Acupuncturists sue Colorado’s physical therapy board over the
very definition of their craft
Board policy allowing less-trained therapists to practice “dry needling” is unsafe, says Acupuncture Association of Colorado in suit.
The Acupuncture Association of Colorado has sued the state’s Physical Therapy Board for refusing to rescind a rule that allows the lesser-trained therapists to practice “dry needling,” a technique acupuncturists say is merely a euphemism for what they have done for centuries.
They claim the procedure is dangerous in the hands of an untrained practitioner and point to a number of Coloradans – including Olympic skier Torin Yater-Wallace – injured as a result, mostly from collapsed lungs.
“They needed to call it something, and you can’t say it’s acupuncture without having to undertake all the requirements of training,” said Stuart Wilcox, the Denver attorney representing AAC. “A lot of the controversy by the acupuncturists isn’t that they’re losing business; it’s that they’re fundamentally concerned that insufficiently trained practitioners are hurting patients.”
The American Medical Association last year noted that “dry needling is indistinguishable from acupuncture” and the U.S. Food and Drug Administration says the needles – called filiform needles – are to be made available only to qualified practitioners of acupuncture.
A spokesperson for the Colorado Division of Regulatory Agencies, which houses the board, said it could not comment because it’s an ongoing legal matter.
“PTs provide essential health care and, concerning dry needling, have demonstrated exceptional safety: No PT in Colorado has lost their license or been sanctioned due to improper use of dry needling in patient care,” said Cameron MacDonald, president of the Colorado chapter of the American Physical Therapy Association, in an emailed statement. “PTs are well-trained, receiving more than 3,400 hours of education as post-graduates after a four-year entry level degree.”
Claiming their petitions to the board to repeal the rule were little more than brushed aside, the AAC and the Colorado Safe Acupuncture Association filed suit in Denver District Court last month to force the issue.
Three states – California, Washington and Oregon – have removed similar provisions after court battles, and several others are expected to do the same.
In the suit, the groups say they pushed to have Rule 211 — adopted five years ago — abolished because it allows physical therapists to practice dry-needling with only 46 hours of training for the very same procedures acupuncturists must attend 1,905 hours of classes to be licensed — more than 40 times the amount.
There are more than 6,000 registered physical therapists in Colorado. There are about 1440 licensed acupuncturists here, according to DORA.
The acupuncture groups say the rule is illegal because it gives therapists the authority to practice an invasive procedure that, by law, they are not allowed to do, with needles that are, by definition, controlled by federal law.
The board is made up of five physical therapists and two members of the public, all appointed by the governor. The legislature reestablished the board in 2012 after a 25-year absence when the authority had been under the director of the state Division of Regulatory Agencies.
Shortly afterward, the board passed Rule 211 allowing physical therapists to practice dry needling, which is described in the rule as “based upon Western medical concepts.” It had been allowed previously, but the rule formalized it.
“Dry needling involves the insertion of needles into the same ‘trigger points’ that have been recognized in acupuncture as reactive acupuncture points, also known as ‘ashi points’ for over 2,000 years,” the lawsuit says. “Physical therapists often argue that they are not engaged in the practice of acupuncture, asserting that dry needling is based on Western medical ‘philosophies’ or concepts. There is no dispute, however, that insertion of FDA-regulated acupuncture needles as deep as five inches into patients qualifies as acupuncture.”
Skier Yater-Wallace suffered a collapsed lung after a physical therapist punctured it during a procedure with an acupuncture needle.
The suit notes two other Olympic athletes – American mixed martial artist Mitch Clarke and Canadian judoist Kim Ribble-Orr – who suffered severe injuries during dry-needling procedures.
The lawsuit lays out how AAC members petitioned the board in January to repeal the rule, in part because physical therapists in Colorado are, by law, only allowed to practice noninvasive procedures and treatments.
The board met in executive session “to obtain legal advice” on the petition, minutes of the meeting show. Then, without explanation, the board in open session declined to rule on it.
“Fear of needles is one of the greatest challenges to acupuncturists seeking new patients,” the lawsuit says. “Regardless of the alternate name ‘dry needling,’ unsafe practice of acupuncture damages the reputation of all acupuncturists in Colorado …”
MacDonald said the scope of the procedure is determined by who’s handling the needle.
“Dry needling, when performed by a PT, is physical therapy, when performed by a chiropractor is chiropractic care, and when performed by an acupuncturist is acupuncture,” MacDonald said in the statement.
Editor’s note: This story has been updated to include a statement from the American Physical Therapy Association and to reflect the accurate number of licensed acupuncturists in the state. An incorrect number initially had been provided by DORA.