AB2497 Puts California
Patients at Risk
This bill would allow physical therapists to insert acupuncture needles into patients with as few as 25 hours of training. Licensed acupuncturists complete 2,000+ hours. Peer-reviewed research documents collapsed lungs, infections, and nerve injuries.
About the Legislation
What Would AB2497 Do?
AB2497 proposes to amend the California Physical Therapy Practice Act to explicitly authorize physical therapists (PTs) to perform "dry needling" — a technique that involves inserting filiform (acupuncture) needles into muscle tissue to release trigger points.
The bill would create an exemption allowing PTs to perform this procedure without holding a California Acupuncture License, as otherwise required under Business and Professions Code §4927.
What the bill does NOT include:
Peer-Reviewed Evidence
Documented Safety Risks
The following adverse events are documented in peer-reviewed medical literature. Minor adverse events occur in over one-third of treatments.
Minor Adverse Events (per treatment session)
Major Adverse Events (documented in literature)
20 Major Adverse Events in a Single Study of 20,494 Treatments
Source: Brady et al. (2021), Journal of Manual & Manipulative Therapy (PMC7015026)
High-Risk Anatomical Areas for Pneumothorax
These are among the most commonly treated areas in physical therapy practice — increasing patient exposure to pneumothorax risk.
Supporting Research
Brady S, McEvoy J et al. (2021)
Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists
Journal of Manual & Manipulative Therapy
20 major adverse events in 20,494 treatments. Minor adverse events in 36.7% of treatments: bleeding (16%), bruising (7.7%), pain during needling (5.9%).
View on PubMed (PMC7015026) ↗Gattie E, Cleland J et al. (2024)
Current State of Dry Needling Practices Among Physical Therapists
PMC
Highly variable training requirements across states with no standardized national certification or oversight body for dry needling.
View on PubMed (PMC11596814) ↗Navarro-Santana MJ (2020)
New perspectives on dry needling following a medical model: are we screening our patients sufficiently?
PMC
Myofascial trigger points implicated in systemic and metabolic pathology; inadequate pre-treatment screening by practitioners with limited training may mask serious underlying conditions.
View on PubMed (PMC6598537) ↗Fernández-de-las-Peñas C, Gallardo-Cámara J (2024)
Pneumothorax as a complication of dry needling technique
ERJ Open Research
2024 case series: four young women suffered pneumothorax after dry needling of shoulder/neck. Two required needle aspiration; three required hospitalization (mean stay 2.7 days); one required chest drain.
View on PubMed (PMC11017104) ↗Kocatürk Ö, Yıldırım T (2024)
Unnecessary Needling: A Case of Iatrogenic Pneumothorax Following Dry Needling
PMC
Patient developed moderate left-sided pneumothorax 2 days after dry needling, confirmed by CT, requiring chest tube and hospitalization.
View on PubMed (PMC11743773) ↗Training Gap
Up to 80× Less Training
The gap between required training for licensed acupuncturists and physical therapists performing dry needling is vast — and in many states, there is no minimum at all.
| Training Component | Licensed Acupuncturist | PT Dry Needling |
|---|---|---|
| Anatomy & Physiology | ✓ Extensive (200+ hrs) | Partial (covered in PT degree) |
| Point Location & Needle Theory | ✓ 500+ hrs | ✕ Not required |
| Needle Technique (supervised) | ✓ 500+ clinical hours | Varies: 0–75 hrs |
| Safety & Contraindications | ✓ Dedicated coursework | ✕ Often minimal |
| National Board Examination | ✓ NCCAOM (required) | ✕ None exists |
| State Licensure & Oversight | ✓ CA Acupuncture Board | ✕ No dedicated board |
| Continuing Education (needling) | ✓ Required for renewal | ✕ Not typically required |
| Total Minimum Hours (CA) | ✓ 3,000+ hours | ✕ No CA minimum in bill |
Many dry needling courses are completed in a single weekend.
California requires a minimum of 3,000 clinical hours for medical licensure. A typical weekend dry needling course represents less than 0.8% of that standard — yet AB2497 sets no minimum at all.
Documented Cases
Real Injuries, Real Consequences
The following cases have been reported in the press or documented in peer-reviewed medical literature. All claims are limited to what is stated in the cited sources.
T.J. Watt
NFL Linebacker, Pittsburgh Steelers · 2024
T.J. Watt reportedly suffered a partially collapsed lung (pneumothorax) following a dry needling treatment session. The case drew national attention to the risks of dry needling and prompted public questions about oversight and standards.
