CCA Policy Statement on Dry-Needling
The Council of Chiropractic Acupuncture (CCA) is the main organization of chiropractic acupuncturists in the United States. The CCA is committed to insuring public health and safety by ensuring that all persons practicing any type of chiropractic acupuncture are properly trained and educated. To that end, the CCA offers post-graduate training in chiropractic acupuncture through various educational institutions. The American Board of Chiropractic Acupuncture (ABCA), which is the credentialing arm of the CCA, assures that these programs meet the stringent criteria of the CCA. The ABCA also provides board certification and testing.
To be granted board certification by the ABCA, a chiropractic physician must be a graduate of a chiropractic institution, and must have 300 additional hours of didactic and clinical education in acupuncture. This training must include clinical training and education in clean needle techniques and patient safety. Upon completion of their training the chiropractic acupuncturist must pass a rigorous examination, which includes both a written and a practical examination.
There is much controversy in the United States regarding the definition of dry needling, and who is qualified to perform this procedure. Dry needling involves the use of solid needles to treat muscle pain by stimulating and breaking muscular knots and bands. Unlike traditional trigger point injections, dry needling does not use any type of anesthetic. While both Acupuncture and Dry Needling (DN) are practiced successfully throughout the world, various types of practitioners define dry needling differently. This has led to a lot of unfortunate static that obscures the nature of what this type of needling has to offer.
On one hand, the acupuncture profession can claim, with considerable support, to have been practicing this style of treatment for at least two thousand years. Every style of needling put forward by "dry needlers" is part of some form of traditional acupuncture practice. This includes superficial needling, deep trigger point needling, short insertion, lengthy insertion, electrostimulation.
On the other hand, medical, osteopathic and chiropractic physicians may consider dry needling as Western Style Acupuncture or Trigger Point Acupuncture. Other practitioners, who are not acupuncturists but who are well placed to use this therapy to good effect, can lay claim to extensive research based material that supports an approach that seems, on the surface at least, to have little to do with traditional acupuncture practice.
Dry needling is an invasive procedure. Since needle lengths can range up to 5 inches in order to reach the affected muscles, the patient can experience adverse sequelae following treatment. This may include bruising, hematoma, pneumothorax, nerve injury, vascular injury and infection.
The ABCA recognizes that dry needling is an invasive procedure using acupuncture needles that carry associated medical risks. The ABCA is of the opinion this procedure should only be performed by practitioners with extensive training and familiarity with routine use of needles in their practice. Chiropractic physicians with additional post-graduate training in acupuncture are well qualified to perform dry needling techniques.