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Hi Sue, I have a 43 y/o female with a history of piriformis syndrome/sciatica that is interested in a needling protocol. She has a history of pulmonary embolism and is currently on a prescribed regimen of Eliquis. I do recall that certain clotting/bleeding disorders and blood thinners can be contraindicated. How would you approach this? Thanks!
Deep needling in this population is contraindicated as you don’t know if you will create a bleed, and thus be able to control it.
I personally would not needle to the depth of piriformis. But that doesn’t mean more superficial needle wouldn’t be helpful. I would start with short, 1/2 needles and see how it is tolerated. If they bruise with that, then I would not increase needle depth. I would “maybe” go to 40mm of a 50mm needle, depending on their reaction to shorter needles and use very thin needles (maybe .22). Again, this is a very general answer and you will need to see how they tolerate it, always with compression upon each needle removal.
Hope that is helpful!
Sue
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