Dry Needling Consent to Treat
The Arizona State Legislature has established the following definition for Dry Needling, with regards to Physical Therapy:
“Dry needling” means a skilled intervention performed by a Physical Therapist that uses a thin filiform needle to penetrate the skin and stimulate underlying neural, muscular and connective tissues for the evaluation and management of neuromusculoskeletal conditions, pain and movement impairments.
(A.R.S. §32-2001(4))
The needle utilized is a very thin monofilament needle. This needle is sterile and has no medication or other substance applied, hence the term dry. All therapists who perform Dry Needling at Spooner Physical Therapy are registered to provide this treatment with the Arizona State Board of Physical Therapy and are compliant with all state requirements for the delivery of this intervention.
Dry Needling is NOT synonymous with acupuncture. As stated by the American Physical Therapy Association:
“The practice of acupuncture by acupuncturists and the performance of dry needling by physical therapists differ in terms of historical, philosophical, indicative, and practical context. The performance of modern dry needling by physical therapists is based on western neuroanatomy and modern scientific study of the musculoskeletal and nervous system. Physical therapists who perform dry needling do not use traditional acupuncture theories or acupuncture terminology.”
Physical Therapists and the Performance of Dry Needling; An Educational Resource Paper, 2014.
Risks/ Side-Effects: Muscle soreness is the most common side-effect of dry needling. Mild bruising at or near the needling site is another possible complication. While the soreness and/ or mild bruising can last up to a couple days, neither should have any significant detriment to your activities. While extremely rare, more significant risks with Dry Needling include pneumothorax (a collapsed lung) or nerve damage. A pneumothorax can only occur with treatment to or around the thorax. All appropriate precautions will be taken to avoid this occurrence. If this were to occur, the most common symptom is shortness of breath. Please note, this shortness of breath does not always occur immediately after treatment and can take up to a few days to develop.
Patient’s Consent: My therapist has discussed with me, and I understand, both the probability of success of this procedure, as well as the potential side-effects. I understand multiple treatment sessions may be required/needed, as such this consent will cover this treatment as well as all subsequent treatments at Spooner Physical Therapy. I understand that I have the right to withdraw consent for this procedure at any time before it is performed, both for the current session and any future sessions.
Minors: If patient is under the age of 18, the signature of a parent or legal guardian is required to receive Dry Needling. While this individual is welcome to be present for any treatments, their presence is not a requirement for the provision of this procedure.
I have read and fully understand this consent form. I understand that I should not sign this form until all items, including my questions, have been answered to my satisfaction. With my signature, I hereby consent to the performance of this procedure.
Submitting the information below serves as my legal signature and consent to the performance of this procedure.