Dry needling is a complex issue, and I may be ignorant of some of its aspects as the debate is all happening in the USA, not over here in the UK. Anyway, here are some thoughts:

On the one hand dry needling is a fairly shallow and demeaning version of a rich tradition. This happens a lot with the Asian life arts, where Westerners tend to want to skim a few ideas off the top while remaining ignorant of the depths beneath.

I cannot imagine we will ever have the power to stop dry needling, even if we wanted to, and it may be a waste of time even discussing this option. There is no point fighting battles we can’t win. For example, will we ever stop MDs inserting needles if they want to? It’s better to stick to a fightable cause – that the term acupuncturist can only be used after a determined level of training.

Do we have the right to say who can and can’t insert a needle?

Lots of physical therapists in the UK needle people using trigger points, or simply ashi points, or acupuncture points. Patients benefit because they are being needled by a person skilled in this narrow application of needling. In fact – dare I say it – for some musculoskeletal conditions patents may benefit more from being needled by a skilled physical therapist than they might by an acupuncturist with little training in this kind of disorder. In fact many physios here become so fascinated by the effects of needling, they go on to study acupuncture more thoroughly.

Debra Betts raised a good point in the IMPACT debate. She teaches midwives to use a limited repertoire of points on their pregnant charges and they benefit enormously as a result. Should we be saying this is a bad thing? Would acupuncturists be able to cover this service effectively and since the midwife needs to see the client anyway, there would be a double cost.

Perhaps there is room for people practising at different skill levels. China always had a tradition of itinerant doctors skilled at a limited number and type of treatments, offering affordable care for ordinary and poor people, while classically trained doctors worked at a more complex level, generally serving the more affluent. I am not arguing for inequality of access to care, just saying that there are precedents.

Might dry needling actually work to the benefit of acupuncturists?

If – as a profession – we devote resources and commitment to strong campaigning and lobbying, it’s a fairly easy task to sell ourselves as the expert needlers that people should turn to for more complex and resistant pain problems. If patients have been introduced to needling via dry needlers they might be more open to this progression.

A meaty subject for debate I think.

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