Why Is Dry Needling Illegal?
Dry needling is not illegal everywhere. In fact, it is allowed for physical therapists in most U.S. states, although the rules and training requirements are different depending on where you live.
Key Takeaways
Dry needling is regulated because it requires specific training. The provider needs to know where to place the needle, which areas to avoid and when dry needling may not be appropriate.
Training and safety matter most. Dry needling should be performed by a licensed, trained provider who can explain why it makes sense for your symptoms and treatment plan.
At Phenom Sports and Rehabilitation in Colorado, dry needling is used as part of a personalized treatment plan. The goal is not just to treat the painful area, but to understand what is causing the problem and help you move and feel better.
Table of Contents
Is Dry Needling Actually Illegal?
No, dry needling is not illegal everywhere.
In the United States, the rules are different from state to state. What usually changes is who is legally allowed to perform it and what training they need.
That is why it can be confusing.
There is also some debate about how dry needling is different from acupuncture.
Physical therapists are probably the healthcare professionals most people associate with dry needling, but they are not always the only providers who can be allowed to use it.
Depending on the state, other licensed healthcare professionals, like chiropractors, occupational therapists and athletic trainers, can also be allowed to perform dry needling if they meet the required training standards.
Each state decides which treatments a healthcare provider is allowed to perform. This is called scope of practice.
Think of it as the treatments that fall within that provider's license.
In Colorado, for example, qualified physical therapists can perform dry needling when they meet the state's training requirements.
So when you hear that dry needling is illegal, it does not necessarily mean the treatment itself has been banned.
Often, it simply means some healthcare providers are not legally allowed to perform it in that state.
Why Is Dry Needling Restricted in Some Places?
The main reason is simple. Dry needling involves more than putting a needle into a tight muscle.
You need to know what is underneath the skin.
Muscles are close to nerves, blood vessels, joints and, in some areas of the body, organs. That is why anatomy and clinical training matter.
With dry needling, a trained provider uses a very thin needle to target areas of muscle or soft tissue that can be linked to pain, tightness, or limited movement.
It is commonly used to address muscle pain, tightness and movement problems.
But knowing where to place the needle, how deep to go and which areas to avoid takes specific dry needling training.
Physical therapists already have strong training in anatomy, movement, and muscle and joint problems. Dry needling requires additional training.
That is one reason the treatment is regulated.
The main concern is making sure the provider knows how to use the technique safely.
Is Dry Needling Safe?
Dry needling is considered a low-risk treatment when it is performed by a trained provider.
The needles used for dry needling are sterile and used only once. A new needle is used for each treatment and safely thrown away afterward. Your provider also follows basic safety steps to help reduce the risk of infection.
Most side effects from dry needling are minor. In a study of more than 20,000 treatments, major problems were reported in less than 0.1% of treatments.
You can feel sore afterward, similar to how a muscle feels after a tough workout. You may also notice a small bruise or a little bleeding where the needle went in.
More serious problems can happen, but they are rare.
These may include infection, irritation of a nerve or blood vessel, or injury to deeper tissues. One rare complication is a pneumothorax, which happens when air gets into the space around the lung.
This is one reason training is so important.
Your provider should also know about your health before treatment.
Be sure to mention any medications you take, bleeding problems, pregnancy, recent surgery, infections, or other medical conditions that may affect your treatment.
Dry needling is not used the same way for every patient. It should be used based on your evaluation, your symptoms and what makes sense for your treatment plan.
Who Is Qualified to Perform Dry Needling?
A qualified dry needling provider needs more than basic knowledge of where a muscle is.
For physical therapists, much of that foundation already comes from their professional education.
According to the Federation of State Boards of Physical Therapy, about 86% of the knowledge and skills needed for dry needling are already covered during physical therapy education.
That includes things like anatomy, evaluating your symptoms, developing a treatment plan, safety and knowing when a treatment may or may not be appropriate.
The remaining skills, especially those involving the needle itself, require additional specialized training.
Providers need to learn specific skills such as handling the needle, identifying the tissue they are treating, choosing the right area and using the technique safely.
So when choosing a provider, look for someone who is:
Licensed to practice their healthcare profession
Specifically trained in dry needling
Experienced using the technique
Able to explain why dry needling makes sense for you
And do not be afraid to ask questions.
How Can You Tell if Dry Needling Is Legal Where You Live?
The easiest way to check is through your state’s physical therapy licensing board, which publishes licensing and scope-of-practice rules.
