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Senate of Pennsylvania
Session of 2019 - 2020 Regular Session


Posted: February 25, 2020 03:57 PM
From: Senator Mario M. Scavello
To: All Senate members
Subject: Legislation Allowing for Improved Access to Physical Therapy and Further Providing for Dry Needling as Acceptable Practice for Physical Therapy in Pennsylvania

In the near future, I intend to introduce legislation amending the Pennsylvania Physical Therapy Act (Act 38 of 2008) to include the performance of dry needling therapy in the scope of practice for physical therapists in the Commonwealth of Pennsylvania. This would clarify that the definition of “physical therapy” includes dry needling, a practice already common among many physical therapists throughout the United States.

Though dry needling is not expressly prohibited in Pennsylvania, most physical therapists do not practice this treatment technique due to the unknown consequence if they choose to provide this service (i.e. licensing issues and insurance-related concerns). While the current Physical Therapy Act does not specifically prohibit dry needling, it still presents a legal gray area which has generated confusion for hospital systems and various practitioners across the Commonwealth. Therefore, the State Physical Therapy Board has determined that legislative clarification is needed because it is not within the Board’s authority to determine treatment techniques performed by physical therapists.

The performance of dry needling (sometimes referred to as “trigger point dry needling” or “intramuscular manual therapy”) is recognized by the American Physical Therapy Association as being within the physical therapist professional scope of practice. Many physical therapist education programs include dry needling in the curriculum.

It is important to distinguish that “dry needling” is not acupuncture. Acupuncture refers to a form of primary health care based on the theory of energetic physiology that describes and explains the interrelationship of the body organs or functions with an associated acupuncture point or combination of points located on “channels” or “meridians.” Dry needling is different in that it is a skilled technique used to treat dysfunctions in skeletal muscle, fascia, and connective tissue; diminish pain; and reduce or restore impairments of body structure and function leading to improved activity.

In addition to formalizing the use of dry needling as a physical therapy practice, this legislation also allows for improved access to physical therapy.

Currently, a physical therapist with a certificate of authorization may only treat an individual without a referral for up to 30 days from the date of first treatment. A physical therapist may not currently treat an individual beyond 30 days from the date of first treatment unless he or she has obtained a referral from a physician, etc. for such treatment. This legislation would revise the time period to permit a physical therapist to treat an individual without a referral for up to 90 days from the first date of treatment, a timeframe consistent with contemporary standards of practice and entry level physical therapist training and education.

Lastly, this legislation would remove the requirement that a physical therapist hold certificate of authorization to practice physical therapy by direct access. This update to the act would make it consistent with other jurisdictions and is supported by the profession’s education, training and previous transition to an entry level doctoral degree.

At a time when we are facing many concerns with addiction and continuing to fight the opioid crisis, we should be supportive of increased access to treatment and alternative methods such as dry needling to address injuries and provide pain management.

At the present time, states that have issued opinions affirming that dry needling is within the physical therapist scope of practice include, but are not limited to, Alabama, Arizona, Colorado, the District of Columbia, Georgia, Iowa, Kentucky, Maryland, Mississippi, Montana, Louisiana, Massachusetts, Nevada, New Hampshire, New Mexico, North Carolina, Ohio, Oregon, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin, and Wyoming. Please join me in co-sponsoring this important legislation.

If you have any questions regarding this legislation, please contact Christine Zubeck in my office at 717-787-6123 or czubeck@pasen.gov. Thank you for your consideration.

Introduced as SB1228