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Hey Joanne!
Great news that he is doing well in the lumbar spine. Regarding the triceps weakness:
C6- C7 for sure. I would use a 25mm needle at that level. Some evidence that lung tissue can sneak up to that level and if you are too wide you could have an accident for sure. So be sure to be behind transverse process, aim for lamina, and use a 25 mm needle.You could also follow down radial nerve path in the tricep on the humerus- or at least hit tricep heads and MT junction.
Hope that helps!
Keep us posted!
SueHey Loren!
Be super careful about treating something like this with DN. This is really playing with the lines of scope of practice, as most practice acts will allow you to use DN for neuromusculoskeletal issues…and many practice acts don’t even include the work neuro…just say MSK.I’d be hesitant to treat something outside of the direct scope of DN. Of course, i don’t know the specifics of your practice act in your state, but I would encourage you to clarify for sure before proceeding.
Whether or not it is in my practice act or not, I feel like this is beyond my personal scope of practice so I don’t have much to offer from an insight standpoint. This is something I would refer to my acupuncture friend for sure!
Just my two cents, and i apologize for not being more hepful.
SueRachel! Way to use the forum!
And you are right we did not go over the AC joint. Super easy though. I wold use 1/2″ needles right at the AC ligament/ joint space and let them marinate for 10 min. If it is more degenerative, I would do a little periosteal pecking on the bone on either end.
I had a baseball player with a degenerative AC joint and we were able to expand on the time between injections by weeks when we would needle. (It was his last season as a player and surgery was not an option for him. He was not a starting player and it only flared up on him if he played/ swung the bat hard several days in a row).
So worked great for us. I know Erik, our other teacher who works hockey and sees acute sprains all the time also uses it and seems to help his guys feel better.
Keep us posted!
SueHey Anthony!
Yes for sure! DN can be very helpful for scars. I will typically go on either side of the scar and aim a short needle (1/2 to 1″) under the scar…so pretty superficial insertion. I will then wind each needle in one direction until some resistance is met. I will do that for each needle, as the patient can tolerate. You will notice the other needles moving as evidence has shown up to 4cm of tissue displacement with winding (Langevin). Let the patient “marinate” for 5 minutes and then maybe wind again. You could also do some of the “tenting” (or opposite of pistoning) with the needles once they are wound.Does that make sense? If you took my old class we didn’t go over all that, but if you took my new Foundations class (since Sept 2017) then we went over that and it should sound familiar.
This can either be totally tolerable by the patient or be fairly painful. I have seen it go both ways, so be mindful and monitor your patients tolerance.
Let me know if that makes sense and is helpful?
SueGreat to hear from you Peer!
Thanks for the question.Right now, I don’t offer any “letters” after your name. I do not provide a certification at this time. I offer a certificate of completion. Until there is a national governing body who controls the standards for dry needling (think ATC, CSCS, CPR, etc), and who independently tests these standards, and follows up annually to ensure continued competencies in the area, current certifications are truly marketing tools. Each state has a minimum requirement for practice for each profession as well, so if you took my class and became “certified”, but work in a state that requires 50 hours of training, your certification wouldn’t mean anything.
A certification in dry needling from another company means nothing to me, and vice versa.
I have a lot of letters after my name, but anything related to DN are not any of them. :-)I am not opposed to creating this scenario in the future, now that we have a 7 (and soon to be 10) course curricula. It would be something that requires multiple classes, a separate testing day (not at the end of a class) and follow up every other year or so to demonstrate continued competency in dry needling. This is at least 1-2 years down the road. If we are going to do it, we are going to do it right! Not just have people complete one class and become “certified”.
Hope that makes sense!
Thanks for spreading the good word about SFDN!!Sue
Hi Jeff!
Yes you have several options for sure!I would imagine Meyer will be pretty competitive with pricing (I get nothing from them if you use them or not, as an fyi), but there are others.
I used to order from LhasaOMS as well. They tend to be fairly expensive but always have good customer service and things are in stock.
http://www.buyacupuncture.com has great pricing as well, but are often out of stock. If you call to place an order, you will have better luck with inventory, as they don’t update their website as often as they should with regards to what they actually have. So, they usually have stuff, even if the website says “sold out”. Just call.
Silver Star are probably the best needle for the price. If I had a large budget, I would probably go with Serin (although their size selection is more limited than silver star). I have not been happy with Tai Chi and HWA as they are sort of “dull” and the patient tends to feel the needle more.
Myotech has a great needle! But…around $16 a box so super pricey. But available to you for sure.
Anyone else? Would love to hear what you guys have been using!
SueHi Kevin!
I have seen dry needling be effective in tendon healing and scars in general. Attaching two studies for your review that may be helpful!Hope you are well! Let us know how it goes!
SueHey David!
Wow! This is a tough one no doubt!Everything you have written above is great to try. Hope that is going well.
Other thoughts:
Psoas (3″ needle)
Mid rectus femoris (fascial point 3″ needle)
Common peroneal nerve (2 fingers distal and 2 fingers anterior from fibular head. may be tender to palpate. 2″ needle)
Saphenous nerve (about 3-4 fingers down from tibial platuea. Might be tender. 2″ needle)
Deep peroneal nerve (between 1st and 2nd metatarsals. 1/2″ needle)
Anterior talocrual joint (3-5 1/2″ needles along the joint line)See if that helps!! Keep me/us posted!!
SueForgot the reference:
1. Dunning, J, Butts, R, Mourad, F, Young, I, Flannagan, S, and Perreault, T. Dry needling: a literature review with implications for clinical practice guidelines1. Phys Ther Rev 108331913X13844, 2014.
Logan!
First off, I love the name of your subject! lol!
Second, let me apologize for taking some time to get back to you. I wanted to look up a few things before I responded.The best answer I can really find is best described by Dr. Dunning in his article: DN- a lit review with clinical implications (1). Most clinical trial research we have, have left needles in for 5-40 minutes and a systematic review showed that leaving needles in the low back for 10 minutes was “better” than immediate removal.
With that said, from a clinical experience perspective, I think there are times when in and out (for safety reasons…upper trap, pec, lat/ teres) is still highly effective and I have seen huge, positive changes with that method. Theoretically, all we need to do is create a lesion to begin the physiological cascade of healing.
I do also feel (personally when I get needled, and subjectively from my athletes) that specifically when in contractile tissue (aka muscle and ligament) that people feel a “letting go” sensation as we let that needle “marinate”. I know I feel like the muscle is melting/ relaxing/ letting go when it is left for some time to fit.
So, for now based on the evidence we have, I will leave a needle sit for up to 40 minutes (but often 10 minutes simply based on scheduling) unless I have a safety concern. In those cases, I am relying on the physiological cascade being kick started by simply creating the lesion.
This would be a FANTASTIC study for any grad student or researcher out there…same diagnosis…same needle areas, different in situ times…look at outcomes. Any takers??? :-)
Hope that helps.
Sue
