Dry Needling Training and Credentials: What Courses Involve

What this page covers

Many people ask how much training a clinician needs before using dry needling, and what a "certified" dry needler really is. The short answer is that it depends on the country, state or province and the clinician's profession, and standards are uneven. This page explains what the sources I could read say. It does not list or recommend courses, schools or practitioners, and it is not a guide to needling. For the law itself, see Dry Needling Regulation.

Who offers dry needling

Dry needling is most often taught to physical therapists (called physiotherapists in many countries). An Ontario, Canada survey of 426 needling physiotherapists found most had trained in medical acupuncture rather than dry needling.[1] Some chiropractors also use needles,[2] and a Delphi panel in Israel discussed needling by physicians.[3] A policy analysis of the United States, Canada and Australia found a wide range of statutory education requirements for needling physiotherapists and chiropractors, most below the 200-hour World Health Organization guideline for physicians.[2] Acupuncturists follow separate licensing paths. See Acupuncture Licensing and Training and Who Else Offers Acupuncture?.

What the training builds on

The Federation of State Boards of Physical Therapy (FSBPT), which represents US licensing boards, sponsored a study of what physical therapists must know to perform dry needling. It found that more than four-fifths of the needed knowledge is acquired in entry-level education, and that advanced training, almost solely about needling technique and psychomotor skills, makes up the rest.[4] The American Physical Therapy Association (APTA) states that where state law allows dry needling, therapists obtain additional post-professional education and hands-on training specific to the technique before using it.[5]

How much training? It varies

Because a jurisdiction's number of hours can change, check the current rule with the regulator rather than relying on a page like this one.

Where I could not read the rule: I did not find a readable source for the UK, Australia, British Columbia or most individual US states, so I make no statements about them here.

What a course may involve

I could not find an independent description of typical course content. One Canadian training provider's own published course page shows the general shape: a first level and a second level, each over two weekend days with a theory and anatomy exam as required by the regulator, followed by further levels leading to the provider's own certification.[10] That is a provider's description, not an independent review. The Manitoba direction lists the topics its acupuncture education must cover: anatomy including anatomical variations in the neck and thorax, consent, recognizing and managing side effects and adverse events, infection control, and an objective evaluation of competence.[8]

What "certified" does and does not mean

"Certified in dry needling" can mean different things: a course certificate from a private provider, a credential recognized by a regulator, or a state registration. Course certificates are not licenses. A license to practice comes from the government regulator for the profession, such as a state physical therapy board. The professions disagree. In one policy analysis, organizations defending short training were associated with the physiotherapy and chiropractic professions, while all the acupuncture educators interviewed called brief training insufficient and unsafe.[2] I treat this as an ongoing professional dispute.

Questions to ask before treatment

• What is your license and who regulates you? Can I check it on the regulator's website?
• Is dry needling within your legal scope here?
• What dry needling training have you completed, and how many hours of it were hands-on?
• Do you use single-use sterile needles? What would you do if I felt faint or had a bad reaction?
• How will we measure whether this is helping, and when will we stop?

Also see How to Choose an Acupuncturist and Questions to Ask an Acupuncturist Before Starting. Do not use needling to delay care for sudden severe pain, new weakness, fever or chest or breathing symptoms. In the US, call 911 for emergencies.