The pain and addiction numbers prove how inane it is that PT's can't use dry needling in California and New York. Enough said, for now.

So why do I care what they say? There is more to it than pain. We have the ability to change neuromuscular conditions. We should be broadening our reach with dry needling, no matter who performs it (acupuncture, chiropractic, PT, MD), instead of hiding it. We should be collaborating as professionals, not back stabbing. We should be doing research into effectiveness or ineffectiveness. We should be studying effects on strokes, Parkinson's Disease, cerebral palsy. We should be studying the effects in the athletic populations, musicians, custodial workers, laborers, and general office workers. We should not be emphasizing each other's mistakes and scaring the general population, but bringing attention to each other's successes. Dry Needling should not be a term that connotes dread, pain, or pure pain relief. It is a technique that can help.

This is why I care what they say.