Dry Needling in California: Can a Physical Therapist Do It?
No. As of October 2026, physical therapists (PTs) in California are not allowed to perform dry needling. California law treats putting needles into the body to treat pain as acupuncture, which requires an acupuncture license. A 2026 bill, AB 2497, would have added dry needling to PT practice, but that part was removed in May 2026, and the bill failed on May 28, 2026.
People often ask us about this after a friend in another state had dry needling from a PT, or after seeing it online. This post explains what dry needling is, what California law says, what happened to AB 2497, what the research shows, and where you can get needling in Burbank and Los Angeles County if you want it. Quad Therapy Inc. does not offer dry needling.
Quad Therapy Inc. is a California therapy company founded by a licensed physical therapist. We provide in-home therapy so patients can get care without clinic wait lines, and we place qualified therapists with clinics, schools, and facilities that need staff.
Key facts
Not allowed: California PTs cannot perform dry needling under current law.
May 28, 2026: AB 2497 was refused passage on the Assembly floor, 26 ayes to 19 noes, after its dry needling section had already been removed.
3,000 hours: the minimum length of an approved acupuncture training program in California, including at least 950 hours of supervised clinical training.
38 states plus Washington, DC allowed PTs to dry needle in the American Physical Therapy Association's 2022 count. California was 1 of 5 states that did not.
13 randomized trials in a 2017 review found short-term pain relief from dry needling by PTs, with very low to moderate certainty and no proven long-term benefit.
What is dry needling?
Dry needling is a treatment where a thin, solid needle is inserted into a muscle to ease pain and tightness. It usually targets trigger points, which are tight, tender spots in a muscle that can send pain to other areas. It is called "dry" because nothing is injected, unlike a shot of medicine.
The needles are the same kind used in acupuncture. Supporters of dry needling explain it with Western anatomy and muscle science. Acupuncture groups say it is acupuncture under a different name. In California, that difference matters, because the law decides who may insert needles.
Can physical therapists do dry needling in California?
No. California's physical therapy law does not include inserting needles to treat pain. Business and Professions Code section 2620 defines what PTs may do, and needling for treatment is not part of it. The only skin penetration a PT may perform is under section 2620.5, which allows needle testing of muscles and nerves (electromyography, or EMG) to evaluate how they work. That requires a physician's authorization and a special certification from the Physical Therapy Board of California, and the PT may not interpret the results to make a diagnosis.
California's acupuncture law, collected by the California Acupuncture Board, defines acupuncture in section 4927 as stimulating points on or near the body by inserting needles to relieve pain or help the body function normally. Section 4935 makes it a misdemeanor to practice acupuncture without an acupuncture license. Physicians are exempt, and dentists and podiatrists may use acupuncture within their own practice after an approved course. PTs are not on that list.
What happened with AB 2497?
AB 2497 tried to update California's physical therapy law in 2026, and it was the closest California has come to allowing PT dry needling. It was introduced on February 20, 2026, by Assemblymember Natasha Johnson. As first written, it added a new section, 2620.6, that would have let PTs use solid filament needles and electrode needles to treat muscle and nerve conditions. The bill also included other changes, such as raising the number of physical therapist assistants a PT may supervise from 2 to 3.
Acupuncture groups spoke against the needling section at hearings. In mid-May 2026, the Assembly Appropriations Committee removed it, as reported by The Acupuncture Times and confirmed in a Medical Board of California bill analysis. Even without dry needling, the bill did not pass. According to the legislative record, on May 28, 2026, it was read a third time and refused passage, 26 ayes to 19 noes. It never reached the Senate.
The 2026 session has ended, so California law did not change. The California Physical Therapy Association told the PT board in September 2026 that it wants a renewed push to update the practice act, so the topic may come back in a future bill. Our post Can a Physical Therapist Diagnose in California? covers the other parts of AB 2497 that also did not become law.
Where is dry needling legal for physical therapists?
Most states allow it, but California does not. In the American Physical Therapy Association's 2022 state chart, 38 states and Washington, DC allowed PT dry needling, 7 states were silent, and 5 states did not allow it: California, Hawaii, New York, Oregon, and Washington.
That list is changing. Oregon passed HB 3824 in 2025, and according to the Oregon Physical Therapist Licensing Board, PTs there may not start dry needling until the law takes effect on July 1, 2027, after new rules are written. A PT license from another state does not allow anyone to practice in California, and a California PT license does not include needling.
Does dry needling work?
Dry needling may give modest pain relief for a few weeks, but it has not been shown to work better than other physical therapy treatments for function. Here is what the reviews found:
A 2017 systematic review by Gattie and colleagues in the Journal of Orthopaedic and Sports Physical Therapy pooled 13 randomized trials. Dry needling by PTs reduced pain more than sham or no treatment for up to 12 weeks, with very low to moderate certainty. Function was no better than with other PT treatments, and the authors found no evidence of long-term benefit.
A 2023 umbrella review by Chys and colleagues looked at 36 systematic reviews. Dry needling beat sham or no treatment for short-term pain and worked about as well as other treatments. Adding it to physical therapy sometimes helped more than physical therapy alone.
A 2026 review of 38 systematic reviews by Jenkins and colleagues rated 82% of them as having a high risk of bias. The authors said this prevents confident recommendations for dry needling.
In plain words, the research is mixed and of uneven quality. Dry needling is not a must-have for recovery.
