Scope of Practice, PT Privileges, and Dry Needling
The statutory core of chiropractic
Maryland defines chiropractic around detecting and correcting vertebral subluxation and related articular dysfunction, chiefly through adjustment and manipulation, plus adjunctive procedures that support that care. The definition is a ceiling: surgery, prescribing or dispensing legend drugs, and procedures assigned to other licensed professions fall outside it. When a task is not chiropractic, the answer is referral, not improvisation.
PT privileges
Chiropractors may use physical therapy modalities as adjuncts to chiropractic care -- thermotherapy, cryotherapy, electrical stimulation, ultrasound, traction, and therapeutic exercise are typical. Two limits matter: the modality must be adjunctive to a chiropractic diagnosis and plan, and the chiropractor may not hold out as a physical therapist or operate an independent physical therapy practice. Delegation to unlicensed staff is confined to tasks requiring no professional judgment; the licensee remains responsible for what is applied.
Dry needling
Dry needling is an advanced, Board-regulated privilege, not part of the entry-level license: the chiropractor must complete Board-approved training and hold the corresponding certification before needling. It means filiform needles placed into myofascial trigger points and related musculoskeletal targets -- not acupuncture (a separate licensure framework) and not injection. Expect items on sterile technique, informed consent, and documenting adverse events.
Worked example
A patient asks for "acupuncture to quit smoking." The chiropractor is dry needling certified. The request is outside scope because the intent and target are acupuncture, not myofascial treatment; certification does not convert one into the other. The chiropractor refers out or limits care to the musculoskeletal diagnosis.
Traps
- Treating "dry needling certified" as a synonym for acupuncture licensure.
- Applying a PT modality with no chiropractic diagnosis and plan.
- Reading "PT privileges" as permission for independent physical therapy practice.
- Delegating judgment-based procedures to unlicensed assistants.