Reinvigorating a decades-long scope-of-practice battle, the Texas Board of Chiropractic Examiners (TBCE) is seeking an opinion from the state’s Office of the Attorney General (OAG) regarding whether the board has authority to adopt a rule permitting chiropractors to perform needle electromyography (EMG).
The Texas Medical Association has long argued the diagnostic needle procedure falls under the practice of medicine.
In 2006, TBCE adopted rules authorizing chiropractors to perform, among other things, needle EMG and acupuncture. TMA successfully challenged the needle EMG rules, first at the district court and then at the Texas Third Court of Appeals in 2012.
On Feb. 5 of this year, TBCE wrote to OAG requesting an opinion on whether it can adopt a rule allowing licensed chiropractors to use a “nonincisive” needle to perform an electromyography (EMG) procedure.
The TBCE request letter posits that some needles used in the procedure are similar to acupuncture needles after a December 2023 ruling by a Travis County judge determined that acupuncture needles fall within the chiropractic scope.
TMA continues its vigilance in a March 23 letter to Attorney General Ken Paxton that responds to TBCE’s renewed effort to expand chiropractic scope.
In its letter to OAG, TMA says the Texas Legislature’s Chiropractic Act, which in part established scope parameters for chiropractors, purposefully excluded nearly all needle insertions from chiropractic scope of practice.
“If a patient is going to have to go through this test, which is fairly involved and somewhat painful, it makes the most sense that the person performing it is fully trained to interpret the readings and has the knowledge needed to make the correct diagnosis,” said Sara Austin, MD. The Austin neuromuscular neurologist and consultant to TMA’s Council on Legislation teaches needle EMG to fifth-year neurology residents via a yearlong neurophysiology fellowship.
In its letter to OAG, TMA asserts that under Texas law, needles are “incisive” with only two specific exceptions:
- Under the Chiropractic Act, chiropractors may use needles for drawing blood for diagnostic testing; and
- Per the Acupuncture Act, the “nonincisive” insertion of acupuncture needles is allowed.
Texas Attorney General opinions are considered persuasive authority. They are not binding on courts. TMA will continue to monitor developments on this issue and provide updates in the future.
Last Updated On
May 22, 2026
Originally Published On
May 22, 2026
Phil West
Associate Editor
(512) 370-1394
phil.west[at]texmed[dot]org
Phil West is a writer and editor whose publications include the Los Angeles Times, Seattle Times, Austin American-Statesman, and San Antonio Express-News. He earned a BA in journalism from the University of Washington and an MFA from the University of Texas at Austin’s James A. Michener Center for Writers. He lives in Austin with his wife, children, and a trio of free-spirited dogs.