December, 2025
Recent news stories have reported that T. J. Watt received a pneumothorax injury (a partially collapsed lung) from dry needling. As always, there is a lot of confusion about dry needling vs acupuncture.
The definition of acupuncture is “the insertion of a stainless steel, filiform needle into the body to create a change.” Therefore, dry needling is absolutely the same as acupuncture. Why not call it acupuncture then? State requirements say that if you use the word “acupuncture” you must have an acupuncture license. Therefore, members of the physical therapy world choose to call it something else to avoid having to go through years of schooling. However, it is the same thing. They use the same needles. We buy them from the same suppliers.
What is the difference? Acupuncturists have a minimum of a Master’s degree in Acupuncture training. Many of us have completed a Doctoral Level of training. This is over 10 years of schooling for me. Acupuncturists must pass several National Board Exams. The testing centers are only in certain locations throughout the country. In my case, I had to travel to Chicago over several weekends of exams. We have to register with the state we are working in and follow all the state guidelines. Many states require passing continuing education programs to stay current in training.
It is my understanding there are no requirements for physical therapists. Many claim to take a weekend course, but again, that is not required.
Acupuncturists have taken a stance against physical therapists doing dry needling, as this is not in the best interest of the public’s safety. They are not properly trained. Do you want to be the first person your physical therapist has ever needled or do you want someone with years of training and experience?
TJ Watt’s injury should never have happened. A pneumothorax is a very serious condition that requires emergency treatment in a hospital. We hear about his case because he is a famous person, but I have to wonder about how many others’ received injuries or damages due to undertrained therapists.
Please do not get dry needling done by a physical therapist. Physical therapy itself can be a helpful modality for patients, but dry needling is not a modality that physical therapists should be doing unless the therapist has completed all the training, passed national board exams, and is licensed with the state as an acupuncturist.
Some Chiropractors and Medical Doctor’s (MDs) are licensed to do acupuncture upon completion of a 300-hour course. So at least they have some training. However, in my experience, it appears that most of them learned this out of curiosity or because the hospital paid for free training for them. They tend to look at it as a side-job compared to their regular medical work. Ultimately, they don’t have the skill and training that a full-time acupuncturist would have.
Dr. Kari Cobb, DACM
Doctor of Acupuncture and Chinese Medicine