A survey of American physical therapists' current practice of dry needling: Practice patterns and adverse events

To estimate the proportion of physical therapists currently performing dry needling and report current practices patterns. Secondary aims were to report the numbers of minor and major adverse events and determine if these adverse events were related to therapist characteristics.

An anonymous electronic survey was distributed through special interest groups within the United States to physical therapists. Participant demographics and responses were analyzed using descriptive statistics. Associations between variables were examined using chi-square.

The estimated response rate was 14.4% (n = 865, mean age 39.89, SD 11.73 years). More than half (55.0%, n = 461) of respondents perform dry needling; levels of training varied. Most (78.8%, n = 337) performed 0-3 needling sessions per day, usually lasting < 15 min (67.3% of respondents, n = 288). Therapists commonly performed 3-6 sessions over a patient's course of care (82.0% of respondents, n = 350). Minor adverse events were common; respondents estimated this occurred in 39.6% (SD 31.5) of treatments. Major adverse events were rare, typically not requiring emergency care. Being male (X² = 8.197, P = 0.004), experienced (>4 years; X² = 34.635, P < 0.001), and having more training (>61 h; X² = 8.503, P = 0.004) were associated with reporting a major adverse event occurred during their career.

Half of physical therapists surveyed performed dry needling. Practice patterns were consistent with expert opinion. The number of adverse events reported suggests further research is needed to quantify the risks of dry needling. Participant characteristics associated with a major adverse event appear to be related to the number of exposures.