You can use the Federation of State Boards of Physical Therapy directory to find the licensing board for your state.
You can also check the APTA's dry needling laws by state for a quick overview of where physical therapists are allowed to perform dry needling.
If you are considering treatment, you can also ask your clinic directly.
Insurance coverage for dry needling also depends on your plan.
Dry needling may be billed under CPT code 20560 for one or two muscles or 20561 for three or more muscles, but using these codes does not guarantee that your insurance will cover the treatment.
How We Use Dry Needling at Phenom Sports and Rehabilitation
At Phenom Sports and Rehabilitation in Arvada, Colorado, we do not use dry needling just because something hurts.
We first look at your symptoms, your movement, your health history and what we find during your evaluation.
Then we decide if dry needling makes sense for you and how it fits into the rest of your treatment.
Dry needling may be one part of your care, along with exercises, mobility work, strengthening and other treatments based on what your body needs.
If we recommend dry needling, we will explain what we are treating, why we think it may help and what you can expect.
As one of our patients, Mandy Mullikin, shared:
Dr. Mark spends a full hour with you, taking the time to deeply understand your injury, tailor your treatment and explain everything along the way. Mandy Mullikin
Dry Needling vs. Acupuncture: What Patients Should Know
Dry needling and acupuncture can look very similar from the outside.
Both usually use a very thin, solid needle called a filiform needle. Unlike the hollow needle used for an injection, a filiform needle does not inject medication into your body.
The main difference is not the needle itself. It is why the needle is used, where it goes and how the treatment is done.
Dry Needling | Acupuncture | |
|---|---|---|
Main focus | Often used for muscle pain, tightness, movement problems and other musculoskeletal issues | Can be used for a wider range of symptoms and health concerns |
How points are chosen | Usually based on anatomy, muscles, movement and findings from your physical examination | May be based on traditional acupuncture points, modern clinical approaches or a combination of both |
Needles | Uses very thin, solid needles without medication | Also uses very thin, solid needles |
Who performs it | Depends on state law, professional license and training | Typically performed by licensed acupuncturists and other professionals permitted by state law |
How it may fit into care | Often used alongside exercise, mobility work, strengthening and rehabilitation | May be provided on its own or as part of a broader care plan |
Because the two treatments use similar needles, there has been debate over how dry needling should be regulated.
That is one reason the laws are not the same everywhere.
As a patient, you do not need to get caught up in the professional debate.
What matters is knowing which treatment you are getting, why it is being recommended and if your provider is licensed and trained to perform it where you live.
The Bottom Line
Dry needling is not illegal everywhere. The rules depend on the state, the provider’s license and the training they have completed.
For you as a patient, the biggest thing is knowing that the person treating you is licensed, trained in dry needling and able to explain why it may be a good fit for you.
Dry needling should not be used just because something hurts.
It should be based on your symptoms, your movement, your evaluation and what makes sense for your overall treatment plan.
At Phenom Sports and Rehabilitation, we look at the full picture before deciding if dry needling is right for you.
If we recommend it, we will explain what we are treating, why we think it may help and how it fits with the rest of your care.
FAQs
Do you need a license to perform dry needling?
Yes. Dry needling should be performed by a licensed healthcare professional who is legally allowed to use the technique in that state. The exact rules depend on the provider’s profession and location.
Can any physical therapist perform dry needling?
No. Being a physical therapist does not automatically mean someone can perform dry needling. State laws differ and additional dry needling training may be required.
What training is required to perform dry needling?
The requirements depend on the state. Physical therapists already learn anatomy, evaluation, safety and clinical decision-making during their professional education, but specialized training is still needed for dry needling techniques and needle-handling skills.
Is dry needling legal in every state?
No. The rules are different from state to state. Some states allow physical therapists to perform dry needling, some prohibit it and others do not have clear rules specifically addressing it.
How can I check if my provider is allowed to perform dry needling?
Start by checking the licensing board for your provider’s profession in your state. You can also ask the clinic directly if the provider is licensed, trained and legally allowed to perform dry needling where you live.
External Links
FSBPT Dry Needling Competencies - It explains what PTs learn in their entry-level education and what requires additional specialized dry needling training.
FSBPT Verify a PT/PTA License - Patients can use it to find their state’s official license-verification system.
Dry Needling: What Patients Should Know - a very patient-friendly resource explaining dry needling, needles, training and how it fits into physical therapy care
APTA Dry Needling Overview - APTA explains that dry needling is included in PT scope of practice in some states but not others and supports appropriate educational qualifications.
