Determining Current Practices of Trigger Point Dry Needling in the Military Health System- APTA CSM 2026

m smith, x yuan, v morris, e harris, l lechanski, n parsons, r condon

Abstract accepted for platform presentation at the 2026 American Physical Therapy Association Combined Sections Meeting

The primary objective of this descriptive survey-based study was to characterize the current trigger point dry needling (TDN) practices of clinical providers within the Military Health System (MHS).

The target sample size was 1,000 participants to ensure at least 250 completed surveys including at least 15-20 responses from each specialty and other categories to facilitate subgroup analysis.

This study was approved with exempt determination by the U.S. Army Medical Center of Excellence Office of Research and Human Subject Protections (24-00027e). Active duty and civilian clinical providers (≥ 18 years of age) within the MHS were eligible to complete the survey. Clinical provider types included Physical Therapists (PT), Athletic Trainers (AT), and Physician Assistants (PA). The survey was disseminated through relevant professional networking for convenience sampling. The survey is comprised of 33 questions focused on provider characteristics, training/experience, clinical practice, perceived outcomes, and barriers. Categorical variables will be presented as counts and proportions.

To date, 847 clinicians have accessed the survey. 755 participants (61.3% active duty) completed the entirety of the survey. Most respondents were PTs (43.8%), followed by ATs (22.6%) and PAs (20.7%). 58.3% (n = 440) reported that they currently perform TDN in their practice. Training sources included military (45.6%) or civilian (35.6%) courses, and training by providers from same (15.6%) or different (10.5%) specialties. The body regions treated most often were the shoulder (92.5%), low back/pelvis (87.6%), and head/neck (85.9%). A small provider cohort of 4.6% (n = 24) reported experiencing a major adverse event. The primary barriers to clinical practice were lack of training (20.0%), difficulty obtaining credentialing privileges (18.8%), and insufficient time (15.8%).

TDN is currently employed by a myriad of providers as a cost-effective, low risk and minimally invasive intervention to treat musculoskeletal (MSK) conditions. PTs are most often using this modality to treat the shoulder, low back/pelvis and head/neck within the MHS. Survey results support the need for practice standardization, better access to training, streamlined credentialing processes, and formal clinical practice guidelines to reduce barriers to TDN use in clinical practice, maximize provider confidence, and further optimize safety.