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Virginia Physical Therapy Dry Needling

Referral Requirement

Dry needling is an invasive procedure that requires referral and direction. Referral should be in writing; if the initial referral is received orally, it shall be followed up with a written referral.

Training Requirement

Dry needling is not an entry level skill but an advanced procedure that requires additional post-graduate training.

    • The training shall be specific to dry needling and shall include emergency preparedness and response, contraindications and precautions, secondary effects or complications, palpation and needle techniques, and physiological responses.
    • The training shall consist of didactic and hands-on laboratory education and shall include passage of a theoretical and practical examination. The hands-on laboratory education shall be face-to-face.
    • The training shall be in a course approved or provided by a sponsor see Virginia PT Continuing Education.
    • The practitioner shall not perform dry needling beyond the scope of the highest level of the practitioner's training.

Informed Consent

Prior to the performance of dry needling, the PT shall obtain informed consent from the patient or the patient's representative. The informed consent shall include the risks and benefits of the technique. The informed consent form shall be maintained in the patient record.


Dry needling shall only be performed by a PT and shall not be delegated to a PTA or other support personnel.


18 VAC 112-20-121

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