A VERSION OF THIS ARTICLE FIRST APPEARED IN THE TALLAHASSEE DEMOCRAT.
BY BURT REED
Sweeping legislation restricting opioid prescribing is in effect across the country. Bad actors in the pharmaceutical industry are facing a reckoning in the courts. But what is to become of people who still need treatment for chronic pain – solutions that allow them to live full, happy and productive lives?
Echoing sentiments from the Centers for Disease Control and the White House, U.S. Surgeon General Jerome Powell recently declared that “physical therapists are key to overcoming not only the opioid epidemic but in creating healthier societies.”
In Florida, however, an antiquated statute governing the definition of physical therapy is restricting PTs from practicing an important pain relief technique allowed across 34 other states, used by the U.S. military, and recognized by both the American Medical Association and the Centers for Medicare and Medicaid.
It’s called “dry needling” – and while the name may seem strange, this form of trigger point therapy is proven to relieve the pain restricting range of motion so that people can more fully recover from both acute and chronic musculoskeletal problems.
Here’s how it works: A filament (solid) needle is inserted into a point within the muscle where pain and dysfunction occur, sending a signal to the brain and causing an involuntary muscle contraction that restores the muscle to its resting position, tone and correct length.
Similar to hitting “control, alt, delete” on a computer, dry needling stimulates the muscle – effectively telling the brain to reset, telling it that it doesn’t have to protect this area of the body. And most importantly, telling the brain that it can end the protective response whereby other muscles are trying to compensate and care for the injured muscle but also causing compression, inefficient movement and more pain.
While some may say dry needling seems similar to acupuncture, the reality is that they are worlds apart – literally, as they are Eastern versus Western techniques. Acupuncturists insert needles along certain pathways, or meridians, in your body to balance the flow of energy or chi.
As experts – with doctorate degrees, licensing and additional training – in human movement, physical therapists use dry needling to target specific muscles and restore normal movement patterns to help people improve much faster.
In other words, the quicker we get pain off the table for a patient, the quicker physical therapy exercises can restore them back to function. By using the dry needling technique and corrective exercises together, the patient can improve more quickly.
I have treated a range of patients with dry needling – from people with TMJ, to a patient with a crushed lumbar vertebrae who turned to physical therapy nine months after surgery and returned to work; to a car accident victim who suffered spinal cord and nerve irritation for a year, leaving his body contorted in pain. Over the course of 18 months of dry needling and physical therapy, we were able to restore his posture and function to normal, and he returned to work.
Dry needling, however, isn’t for every physical therapy patient; it’s just a tool that needs to be in a PT’s arsenal to provide where appropriate.
Yet without an update to the state’s Physical Therapy Practice Act, physical therapists in Florida can no longer practice dry needling or many other modern rehabilitation techniques which we are trained to provide improving patient outcomes.
And the impact of this outdated statute goes beyond affecting just Floridians. Visitors to our state during the winter months expect to have the same level of physical therapy care they receive at home. And without it, they are more apt to leave the Sunshine State. I have seen and heard their complaints firsthand.
The Florida Legislature has long endeavored to make our state a destination for health care. Updating the Physical Therapy Practice Act is a huge step to achieving that goal, especially as we seek better, more effective methods to treat pain.
Burt Reed, PT, OCS, FAAOMPT owns Mountain River Physical Therapy, which operates in Florida and five other states. He is a member of the Florida Physical Therapy Association and lives in Ocala.