VCU DPT - Agents (Dry Needling)

what needles used in dry needling

sterile, single use needles (same as acupuncture)

what is the mechanism of dry needling

to create inflammatory response in the tissue from microtrauma

helps trigger cycle of tissue repair

can dry needling be used for pain relief

yes

what force is delievere to the cell nucleus to be a catalyst for systemtic responses, in dry needling

mechanical shearing forces

mechanical load targets with dry needling can be what tissues (4)

connective tissue

muscle fiber

bone

cartilage

do PTs use physical force often?

YES!!!!!!!!!

manip

mob

STM

nerve glides

e-stim

etc, etc

what are the two techniques for dry needling

pistoning

whorl

which technique for dry needling is used for

- breaking up trigger point

- promoting healing and breaking up scar tissue

trigger: piston

whorl: healing, scar

how do you do "pistoning" for dry needling (like explain it)

identify trigger point

insert needle into trigger point, then withdrawl 1/2 way and put back in

create a twitch response

interrupts the self sustaining cycle of trigger point

what can cause a trigger point

spot of overload, via poor posture/abnormal activity and are a protective response to gaurd this damaged tissue

what do we have to do with pistoning to get a twitch response

put needle in, slightly take it out and put it back in

with pistoning, what is significance of creating the twitch response

it will interrupt the self sustaining cycle of a trigger point

with the whorl, what is the result

collagen and tissue will reorgnaize into better, more parallel arragnement

when do you use whorl technique for scar tissue

after the initial healing period, at least 6 weeks

good bc scar tissue fibers are often not aligned parallel

does dry needling help increase enorphin producing cells and active opiod receptor

yes

helps utilize own body system

how does dry needling help normlaize body tissue

through inflammatory process to bring extra blood into the area, and initiate natural pain control process

3 common dry needling side effects

bruising

soreness

fatigue

dry needling precautions (6)

pacemakers or spinal stimualtor

hx of faint/seizure

take anticoagulants

acitvely pregnant

diabetes

infectio

dry needling contraindications (4)

fear of needles

active infection/open wound

pregnancy between trimesters

can not use ESTIM if impalnted devices

what makes a good candidate for dry needling

patient with tightness/trigger points

pt may not be able to tolerate prolonged manual release/not responding well to traditional treatment

with ROM limits from muscular restriction

nn conditions, incluing sciatica and carpal tunnel

what makes a bad candidate for dry needling

those who can not remain still/lay in needed positions

fear of needles

t/f; dry needling can be used all by iteself to fully treat someone

FALSE

dry needling ___(is/is not)___ covered by insurance

true: what code is it

false: how do you charge for it

false

cash based

- unbilled time

posterior shoulder DN saw benefits w what 3 thingsq

trigger points

ROM

pain

anterior shoulder DN is helpful for what

pec minor/mj

subscap

shoulder impingement or post op (6 weeks out)

why must you wait 6 weeks post op to DN an area

due to the infection risk

does DN help with carpal tunnel and lateral epicondlyitis

yes

is DN good for chronic neck pain

YES

name 3 anterior hip issues DN can help w/

hip flexor tendonitis

knee Oa

ITB syndrome

is DN helpful with hamstring injury or piriformis syndrome

yes

is DN helpful for KNEE oa

yuh

what benefits doe sDN have for achilles tendonitis

improved collagen quality, leading to more strength

does DN help w plantar fascitis

yes

is DN helpful for LBP? what about long term?

yes

yes, 3 months!