1. (1) Definition. Dry Needling is a technique within the scope of chiropractic medicine where the practitioner uses a filiform needle to stimulate trigger points and treat neuromuscular pain and deficit in functional movement. Dry Needling is appropriately indicated only after an examination and diagnosis consistent with its use where specific anatomical entities are identified according to physical signs.

   Dry Needling does not include stimulation of auricular or distal points nor auricular detoxification, the latter being strictly limited to the five ear-part treatment protocol for detoxification, substance abuse or chemical dependency as set out by the National Acupuncture Detoxification Association.

2. (2) Must complete in order to perform Dry Needling, a licensed chiropractor:

   1. (a) Must be certified and maintain certification in acupuncture as mandated by Board Rule 190-X-3.01 and any future amendment thereto; and/or

   2. (b) Submit documentation of completion of a Dry Needling course of study approved by the Board, which at a minimum shall include 12 hours of live face to face Dry Needling study.

      Online or distance based courses do not qualify as an approved course of study.

3. (3) Specific and written informed consent shall be obtained prior to performing Dry Needling and made a permanent part of the patient’s record. At a minimum, the informed consent must include risks and benefits of the procedure(s).

   In addition, the patient record must clearly indicate and document the performance of the procedure(s), how the patient tolerated the procedure(s) and outcome. This documentation shall be in addition to the record keeping requirements of Board Rule 190-X-5.09, any future amendments or any requirements adopted in the future.

4. (4) Dry Needling is a non-delegable procedure to be performed only by licensed chiropractors meeting the requirements of this Rule.
5. (5) Dry Needling must be performed in a manner consistent with generally accepted standard of practice to include clean needle techniques and all applicable standards relating to infection control.
6. (6) Upon request by the Board, any licensed chiropractor performing Dry Needling must submit within 10 days documentation demonstrating compliance with this Rule, to include but not limited to the required informed consent, sampling of patient records and infection control procedures. Failure to provide the requested information may result in the Board taking appropriate measures to prevent the licensed chiropractor from performing Dry Needling until compliance is demonstrated in addition to any other disciplinary action deemed appropriate.

Author: Board of Chiropractic Examiners

Statutory Authority: Code of Ala. 1975, §§34-24-144, 34-24-165.

History: New Rule: Filed October 15, 2018; effective November 29, 2018. Amended: Filed April 12, 2019; effective March 27, 2019.