May a licensed chiropractor treat, attempt to treat or claim to treat patients for type II diabetes?

No.

What about ear infections?

No.

Thyroid problems? No.

The chorus of noes isn't coming from chiropractors' usual nemesis, the Texas Medical Association, which represents physicians.

Rather, it's coming from initial advice to the Texas Board of Chiropractic Examiners, according to notes by Executive Director Glenn Parker of a February meeting. The board has told its staff attorneys to draft rules to tackle these and other questions from chiropractors, a process that could ultimately lead to sanctions against violators.

To be sure, the medical association and chiropractors are still tangling. The association won a lawsuit last year that bars chiropractors from certain medical procedures and use of the word diagnosis for medical conditions, but that judgment is under appeal. In recent weeks, the TMA sued again, this time over a neurological test that the board authorized some chiropractors to use.

Unbowed, chiropractors in Arlington, Fort Worth and elsewhere have continued attempts to broaden their scope of practice. They are backing bills in the Legislature that would remove legal and financial hurdles. They're also seeking approval under board rules.

Questions they're asking the board include: Can chiropractors screen arteries to determine risk of stroke or heart attack? Can they use an oxygen concentrator? Can they perform dry needling, a practice akin to acupuncture?

Acupuncture and lasers

While nixing some of the procedures, the board signaled approval of arterial screening to determine the risk of stroke or heart attack and doing manual lymphatic drainage near a female's breast. And though court action blocked some board rules on diagnoses, Parker said the ruling still allows chiropractors to diagnose some muscular and spinal conditions.

Brian Mulhall, a chiropractor at Active Spine and Sport Therapy in Fort Worth, asked the board to approve dry needling, which he describes as a more Western take on acupuncture that doesn't rely on "meridians and lines of chi."

"You just gently spin the needle ... and the scar tissue wraps around the needle like cotton candy," he said. "It can actually break down a lot of that scar tissue."

Mulhall, who lists two Bachelor of Science degrees, said he traveled to Boulder, Colo., to learn dry needling in "one long weekend."

In handwritten notes from a recent board meeting, Parker wrote that dry needling is "OK if certified in acupuncture. Otherwise, no."

However, to gain that certification, chiropractors must complete a training course of at least 100 hours. For licensed acupuncturists, "It's a three-year postgraduate program," said Allen Cline, presiding officer of the Texas State Board of Acupuncture Examiners.

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