LAC 46:XLV.4930. Dry Needling

A. Dry Needling is a skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying neural, muscular, and connective tissues for the management of neuromusculoskeletal conditions, pain, and movement impairments. As with all other physical agent modalities in occupational therapy, dry needling is to be utilized in the therapeutic process to ultimately achieve improved function and therefore must not be applied as a stand-alone treatment. 1. In order to perform dry needling, an occupational therapist must obtain all of the educational instruction described in Paragraphs (2)(a) and (2)(b) herein. The majority of the educational instruction must be obtained in person, allowing for self-study and partial online instruction. 2. Mandatory Training. Before performing dry needling to the upper limb, a practitioner must complete educational requirements in each of the following areas: a. Instruction in each of the four areas listed herein, from a LOTA, AOTA or NBCOT approved continuing education provider: i. musculoskeletal and neuromuscular systems; ii. anatomical basis of pain mechanisms, chronic pain, and referred pain; iii. trigger points; and iv. universal precautions. b. A minimum of 24 hours of dry needling instruction must include specific instruction on the upper limb defined as hand, wrist, elbow, and shoulder girdle. i. The 24 hours must include instruction in each of the following six areas: (a). dry needling technique; (b). dry needling indications and contraindications; (c). documentation of dry needling; (d). management of adverse effects; (e). practical psychomotor competency; and (f). Occupational Safety and Health Administration's Bloodborne Pathogens Protocol. 3. Each instructional course shall also specify what anatomical regions are included in the instruction and describe whether the course offers introductory or advanced instruction in dry needling; contain a practical examination and a written examination with a passing score; include an anatomical review for safety and effectiveness, and evidence-based instructions on the theory of dry needling. 4. Advanced dry needling (i.e., craniofacial, spine, abdominal, etc.,) will require more advanced training than the minimum requirements outlined above. It is the responsibility of each occupational therapist to acquire specialty certification through additional training beyond the minimum requirements. 5. Any occupational therapist who obtained the requisite hours of instruction to meet another state’s requirements for dry needling must provide the documentation to the LSBME that demonstrates compliance with Louisiana’s minimum instructional requirements as outlined in Paragraphs 2(a), (b), and (c). 6. Dry needling may only be performed by a licensed occupational therapist and may not be delegated to an occupational therapy assistant or support personnel. 7. Dry needling may only be performed with an order from a physician or otherwise authorized prescriber or provider for dry needling. 8. An occupational therapist practicing dry needling must supply written documentation, upon request by the board, that substantiates appropriate training as required by this Rule. 9. An occupational therapist performing dry needling in their practice must have informed consent for each patient that is maintained in the patient's chart/medical record. The patient must sign an informed consent form created by the therapist. The consent form must, at a minimum, clearly state the following information: a. risks and benefits of dry needling; b. the occupational therapist's level of education and training in dry needling; and c. potential side effects of dry needling. 10. When dry needling is performed, the occupational therapist must document in the patient's daily encounter/procedure note. The note shall indicate how the patient tolerated the intervention as well as the outcome of the intervention, including any adverse reactions/events that occurred, if any. 11. When dry needling is performed, the clinic or facility must have a written plan in place for management of major complications in a prompt and effective manner. 12. Practicing dry needling without compliance with this requirement constitutes unprofessional conduct and subjects a licensee to appropriate discipline by the Board and its agents.