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The struggle between acupuncture and dry needling – an analysis of facts

by Jason Tutt on April 01, 2015 in Uncategorized with No Comments


As you have probably figured out by now, I am a registered Acupuncturist and I received my initial training in TCM Acupuncture. Since entering the real world, I have been bombarded with the never ending argument that we Acupuncturists must fight against dry needling. I am part of several Acupuncture Facebook groups, and the administrator of the largest group told me in a private message.

Supporting dry needling by PT’s or DC’s or even MD’s who have not gone through full acupuncture training is just foolish

This is an argument that gets repeated over and over again, that these practitioners should go through acupuncture school. But this is simply a straw man argument because acupuncturist are using acupuncture in an attempt to treat everything, not just pain like dry needling is.

Another argument I have come across time and time again.

A Licensed Acupuncturist (LAc), or Acupuncture Physician (A.P.) is required to have a minimum of 4 years (nearly 3,000 hours) of post graduate training in the art and techniques of Acupuncture and Oriental Medicine.

On the other hand, a medical professional who practices dry needling is not required to complete any training. In the US, most practitioners of dry needling have a working knowledge of the musculoskeletal system but have not been trained on needle insertion or technique.

From another source

PTs do “dry needling,” aka acupuncture, with less than 40 hours of training using acupuncture needles! Yeek!

A news story on Arizona Nightly News featured acupuncturists making the following statements in regards to physical therapists performing dry needling.

  • There is a severe risk to public health
  • Physical therapists do not realize that when they needle a particular area, they’re actually affecting a change throughout the whole body
  • They’re going for a weekend or two weekends of training and they’re going out and doing this.
  • Dry needling patients are exposed to health risks like extreme pain, nerve damage, even punctured organs.

Another news story on CBS in Arizona involving an acupuncturist from the previously story named Lloyd Wrist, a licensed Acupuncturist in Arizona brought forth another argument in which he claimed;

  • Acupuncturist are trained for a minimum of 800 hours supervised time

Now let’s look at the facts. I can tell you right now that some of these above claims are false.


First of all, let’s talk about TCM Acupuncture training in Canada and what it takes to become licensed in the five difference provinces that actually regulate TCM acupuncture.

  1. British Columbia
    • 1,900 hrs including 450 hrs of practicum completed in a minimum of 3 academic years – Source: CTCMA
  2. Alberta
    • To be eligible to write the Provincial Acupuncturist Registration Examination of Alberta, applicants must have satisfactorily completed an acupuncture program approved by the Alberta Health Disciplines Board. – Source: CAAA
      • Grant MacEwan – MacEwan’s Acupuncture program features more than 600 hours of clinical practice on campus at our acupuncture teaching clinic. – Source: Grant MacEwan
  3. Ontario
    • Successfully completed a program of clinical experience in the profession that is structured, comprehensive, supervised and evaluated and which consists of at least 45 weeks of clinical experience involving 500 hours of direct patient contact. – Source: CTCMPAO
  4. Newfoundland
    • 1,900 hrs including 450 hrs of practicum completed in a minimum of 3 academic years – Source: CTCMPANL
  5. Quebec
    • Applicants who do not hold an acupuncture degree from Rosemont College, or is legally authorized to practice the profession issued acupuncturist in Alberta, British Columbia, Ontario and Newfoundland, must obtain a diploma equivalence or such training specified in the Regulations for equivalence of diplomas and training standards for the licensing of the Order of Acupuncturists of Quebec. – Source: OAQ

So in Canada, you can practice Acupuncture after an average of just under 500 clinical hours, the other roughly 2000 hours are didactic training spent in the classroom, many of which are spent learning theories that don’t have anything to do with how you insert needles into the body like QiGong, TuiNa, TCM Diagnosis, Acupuncture Therapy, Case studies, Pin Yin, Herbology, Patient Counselling, Business and Ethics, Shi Lao (Chinese Diet), etc….

Western courses are taught as well.

  • Anatomy – 80 hours
  • Physiology – 40 hours
  • Pathology – 40 hours
  • Microbiology – 20 hours
  • Pharmacology – 20 hours
  • Western Diagnosis – 40 hours

So again, in Canada, it’s very misleading to say that we get 2,500 hours of Acupuncture training, when the majority of it is in the class room, and only around 500 hours of it is in the clinic. And I can tell you from my own personal experience, there were times in our school clinic where we just sat around talking because sometimes we didn’t have enough patients for everybody.

Anyway, let’s look at the United States. In the US, 43 states plus D.C. require certification by the National Certification Commission for Acupuncture and Oriental Medicine. So I’m going to use that as our standard for eligibility to practice Acupuncture in the United States.

  • Acupuncture Program – Source: NCCAOM
    • Minimum 3 years – 1905 hours
    • Acupuncture clinic – 660 hours

Where does this number of 3,000 hours of Acupuncture training that I keep seeing getting thrown around come from? California

California is the gold standard in the United States, and the California Acupuncture Board has the strictest requirements to become an acupuncturist in the entire country.

  • An educational and training program approved by the Board for students who enrolled in an approved acupuncture and Oriental medicine training program must complete a minimum of 3,000 hours of theoretical and clinical training. The clinical training required is 950 hours. – Source: California Acupuncture Board

I think California is doing it correctly, 950 clinic hours is absolutely appropriate for doing something like acupuncture which could be fatal if done incorrectly or by somebody who is under trained. But to argue that we acupuncturists are trained for 3,000 hours in Acupuncture is very misleading and certainly the number thrown out by Mr.Lloyd Wright about acupuncturists being trained in 800 hours of supervised time is a stretch unless you are referring to California.

