Dry Needling State Regulation Updates
Dry needling, referring to the insertion of thin monofilament needles without the use of injectate, is a topic of interest within the athletic training profession, resulting in efforts by states to address the issue of dry needling use in practice.
Dry needling is typically used to treat muscles, ligaments, tendons, subcutaneous fascia, scar tissue, peripheral nerves, and neurovascular bundles. Athletic Trainers (ATs) can use dry needling to manage pain, musculoskeletal injuries, arthritis and other diagnoses. It is an effective and safe modality when used appropriately. As such, ATs have been trained for dry needling in greater numbers as state boards have allowed the practice.
Here’s a detailed overview of dry needling regulations for ATs in applicable states:
Alabama: ATs are permitted to perform dry needling after completing a BOC-approved course that is at least 25 hours covering full body training and submitting a supervising physician-approved letter of attestation to the Alabama Board of Athletic Trainers.
Arizona: Senate Bill 1398 authorizes athletic trainers to perform dry needling, provided they meet the state’s established training and competency standards including 24 contact hours of education covering clean needle techniques, bloodborne pathogens, indications/contraindications and anatomy. Courses must be approved by BOC, National Athletic Trainers’ Association (NATA) or Commission on Accreditation of Athletic Training Education (CAATE).
Florida: The AT may administer monofilament intramuscular stimulation treatment for trigger points or myofascial pain at the direction of a physician.
Illinois: ATs must complete at least 50 hours of instructional courses, including 30 hours of didactic coursework and 54 practicum hours specific to dry needling. Additionally, they are required to perform a minimum of 200 supervised patient treatment sessions and pass a competency examination. Dry needling can only be performed upon referral.
Kentucky: ATs must complete at least 54 classroom hours of BOC-approved dry needling training, which includes instruction in clinical application. The procedure has to be ordered by a supervising physician and administered in a designated room or facility separate from a gymnasium, locker room, sports field or sideline.
Maryland: ATs must obtain approval from the board before performing dry needling. This involves completing at least 80 hours of instruction in a course approved by BOC, NATA or the United States armed forces. Of these, a minimum of 40 hours should cover specific content areas such as dry needling theory, techniques, indications, contraindications, infection control, emergency procedures and proper documentation. The remaining 40 hours must be practical, hands-on instruction under the guidance of a qualified health care practitioner with at least five years of dry needling experience.
Nebraska: An AT may perform dry needling only in accordance with the level of education and training successfully completed. Education and training must have been approved by the BOC and includes clinical instruction and application on the performance of dry needling.
Nevada: ATs are required to complete a total of 150 hours of education and training in dry needling. This includes at least 25 hours of in-person didactic education from an approved postgraduate course, encompassing both written and practical examinations. The remaining 125 hours can be fulfilled through approved graduate-level courses or continuing education relevant to dry needling. Prior to performing the technique, athletic trainers must submit documentation verifying their qualifications to the Nevada State Board of Athletic Trainers for approval.
North Carolina: The North Carolina Board of Athletic Trainer Examiners allows ATs to perform dry needling, provided they have completed a minimum of 54 hours of classroom education in a board-approved program. This training must include instruction in the clinical application of dry needling. ATs are also required to demonstrate competency and ensure that their written protocol with a supervising physician includes provisions for dry needling.
Ohio: The Ohio Athletic Trainers Practice Act does not specifically prohibit an AT from practicing dry needling as a part of patient care if the AT has received adequate training, has the necessary knowledge and competency to perform dry needling, and has dry needling addressed in either in the Collaboration Agreement or Standard Operating Procedures that are approved by a physician or other permissible referral source.
West Virginia: To perform dry needling, an AT must obtain educational instruction approved by the West Virginia Board of Physical Therapy. Dry needling by an athletic trainer must be performed under general supervision as described in W. Va. Code R. §16-5-2.9. Licensed ATs are prohibited from performing dry needling within primary and secondary school settings.
Please note that regulations and requirements for dry needling by ATs vary by state and are subject to change. It’s essential for practitioners to consult their respective state boards or official publications to ensure compliance with current laws and guidelines.
