CSOMA is aware of recent media coverage reporting that Pittsburgh Steelers linebacker T.J. Watt experienced a collapsed lung (pneumothorax) following a dry needling procedure. While pneumothorax is a rare complication of needle-based therapies, CSOMA has received an alarming and growing number of reports from the athletic community involving injuries associated with dry needling performed by providers who are not licensed acupuncturists.
Based on reports and testimonials submitted to CSOMA, these injuries have resulted in significant consequences for athletes, including:
Lost playing time for Division I and professional athletes
Negative impacts on draft status and recruitment opportunities
Premature or permanent loss of athletic careers
We have learned that the procedures in these cases were performed by unlicensed practitioners using the term “dry needling” to describe what is, in practice, acupuncture performed without the education, clinical training, or licensure required of acupuncturists.
In addition to pneumothorax, nerve injury is a known risk of needle-based therapies when performed improperly or by individuals without sufficient training. These risks underscore the importance of appropriate education, anatomical knowledge, and regulated clinical experience when inserting needles into the body.
Our intention in responding is not to comment on the specifics of any individual case, but rather to use this moment to help the public better understand an important and often misunderstood issue: the difference between acupuncture and dry needling.
Dry Needling Is Acupuncture—by Law and by Science
Dry needling is not a new or separate modality. It involves the insertion of solid filiform needles into the body for therapeutic effect—the very definition of acupuncture under California law. The needles used, the anatomical targets, and the physiological mechanisms are the same.
In California, the insertion of acupuncture needles for therapeutic purposes is legally defined as the practice of acupuncture and is restricted to licensed acupuncturists and physicians. This framework exists for one primary reason: public safety.
Training Standards Matter
Licensed acupuncturists in California complete more than 3,000 hours of formal education, including approximately 1,000 hours of supervised clinical training. Their education includes detailed instruction in anatomy, physiology, depth and angle of needle insertion, contraindications, risk management, and emergency response.
By contrast, dry needling certifications for other healthcare professionals may involve as little as 20–30 hours of coursework, often without standardized oversight or clinical supervision requirements. While many healthcare professionals are highly skilled within their own scopes of practice, brief training courses do not provide equivalent preparation for performing invasive needle procedures safely across all regions of the body—particularly near vital organs such as the lungs.
Acupuncture needles are classified by the FDA as Class II medical devices, meaning they carry inherent risk and require appropriate training and regulation.
CSOMA’s Ongoing Advocacy for Patient Protection
CSOMA has consistently worked to protect the public by advocating for clear, enforceable standards around acupuncture needle use. Most recently, our lobbyist—on behalf of the California Acupuncture Coalition—submitted formal comments to the Physical Therapy Board of California reaffirming that dry needling falls within the scope of acupuncture and should be held to the same licensure and safety requirements.
Allowing invasive needle procedures to be performed without the rigorous training required of licensed acupuncturists creates confusion for patients, undermines California’s regulatory system, and increases the risk of preventable harm.
Our Position Is Simple
Our position is about patient safety, informed consent, and appropriate standards of care.
CSOMA believes that:
- Dry needling is acupuncture.
- Acupuncture should only be performed by practitioners with comprehensive, regulated training per the California Acupuncture Board’s Laws and Regulations.
- California’s existing licensure standards are essential safeguards for the public.
We encourage patients to ask questions about their provider’s training and licensure before receiving any needle-based treatment. We also urge regulatory bodies to uphold the standards that exist to protect the health and safety of all Californians.
Respectfully,
CSOMA
Media contact: Dr. Robyn Adcock, LAc, Executive Director
12/16/25