Palo Alto physicians evaluate dry needling for managing spinal injury rehabilitation

The Physical Therapy Board of California convened on March 20, 2025, for the second day of its meeting, focusing on advancements in physical therapy practices, particularly the use of dry needling and its implications for patient care.

The session began with a discussion on the collaboration between physical therapists and physicians in Palo Alto, emphasizing the preference for dry needling as a preliminary treatment option. This approach aims to mitigate the risks associated with alternative treatments such as NSAIDs and corticosteroid injections, which can lead to serious side effects including heart attacks, strokes, and nerve damage. The board highlighted the importance of evaluating the effectiveness of dry needling before proceeding to more invasive treatments like Botox injections.

A significant portion of the meeting was dedicated to the education and competency of physical therapists in dry needling techniques. The board referenced a report from the Human Resources Research Organization (HUMRO), which indicated that 12% of physical therapists need to be proficient in surface anatomy and palpation to effectively perform dry needling. The discussion underscored the necessity of having a strong foundational knowledge in anatomy, as the non-needling hand plays a crucial role in identifying dysfunctions during treatment.

The board also reviewed a study comparing the knowledge of physical therapists with that of other medical professionals regarding musculoskeletal conditions. The findings revealed that orthopedic specialists had a higher level of expertise compared to physical therapy students and licensed therapists without specializations. This raised concerns about the ongoing education and training of physical therapists in managing complex conditions.

In terms of clinical evidence, the board noted that dry needling has been practiced since the 1980s and is supported by systematic reviews demonstrating its effectiveness in reducing pain across various body parts. One study highlighted the benefits of combining dry needling with exercise programs for patients suffering from chronic low back pain, reinforcing the idea that physical therapy interventions should be multifaceted.

The meeting concluded with a consensus on the need for continued education and research in dry needling and other physical therapy practices to enhance patient outcomes. The board plans to follow up on these discussions in future meetings, focusing on integrating new evidence-based practices into physical therapy education and clinical applications.