In an opinion released on June 19, 2014, the Office of the Tennessee Attorney General stated that Physical Therapists cannot lawfully perform Intramuscular Manual Therapy or Trigger-Point Dry Needling. Dry Needling therapy involves application of a fine, filiform needles to the neuromusculoskeletal system to restore movement, reduce pain and address other musculoskeletal disorders. That practice, the Attorney General found, was similar to acupuncture – a separate branch of medicine.

To support its opinion, the Attorney General noted:

• The Tennessee Occupational and Physical Therapy Practice Act, does not specifically authorize the invasive use of needles for therapeutic purposes.

• Dry Needling and acupuncture are similar therapies, and physical therapists may not perform acupuncture pursuant to Tennessee Code Annotated section 63-6-1002(a) – (b).

• The Rules of the Tennessee Board of Physical Therapy allow physical therapists to perform kinesiologic electromyography and diagnostic electromyography for diagnostic or academic purposes and then only in a university setting or upon referral from an allopathic or osteopathic physician, dentist or podiatrist.

The opinions of the Office of Attorney General are not binding upon a court of law; however, they are given precedential effect. The Attorney General suggested that the appropriate manner of addressing the issue would be by legislative amendment. Until an amendment is enacted, physical therapists and practitioners who employ physical therapists should not submit claims for Dry Needling therapy to Medicare or Medicaid as those claims could be deemed “fraudulent.” For more information, see Tennessee Attorney General Opinion No. 14-62 (June 19, 2014).