Judge pokes hole in ‘dry needling' rule

TALLAHASSEE, Fla. – Florida physical therapists cannot offer “dry needling” procedures to their patients, a state judge ruled Monday in a legal challenge filed by a group representing acupuncturists.

Administrative Law Judge Lawrence P. Stevenson issued an order rejecting a proposed rule by the Florida Board of Physical Therapy that set minimum standards for physical therapists to use dry needling. Stevenson said the proposal exceeded the Board of Physical Therapy’s “grant of rulemaking authority because it would expand the scope of physical therapy practice, not merely establish a standard of practice.”

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The order can be appealed to the 1st District Court of Appeal in Tallahassee.

Tad Fisher, chief executive officer of the Florida Physical Therapy Association, said Monday he was still reviewing the order with his attorneys and that he wasn’t sure if the association, which formally intervened in the case, would appeal.

Dry needling is the name physical therapists use to describe a technique of inserting filiform needles into the skin at various “trigger points,” which causes certain responses. Filiform needles --- which are used for acupuncture --- are solid. They cannot be used to inject substances or medicine, hence the word “dry.”

Physical therapists in more than 30 states practice dry needling, but it is not authorized by law in Florida.

The Florida Board of Physical Therapy initially published the proposed rule last year. It was pushed in part by the Florida Physical Therapy Association, which touted dry needling as a possible alternative that patients could seek for chronic pain management.

The proposed rule called for allowing physical therapists to perform dry-needle techniques so long as they had taken courses recognized by the Commission on Accreditation in Physical Therapy Education, the American Physical Therapy Association, the Federation of State Boards of Physical Therapy or any branch of the United States Armed Forces.

The Florida State Oriental Medical Association, which represents acupuncturists, challenged the proposed rule in the state Division of Administrative Hearings arguing, among other things, that the proposal modified existing law and that it was vague and capricious.

Stevenson agreed with the Florida State Oriental Medical Association that the Board of Physical Therapy expanded state law by passing the rule.

Stevenson said that “dry needling meets the definition of acupuncture in Florida law because it involves the insertion of acupuncture needles” into specific areas of the body.

He noted that the law generally bans physical therapists from performing acupuncture, allowing it only when “no penetration of the skin occurs.”

The Florida State Oriental Medical Association had an announcement on its website Monday afternoon saying “WE WON!!! The Dry Needle Challenge.”