Source: ESPN (2024) ↗Torin Yater-Wallace
US Olympic Halfpipe Skier · 2014
According to reports, American professional freeskier Torin Yater-Wallace sustained a collapsed lung attributed to dry needling performed by a physical therapist prior to the 2014 Winter Olympic season.
Source: Change.org Stop AB2497 ↗Kim Ribble-Orr
Professional Athlete · Reported 2025
Canadian professional athlete Kim Ribble-Orr reportedly suffered a career-ending lung injury and subsequent infection following dry needling performed by a massage therapist, as cited in opposition materials to AB2497.
Source: Change.org Stop AB2497 ↗2024 Peer-Reviewed Case Series
Four Young Women · 2024
A published case series documented four young women who developed pneumothorax after dry needling of the shoulder and neck region. Two required needle aspiration, three were hospitalized (mean stay 2.7 days), and one required chest drain placement.
Source: PMC11017104 — ERJ Open Research (2024) ↗Legal & Regulatory Arguments
Why AB2497 Is Legally and Ethically Problematic
Beyond the safety data, AB2497 raises fundamental questions about California law, federal device regulation, and professional oversight.
Take Action
Tell Your Legislator to Oppose AB2497
The most effective action you can take is contacting the Assembly Health Committee members and the bill's author directly.
Contact Key Decision-Makers
Select a legislator to get their contact info and a pre-composed email.
Talking Points
- 1.AB2497 would allow physical therapists to insert acupuncture needles with as little as 25 hours of training — compared to the 2,000+ hours required of licensed acupuncturists.
- 2.Peer-reviewed research documents 20 major adverse events including collapsed lungs (pneumothorax), infections, and nerve injuries in a single study of 20,494 treatments.
- 3.California Business and Professions Code §4927 already defines needle insertion to stimulate points as acupuncture — AB2497 creates an unlicensed workaround to this law.
- 4.There is no national standardized certification, exam, or oversight board for dry needling. No state credentialing body would investigate complications.
- 5.California already has over 13,000 licensed acupuncturists who completed rigorous training. There is no patient access gap that requires a less-trained alternative.
Spread the Word
Research & Sources
All Citations & Resources
Every claim on this website is supported by a cited source. Browse the full bibliography below.
Brady S, McEvoy J et al. (2021)
Adverse events following trigger point dry needling: a prospective survey of chartered physiotherapists
Journal of Manual & Manipulative Therapy
20 major adverse events in 20,494 treatments. Minor adverse events in 36.7% of treatments: bleeding (16%), bruising (7.7%), pain during needling (5.9%).
View on PubMed (PMC7015026) ↗Gattie E, Cleland J et al. (2024)
Current State of Dry Needling Practices Among Physical Therapists
PMC
Highly variable training requirements across states with no standardized national certification or oversight body for dry needling.
View on PubMed (PMC11596814) ↗Fernández-de-las-Peñas C, Gallardo-Cámara J (2024)
Pneumothorax as a complication of dry needling technique
ERJ Open Research
2024 case series: four young women suffered pneumothorax after dry needling of shoulder/neck. Two required needle aspiration; three required hospitalization (mean stay 2.7 days); one required chest drain.
View on PubMed (PMC11017104) ↗Kocatürk Ö, Yıldırım T (2024)
Unnecessary Needling: A Case of Iatrogenic Pneumothorax Following Dry Needling
PMC
Patient developed moderate left-sided pneumothorax 2 days after dry needling, confirmed by CT, requiring chest tube and hospitalization.
View on PubMed (PMC11743773) ↗Şeker A, Kafa N (2018)
A case with iatrogenic pneumothorax due to deep dry needling
PMC
36-year-old male presented 2 hours after dry needling with right chest pain; confirmed pneumothorax requiring intervention.
View on PubMed (PMC6148831) ↗Stacy D, Sherri W (2025)
Pneumothorax After Dry Needling of Intrascapular Muscles
Physical Therapy Journal
Case documenting pneumothorax following dry needling of intrascapular muscles, a commonly treated area in PT practice.
View Source ↗Navarro-Santana MJ (2020)
New perspectives on dry needling following a medical model: are we screening our patients sufficiently?
PMC
Myofascial trigger points implicated in systemic and metabolic pathology; inadequate pre-treatment screening by practitioners with limited training may mask serious underlying conditions.
View on PubMed (PMC6598537) ↗California Society of Oriental Medicine (CSOMA) (2025)
Acupuncture Profession Joint-Position Statement on Dry Needling in California
Joint statement by California acupuncture organizations asserting that dry needling constitutes acupuncture under CA Business and Professions Code §4927 and must not be performed without an acupuncture license.
