# COMAR Title 10 — Maryland Department of Health

## Subtitle 43 — Board of Chiropractic Examiners

### Chapter 16 — Dry Needling

#### Regulation .04 Minimum Education and Training Required.

*COMAR 10.43.16.04*

A. A chiropractor with physical therapy privileges shall be in good standing before registering to perform dry needling.

B. The Board shall accept a dry needling course completed before May 18, 2020, if:

  (1) The same course, in substantially similar form, is sponsored by a continuing education provider approved by the Board; and

  (2) The chiropractor seeking to perform dry needling provides the Board with a certificate of completion of 3 hours of a recertification course in dry needling.

C. In order to perform dry needling, a chiropractor with physical therapy privileges shall complete a minimum of 80 hours of total instruction in the following content areas, including:

  (1) 60 hours of:

    (a) Academic coursework obtained through completion of a college program accredited by the Council of Chiropractic Education, as part of the Doctor of Chiropractic program, including the following minimum requirements:

      (i) Foundations;

      (ii) Basic sciences;

      (iii) Clinical sciences; and

      (iv) Professional practice; or

    (b) Coursework required to sit for Part I, Part II, Part III, Physiotherapy, and Part IV of the examination administered by the National Board of Chiropractic Examiners; and

  (2) Board-approved coursework consisting of 20 hours to be done in a hands-on classroom setting, including but not limited to the following learning topics:

    (a) Philosophy and historical perspective of dry needling;

    (b) Indications, contra-indications, and qualifications for treatment;

    (c) Protocols, doctor and patient safety, usage of dry needling, and dry needling as a diagnostic tool;

    (d) Case management and jurisprudence; and

    (e) Direct, hands-on implementation and testing for competency in dry needling of:

      (i) Cervical, thoracic, lumbar, and pelvic regions;

      (ii) Anterior and posterior thoracic and ribs;

      (iii) The upper and lower extremity;

      (iv) The face and head;

      (v) Technique; and

      (vi) Needle size and gauge appropriateness.