Is dry needling safe?
Most side effects are minor, but serious ones can happen. In a 2014 study by Brady and colleagues of 7,629 treatments by trained physiotherapists in Ireland, 19% had mild side effects such as bleeding, bruising, or soreness, and none had a serious one. A 2020 study by Boyce and colleagues of more than 20,000 treatments by more than 400 PTs found minor side effects in 36.7% of treatments and 20 major events, less than 0.1%.
The most feared complication is a collapsed lung (pneumothorax) from needling over the chest or upper back. It is rare, but it is a big part of why training rules are debated. In California, an approved acupuncture program must include at least 3,000 hours of training, including 950 hours of supervised clinical work, under section 4927.5.
What can a California physical therapist do instead of dry needling?
A California PT can treat the same muscle and joint pain with exercise, hands-on therapy, and education. Treatment may include:
Strength, stretching, and movement exercises, which have the strongest evidence for many kinds of pain.
Manual therapy, meaning hands-on work on joints and soft tissue.
Heat, cold, and electrical stimulation through pads on the skin.
Teaching you how to sit, lift, sleep, and move with less strain.
A home program so progress keeps going between visits.
You can start in California without a referral for up to 12 visits or 45 days, as explained in Can You See a Physical Therapist Without a Referral in California? For back pain, see Physical Therapy for Lower Back Pain: What Works and What to Expect.
Where can I get dry needling in California?
In California, needling to treat pain is done by licensed acupuncturists and physicians. Many acupuncturists treat trigger points and muscle pain. Before you book, check the provider's license on the California Department of Consumer Affairs License Search.
If a California clinic advertises dry needling, ask who will insert the needles and what license that person holds. You can keep seeing your PT for exercise and hands-on care while you get needling from an acupuncturist or physician. Tell each of them about the other treatment.
Frequently asked questions
Is dry needling the same as acupuncture?
They use the same type of needle but are explained differently. Dry needling targets trigger points based on muscle anatomy, while acupuncture comes from traditional East Asian medicine. California law treats inserting needles to treat pain as acupuncture.
Can a physical therapist licensed in another state dry needle in California?
No. Anyone practicing physical therapy in California needs a California license, and that license does not include dry needling. Training or permission from another state does not change this.
Will California allow physical therapists to do dry needling in the future?
It is possible, but only if a new bill passes the Legislature and the governor signs it. AB 2497 failed in 2026, and the dry needling section had already been removed before the vote.
Does Quad Therapy offer dry needling?
No. Our physical therapists stay within California scope of practice and do not perform dry needling. We treat pain with exercise, hands-on therapy, and education, often in your home.
About Quad Therapy
Quad Therapy Inc. is a therapy company in Burbank, California, founded by a licensed physical therapist. We go to the patient. Our licensed therapists provide [SERVICES] in the home, and we staff clinics, schools, and facilities with qualified therapists. Every service is provided by a clinician licensed by the matching California board and stays within that board's scope of practice. To schedule a visit or ask about staffing, call (855) 313-3201 or visit quadtherapy.com. Our office is at 455 N Moss St, Suite 102, Burbank, CA 91502.
Next step: if you want help with muscle or joint pain in Burbank or Los Angeles County without needles, call (855) 313-3201 to ask about an in-home physical therapy evaluation. If you want needling, check that your provider is a licensed acupuncturist or physician.
This article is for education. It is not medical advice. Talk with a licensed clinician about your situation.
Sources
California Legislature. AB 2497 (2025-2026), Physical therapists: bill history and votes. calmatters.digitaldemocracy.org
Medical Board of California. Bill analysis, AB 2497, board meeting May 21, 2026. mbc.ca.gov
Cho N. AB 2497 amendment removes provision allowing PT dry needling. The Acupuncture Times. May 2026. theacupuncturetimes.com
California Business and Professions Code section 2620, physical therapy defined. california.public.law
California Business and Professions Code section 2620.5, tissue penetration for evaluation. california.public.law
California Acupuncture Board. Acupuncture Licensure Act and regulations (sections 4927, 4927.5, 4935). acupuncture.ca.gov
American Physical Therapy Association. Dry needling laws by state. 2022. apta.org
Oregon Physical Therapist Licensing Board. HB 3824 implementation. oregon.gov
Gattie E, Cleland JA, Snodgrass S. The effectiveness of trigger point dry needling for musculoskeletal conditions by physical therapists: a systematic review and meta-analysis. J Orthop Sports Phys Ther. 2017;47(3):133-149. doi.org
Chys M, De Meulemeester K, De Greef I, et al. Clinical effectiveness of dry needling in patients with musculoskeletal pain: an umbrella review. J Clin Med. 2023;12(3):1205. doi.org
Jenkins L, Scanlon E, Verhagen AP, et al. Most systematic reviews of dry needling for musculoskeletal pain have high risk of bias: a systematic review of systematic reviews. JOSPT Methods. 2026. doi.org
Brady S, McEvoy J, Dommerholt J, Doody C. Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists. J Man Manip Ther. 2014;22(3):134-140. pmc.ncbi.nlm.nih.gov
Boyce D, Wempe H, Campbell C, et al. Adverse events associated with therapeutic dry needling. Int J Sports Phys Ther. 2020;15(1):103-113. doi.org
California Physical Therapy Association remarks to the Physical Therapy Board of California, September 2026 (meeting summary). citizenportal.ai