View Source ↗Yo San University (2025)
Protect Access to Acupuncture! Oppose AB 2497
Calls on California community to oppose AB2497, citing patient safety risks and the established training standard for licensed acupuncturists.
View Source ↗ESPN (2024)
T.J. Watt's collapsed lung injury update, dry needling explained
NFL linebacker T.J. Watt (Pittsburgh Steelers) suffered a partially collapsed lung (pneumothorax) following a dry needling treatment session in 2024.
View Source ↗Change.org (2025)
Stop AB 2497 – Protect California Patients from Unsafe Dry Needling
Public petition opposing AB2497, documenting athlete injury cases including Torin Yater-Wallace (2014 Olympics) and Kim Ribble-Orr (career-ending injury).
View Source ↗California Legislative Information (2025)
AB-2497 Physical therapists: dry needling
Full text of California AB2497 proposing to amend the Physical Therapy Practice Act to authorize dry needling by licensed physical therapists.
View Source ↗FDA (2023)
21 CFR 880.5860 — Acupuncture needle classification
FDA classifies filiform needles used in both acupuncture and dry needling as Class II medical devices under 21 CFR 880.5860 — labeled 'Acupuncture needles.' There is no separate 'dry needling needle' classification.
View Source ↗Cummings M, Ross-Marrs R et al. (2014)
Pneumothorax complication of deep dry needling demonstration
Acupuncture in Medicine
Pneumothorax occurred during a live dry needling demonstration by an instructor needling the thoracic paraspinal region — managed conservatively.
View Source ↗Grusche F, Egerton-Warburton D (2017)
Traumatic Pneumothorax Following Acupuncture/Dry Needling: A Case Series
Clinical Practice and Cases in Emergency Medicine
Case series of three young patients (including a 24-year-old female with low BMI) presenting to an Irish ED with pneumothorax following acupuncture or dry needling of the shoulder/neck region.
View on PubMed (PMC5965435) ↗Patel N, Patel M et al. (2019)
Dry Needling-Induced Pneumothorax
Journal of the American Osteopathic Association
44-year-old male developed a small left apical pneumothorax after dry needling of the infraspinatus, supraspinatus, rhomboid, and paraspinal muscles. Managed conservatively with supplemental oxygen.
View Source ↗Dalton B, Swarbrigg C et al. (2022)
Bilateral pneumothoraces following dry needling — a case report
Irish Medical Journal
First published case of bilateral pneumothoraces caused by dry needling: a 24-year-old patient required needle aspiration of the right side with conservative management of the left.
View Source ↗Swarbrigg C (2023)
Dry Needling — the Life-Threatening Risk of Iatrogenic Pneumothorax
Irish Medical Journal
Reports five female patients from a single Irish hospital who developed pneumothorax after upper thoracic dry needling by physical therapists. All resolved with oxygen therapy and conservative management within two weeks.
View Source ↗Ronconi G, et al. (2017)
Pneumothorax following dry needling treatment: legal and ethical aspects
Igiene e Sanità Pubblica (Italian Journal of Public Health)
Documents a pneumothorax case involving a professional swimmer in Italy treated by a physical therapist, with analysis of medicolegal liability and practitioner accountability.
View Source ↗Virginia Regulatory Town Hall (2019)
Public Comment to Virginia Board of Physical Therapy on Dry Needling Adverse Events
Official Virginia government record documenting multiple dry needling pneumothorax cases across Virginia, Ohio, and North Carolina, submitted as public comment urging regulatory action.
View Source ↗Oregon Legislative Assembly (2025)
Public Testimony: Safety of Dry Needling (Oregon Legislature, 2025 Session)
Oregon legislative testimony documenting dry needling adverse events including pneumothorax cases, nerve injuries, and lack of standardized training — submitted during 2025 legislative session.
View Source ↗Flathers E, Tahhan S et al. (2024)
Dry Needling — The Double-Edged Sword
Society of Hospital Medicine Annual Meeting Abstracts
Abstract: 66-year-old female developed a 3.5 cm left apical pneumothorax two days after posterior cervical dry needling at a chiropractic clinic. Managed with supplemental oxygen.
View Source ↗Bontinck JS, Lyphout C et al. (2024)
Pneumothorax as a complication of dry needling technique — a case series of four patients
ERJ Open Research
Four Belgian women (ages 28–35) developed pneumothorax after left shoulder/trapezius/neck dry needling. One patient required a chest drain for six days after re-collapse following initial aspiration.
View on PubMed (PMC11017104) ↗