Newspaper article News Sentinel

Sticking Point ; Law Now Allows Physical Therapists to 'Needle' Clients

Newspaper article News Sentinel

Sticking Point ; Law Now Allows Physical Therapists to 'Needle' Clients

Article excerpt

Wendy Besmann waited two painful years for her physical therapist to stick a needle in her neck again.

Besmann, who gets physical therapy from Dina Kramer at Kramer's West Knoxville practice, has musculoskeletal pain. She used to have Kramer routinely practice intramuscular manual therapy -- more commonly called "dry needling" -- on her "trigger points," tightened bands of tissue.

But in June 2014, state District Attorney Robert Cooper Jr. delivered an opinion that dry needling -- first practiced in the 1950s -- was legally out of the scope of practice for physical therapists in Tennessee.

Finally, last Wednesday, Kramer was again able to insert and quickly remove a very thin needle into Besmann's trigger points, which she said forces the muscle to twitch and release the tension that can cause pain. Besmann is a believer. After being "needled" in six places and then getting some manual manipulation from Kramer, she demonstrated how she could turn her head farther than before and said her pain had decreased.

Besmann, whose 2008 book on advocating for children

See needling, 4B

with behavioral disorders has been developed into a nationally taught curriculum, travels a lot for her work. She's also prone to migraines. She said the needling seems far more effective for those issues than physical therapy alone -- an opinion Kramer supports.

"I can cut visit time in half with needling," said Kramer, who said she had former clients "lined up" for the procedure once she was again able to perform it.

That was the result of a grassroots effort by physical therapists, spearheaded by the Tennessee Physical Therapy Association, to lobby legislators to amend physical therapists' scope of practice to include dry needling.

Cooper's initial opinion cited dry needling's similarity to acupuncture, which physical therapists can't practice unless they're also licensed acupuncturists. It was a position shared by many of the state's acupuncturists, who considered trigger points to be a subset of acupuncture points.

"The concern of occupational and physical therapists, and even chiropractors, performing dry needling lies in the level of training specific to the application of applying needles to the body," Nashville's Affinity Acupuncture wrote in an op-ed piece for the Tennessean. …

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