This policy statement is issued to clarify that dry needling, as defined below, is within the scope of practice for physical therapists in the District of Columbia as long as it is practiced under the conditions set forth in this guidance document.

Dry needling is an advanced procedure that requires additional training before it can be performed.  The Board is currently in the process of drafting rulemaking to clarify and establish the training, informed consent, and recordkeeping standards that must be met and adhered to by any D.C. licensed physical therapist that performs dry needling procedures and techniques in the District of Columbia. 

A physical therapist must have the knowledge, skill, ability, and documented competency to perform an act that is within the physical therapist’s scope of practice. 
A physical therapist that performs dry needling in the District of Columbia, without documented proof of having sufficient education and training to ensure competence with the treatment or intervention, may be subject to disciplinary action under the Act.  If you are unclear as to whether your education and training is sufficient, please contact the Board for further guidance.

Dry Needling: is a physical intervention that uses a filiform needle to stimulate trigger points and treat neuromuscular pain and functional movement deficits; is based upon Western medical concepts; requires an examination and diagnosis; and treats specific anatomic entities selected according to physical signs.  It is not acupuncture.  No physical therapist may engage in the practice of acupuncture in the District of Columbia unless he or she holds a valid license to practice acupuncture from the District of Columbia Board of Medicine.

• Dry needling is an advanced procedure that requires additional training.

• A physical therapist using dry needling must have documented proof of having sufficient education and training to ensure competence with the treatment or intervention.  The Board strongly recommends completion of a board-approved or Commission on Accreditation in Physical Therapy Education (CAPTE) approved professional training program on dry needling that includes evidence of meeting expected competencies and demonstration of cognitive and psychomotor knowledge and skills, and that is not an online or self-study course, or graduate or higher level coursework in a CAPTE approved educational program, which included dry needling in the curriculum.

• The licensed physical therapist bears the burden of proof of having sufficient education and training to ensure competence with the treatment or intervention.

• Dry needling procedures should be performed in a manner that is consistent with generally accepted standards of practice, including clean needle techniques, and other applicable standards of the Centers for Disease Control as they may be amended or republished from time to time.

• A physical therapist who performs dry needling procedures should obtain written informed consent from each patient that will receive dry needling, and should provide the patient with a copy of the informed consent form prior to performing the procedure.

• The informed consent form should include: the patient’s signature, the risks and benefits of dry needling, the physical therapist’s level of education and training in dry needling, and a clearly and conspicuously written statement that the patient is not receiving acupuncture.  It should further advise the patient that acupuncture treatment, as performed by a licensed acupuncturist, might yield a holistic benefit not available through a limited dry needling treatment.

• A physical therapist who performs dry needling procedures should maintain a separate procedure note in the patient’s chart for each treatment and the note must indicate how the patient tolerated the technique as well as the outcome after the procedure.

• A physical therapist that performs dry needling procedures must be able to produce documentation of meeting these requirements upon request by the board or an agent of the board as proof that the physical therapist is practicing within the scope of practice of physical therapy.