DRY NEEDLING BIOMEDICAL ACUPUNCTURE OR INTRAMUSCULAR MANUAL THERAPY

DRY NEEDLING: BIOMEDICAL ACUPUNCTURE OR INTRAMUSCULAR MANUAL THERAPY Denise Wetzel, DPT

According to myopain seminars: At this point in time, dry needling is formally within the scope of physical therapy practice in the District of Columbia and Alabama, Alaska, Arizona, Colorado, Connecticut, Deleware Georgia, Illinois, Indiana, Iowa, Kentucky, Louisiana, Maryland, Minnesota, Mississippi, Montana, Nebraska, New Hampshire, New Jersey, New Mexico, Nevada, North Carolina, North Dakota, Ohio, Oregon, Rhode Island, South Carolina, Texas, Virginia, West Virginia, Vermont, Wisconsin, and Wyoming. RED: NO- RULED IT’S NOT PART OF PRACTICE ACT GREEN: YES BLUE: NOT SUGGESTED- CONFUSING GREY: NOT ISSUED FORMAL STATEMENTS

LATEST MAP FROM IDN

FSBPT'S POSITION PAPER ON INTRAMUSCULAR MANUAL THERAPY WAS REFERENCED AND DISCUSSED. IT WAS MOVED BY DAVE RELLING, SECONDED BY JEANNE DEKREY AND PASSED UNANIMOUSLY TO ADOPT AS BOARD POLICY THAT INTRAMUSCULAR MANUAL THERAPY (DRY NEEDLING) IS WITHIN THE SCOPE OF PRACTICE FOR NORTH DAKOTA PHYSICAL THERAPISTS.

WANT TO LEARN HOW? American Dry Needling Institute- Yun-Tao Ma IDN- Integrative Dry Needling- Dr. Frank Gargano and Yun-Tao Dr. Ma’s Systemic Dry Needling- Sue Falsone Kineticore- many instructors – large network EIM- mix of online and classroom Myopainseminars

DRY NEEDLERS do not and cannot claim to practice acupuncture do not use acupuncture traditional Chinese medicine theories, meridian acupoints and terminology do not use acupuncture diagnosis like tongue and pulse Chinese acupuncture is based on Eastern medicine philosophy, which says that energy flows through meridians located throughout the body. Dry needling is based on Western medical science, anatomy and neurophysiology.

WHAT IS DRY NEEDLING THERAPY AND HOW DOES IT WORK? Local effects: Puncturing Physical the skin stretching of the tissues (down/up or rotation of the needle) We’ve created lesions thus an INJURY! This activates the body’s natural want to heal itself and tissue remodeling begins to occur 1. Reducing physical stress (tissue tension) 2. Normalizes local inflammation 3. Replaces injured tissues with new healthy tissues

WHAT IS DRY NEEDLING THERAPY AND HOW DOES IT WORK? Systemic effects: Relieving physical stress Muscle tension that creates mm imbalances such as postural imbalance Relieving physiological stress Local inflammation or tissue ischemia etc Do Trigger points cause the pain/inflammation or does inflammation cause the trigger point?

WHAT IS DRY NEEDLING THERAPY AND HOW DOES IT WORK? Molecular mechanism: Anti-inflammatory process Balances sympathetic nervous system Ex) needling reduces secretion of Norepinephrine from sympathetic nerves which stimulate the adrenaline hormones and increase secretion of ACH of the parasympathetic nerves which normalize physiology Also balances vasodilators and vasoconstrictors IMPROVING LOCAL CIRCULATION

LIMITATIONS: EACH PERSON’S IMMUNE SYSTEM- THEIR ABILITY TO SELF HEAL HOW HEALABLE THE PATIENT’S SYMPTOMS ARE

CLINICAL IMPLICATIONS: Prevention of injuries in Athletes: VS. Chronic Pain: VS. Acute Pain:

YUN-TAO’S LAW OF DRY NEEDLING 1. all needling models clinically work 2. if any scientific researches support one model, these researches support all models 3. if any scientific researches deny/falsify theory of particular model, they only deny that theory, not the clinical practice of the model 4. physiologically all models do not conflict with each other, thus it is possible to integrate all models into a new model

EMPIRICAL MODEL TYPES Traditional Gunn model approach Trigger point model Peripheral nerve model

POSITIVE REACTIONS TO DRY NEEDLING: Relaxed 79. 1 Energized 32. 7 Tiredness 24. 4 Types of short term reactions associated with acupuncture (2005)

TYPES OF SHORT TERM NEGATIVE REACTIONS: Pain where needle was inserted 12. 3 Bruising Pain 4. 0 other than at site of needling 4. 0 Faint/dizzy Worsening Sweating Nausea 2. 6 of condition 1. 8. 8 1. 2

PRIMARY ACU-REFLEX POINTS OR HOMEOSTATIC ACUPOINTS Help predict success of treatment – Prognostic Indicator The more tender acupoints, the longer it typically takes to heal someone (sicker takes longer)