If you don’t like needles, we recommend you click over to the next story. But know that if you do, you’re missing out on an interesting debate over the use of the pointy, prickly objects in a therapeutic context.

Although needles have long been used in acupuncture, a related practice—called trigger-point dry needling—has recently gained popularity among physical therapists, an increasing number of whom are offering this service to clients as a pain-management tool.

As a result, a technique that’s meant to release pressure is actually creating some—between groups representing the two professions. More details:

Two disciplines, two approaches: Advocates of the technique argue that dry needling isn’t the same thing as acupuncture—for one, there’s no Eastern-medicine component to it, and it is generally tied to traditional therapy treatments. “We use the solid filament needles to reset the muscles to decrease pain and restore function. We are trying to reset the system,” J.J. Thomas, a physical therapist in Delaware, explained to The News Journal as she demonstrated dry needling on a patient. In August, Delaware became the 29th state to legislate the technique when the governor signed a law expanding physical therapy practice to include it.

What’s the problem? According to acupuncture professionals, while there may be some differences, dry needling is very similar to acupuncture but is not regulated to the same degree. That means physical therapists may be offering dry-needling services with limited training and experience. “Attempts to circumvent acupuncture training standards, licensing, or regulatory laws by administratively retitling acupuncture as ‘dry needling’ or any other name is confusing to the public, misleads the public as to therapeutic intervention expected, and, through lack of meaningful education and practice regulation, creates a significant endangerment to public welfare,” the American Association of Acupuncture and Oriental Medicine wrote in a 2013 position statement [PDF].

Exposing a sharp pain: The issue came to a head earlier this month, after members of the New Jersey Association of Acupuncture and Oriental Medicine pressured a CBS affiliate, via a Facebook message to its members, not to air a segment on dry needling featuring a physical therapist in the state. NJAAOM claimed that by broadcasting the segment—including in New York, where the technique currently is not legal—the network would be “confusing the public and compromising public safety.” CBS eventually pulled the segment, according to NJAAOM, but the controversy exposed bad blood between the acupuncture group and the American Physical Therapy Association of New Jersey.

The national branch of the American Physical Therapy Association expressed frustration over the controversy.

“This issue has … really blown up within the last six years,” Justin Elliott, director of state government affairs at APTA, told The Philadelphia Inquirer. “Regrettably, it has become one of our biggest scope-of-practice battles.”

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