Dry needling – What does it take to learn it and be allowed to practice it?

Let’s again start with Canada. The eligibility to practice dry needling is that you must complete 1 of 9 approved courses. So just to cut down on time and space, I’ll only outline the one that appears to be the weakest in terms of training and hours.

In The United States, each state is different in their regulation of dry needling with some states completely ruling against it, and others only requiring 24 hours of training, to some requiring as much as 50 hours of training. You can find out more about each individual state on the KinetaCore’s scope of practice page. KinetaCore is one of the most popular dry needling training course providers in the United States and Canada.

KinetaCore does offer two levels of training. Level 1 is 27 hours on-site, and to qualify for level 2 you must complete and submit proof for 200 treatment sessions before being accepted. Level 1 includes the hip, lumbar spine, thigh, cervical spine, shoulder, upper and lower extremity. While Level 2, includes the all dangerous thoracic spine, the TMJ/face and advanced needling in previously mentioned areas.


Statements being made by acupuncturists are untrue in that we receive 3,000 hours of Acupuncture training. In fact, we are closer to around an average of 600 hours in North America, with some provinces in Canada requiring as little as 450 hours and California requiring as much as 950 hours of clinical practice. It is important to note, that we acupuncturists do not spend 100% of our clinical training treating musculoskeletal pain and releasing ashi/trigger points. During school we are instructed to treat everything from digestive issues, to cold feet, to back pain, to headaches, to dry eyes, and the list goes on.

We acupuncturists are not experts in treating pain by the time we get out of school, we graduate as general practitioners knowing a little bit of everything. In fact, in my school, pain was probably what we focused on the least.

Certainly there are continuing education courses on sports acupuncture that we can take post-graduate by people like Whitfield Reeves and Matt Callison, but these are anatomically based acupuncture courses and when I took them, I realized how poor our anatomy training really was, at least in Canada.


There is an obvious difference of requirements in North America ranging from 24 hours to 80 hours training in dry needling that allows physiotherapists to insert needles into their patients. This, in my opinion is not enough training to be inserting needles into areas such as over the thoracic spine, around the cervical spine and other high risk areas. However this may be sufficient for low risk areas like the majority of the areas focused on in Level 1 of KinetaCore’s dry needling course, as long as physiotherapists only needle the areas they have been shown how to do.


A statement from the APTA (American Physical Therapy Association)

It is unreasonable to expect a profession to have exclusive domain over an intervention, tool, or modality. – Source: APTA

A publication titled Changes in Healthcare Professions Scope of Practice: Legislative Considerations which was a collaboration by the following associations; Association of Social Work Boards (ASWB), Federation of State Boards of Physical Therapy (FSBPT), Federation of State Medical Boards of the United States, Inc. (FSMB), National Association of Boards of Pharmacy (NABP®), National Board for Certification in Occupational Therapy, Inc. (NBCOT®), and National Council of State Boards of Nursing, Inc. (NCSBN®) included the following statements:

Overlap among professions is necessary. No one profession actually owns a skill or activity in and of itself. One activity does not define a profession, but it is the entire scope of activities within the practice that makes any particular profession unique. Simply because a skill or activity is within one profession’s skill set does not mean another profession cannot and should not include it in its own scope of practice.

Overlapping scopes of practice are a reality in a rapidly changing healthcare environment. The criteria related to who is qualified to perform functions safely without risk of harm to the public are the only justifiable conditions for defining scopes of practice.


Acupuncturists are not experts in pain management after they graduate from school and therefore saying we are receiving 3,000 hours in Acupuncture, or even our full average of 600 hours of training 100% in pain management is false and misleading. We are trained in balancing meridians and moving qi, which is a practice I have discussed has it’s own issues in a previous article.

I believe dry needling courses are likely inadequate at the current time, and should be re-evaluated and require more clinical training before physiotherapists are left on their own to perform on their patients, especially in high risk areas of the body. Failure to do this can, and has resulted in several high profile cases of pneumothorax, which I talked about in previous articles here, here and here.

Sean Flannigan a physiotherapist from the second news story above was quoted as saying in regards to dry needling;

I’m not against us having a certain amount of requirements to do it.

And I, an acupuncturist, am not against physiotherapists learning dry needling, and I disagree with acupuncturists like the Facebook group administrator above quoted saying they should go through full acupuncture training because they are not trying to accomplish the same thing. Acupuncture was developed and taught to students with the intention of balancing meridians and treating everything. Dry needling was developed and taught to students for treating pain, and pain only. Saying that a physiotherapist needs to learn about meridians and qi in order to qualify to do dry needling is one of the most ignorant statements I have ever heard.

I don’t think Acupuncturists own the rights to do needling, just like chiropractors don’t own the right to do spinal manipulation. As we move into the future, more professions will be expanding their scopes to include more skills, more treatment options and those professions that are unwilling to adapt and bring in new skills will be the ones who miss out, not the ones who have their skills “stolen” from them.

Since originally “coming out” about this, I have received numerous threats from Acupuncturists who are attempting to have my license suspended for being what they believe to be “against acupuncture”. I’m not against acupuncture, I’m against stupid arguments and bending the truth about our own profession in order to appear better trained than we actually are, and claiming that we “own needling” and no one else should be allowed to do it unless they play by our rules.