IMPORTANT NEWS REGARDING

NEW TREATMENT PROCEDURES

With a recent policy change by the Chiropractic Board and in conjunction with Dr. Lee’s training in acupuncture, we are pleased to offer dry needling for the treatment of pain and injuries. Dry needling is a proven, safe and effective treatment modality.

Finally, relief for muscle pain!

By definition, “Dry Needling denotes the insertion of a needle into a myofacial trigger point associated with a hypersensitive palpable module in a taut band. This procedure is used when a patient presents with myofascial or musculoskeletal pain. The procedure consists of piercing a trigger point with a fine, thin gage (25 gage or smaller) needle.

When a medical physician injects local anesthetic, saline, corticosteroids or other agents into a trigger point or known acupuncture point, it is medically referred to as trigger-point injection. However, when the same practitioner utilizes a needle into the same precise point without the administration of a substance, it is globally referred to as "dry needling." The term wet needling does not exist it is simply known as trigger-point injection therapy.

Trigger points (TrPs), described by Drs. Travell and Simons in the mid-1960s, are hyperirritable spots in skeletal muscle that are painful on deep palpation and give rise to referred pain and motor dysfunction. They are found in palpable, taut bands of skeletal muscle. They are extremely sensitive to palpation and will produce referred pain for the associated muscle, and are often remote from the TrP itself. The most frequently affected sites are the trapezius, supraspinatus, infraspinatus, teres major, lumbar paraspinals, and gluteal and pectoralis muscles. Myofascial pain syndromes are regional, painful muscle conditions with a direct relationship between specific trigger points and their associated pain region. They are commonly seen in both acute and chronic pain conditions. It has been said that myofascial trigger points are the most commonly missed diagnosis in chronic pain patients. Some examples are tennis/golfer’s elbow, shoulder pain, headaches, back pain, hip pain, TMJ pain, plantar fasciitis, achilles tendonitis, frozen shoulder chrondromalacia patellae, headaches, myofascial pain syndrome (MPS), Fibromyalgia, chronic fatigue and any other pain and injury where the muscle is the primary contributor.

Medically, injection of trigger points with a variety of substances including saline, magnesium sulfate, corticosteroids, local anesthetic, glucose, etc., has been used to deactivate TrPs. It appears that each of the injected substances works to treat trigger points; however, research has shown that the pain relief obtained apparently is not dependent on the specific properties of the substance, but the precise location of the point to be injected and the stimulation of the needle itself. This particular action is apparently the same identical mechanism classically known as acupuncture.

In 1979, Dr. Karel Lewit reported his stunning success with a large number of patients with musculoskeletal pain by employing nothing more than what is described as "dry needling." Dry needling refers to the therapeutic effect of applying needle stimulation directly to trigger points without the use of injection. Dry needling utilizes a solid filament needle, as is used in the practice of acupuncture, but its gauge varies depending on the area of treatment. It mechanically disrupts the integrity of the dysfunctional endplates within the trigger area, resulting in mechanical and physiological resolution of the TrPs. It also shows a strong pain-inhibitory role by opioids released through needle stimulation of A-delta receptors. The approach of dry needling is based on Western anatomical and neurophysiological principles. This is not to be confused with the traditional Chinese medicine (TCM) rationale for the stimulation of acupuncture points.

There are similarities, but also very significant differences between the TCM style of acupuncture and dry needling. Acupuncture follows rules and beliefs that have been established since ancient times, whereas dry needling ignores ancient acupuncture philosophy. Most, if not all of TCM, is based on pre-scientific ideas, whereas dry needling is totally based on modern scientific neurophysiology and anatomy. Dry needling is for pain relief and based on recent understandings in pain science.

In the evaluation of pain, there are two primary types: neuropathic pain from a damaged or dysfunctional nerve, and nociceptive pain, which is very common, caused by osteoarthritis, headaches, sprains/strains, myofascial pain, etc. Both of these pain types have shown extremely good response to dry needling of associated trigger points.

Dry needling is quickly becoming a very popular modality as musculoskeletal complaints are one of the most reported conditions for which people seek professional attention. By deactivating TrPs using needle stimulation directly into the trigger point, the reported pain relief is noteworthy. It is quick, easy and very effective.

Dry needling is based entirely on the neurophysiologically modern understanding of pain as it surrounds hyperactive trigger points in a specific area. The diagnosis is totally based upon palpation, as trigger points are invisible to X-ray, CT scan or MRI. Contracted muscle fibers provide resistance to the needle and may cause a "needle grasp." This phenomenon causes a deep ache, which in acupuncture is described as de qi.

Around the world, physicians of all disciplines are utilizing dry needling over trigger points, with outstanding clinical success. It is an internationally accepted, scientific, neurophysiologic treatment approach that is gaining wide popularity as its use by the health care professions accelerates.