Why Dry Needling?
The Myofascial Trigger point and tender point that we have all known and treated has been hiding right beneath our nose under the wrong name. I would advocate it should be re-named the “peripheral soft tissue subluxation.” Just as John Faye created a new paradigm for the subluxation, by introducing my generation to the subluxation complex era through the Motion Palpation Institute in the 1980’s, the myofascial trigger point and tender point is worthy of a similar paradigm shift.
Over the last ten years, the knowledge and experience we have gathered regarding trigger points, or peripheral soft tissue subluxation, has allowed us to see that it is directly related to, influencing and influenced by the central spinal subluxation that we know so well. The peripheral soft tissue subluxation is a reflection of the nervous system’s activity and behavior. It also directly drives and influences nervous system behavior both locally and systemically. The central subluxation complex that resides in our spine is intertwined with the peripheral subluxation complex. Because treating the central subluxation complex does not always remove all the interference necessary to restore homeostatic balance, treatment of the peripheral soft tissue subluxation must also be considered in order to restore overall balance to the system.
The question then arises how best to treat the soft tissue. We have been treating these formations for a very long time with many different approaches. The effectiveness of Dry Needling has been gaining attention over the last several years. Why is this approach so important? Is it any better than electrical muscle stimulation that has been used for decades or ultrasound, Nimmo, Graston etc? The answer is yes, because the direct disruption of the myofascial trigger and tender point by Dry Needling causes a rapid improvement in muscle physiology and function that no other modality achieves. It also causes cord and brain responses that are unique. Needle penetration is the most effective means to achieve measurably improved clinical outcomes in both time and duration. This technique supports all manual techniques regardless of what technique you use. For those practitioners whose techniques are osseous and synovial joint complex focused, this technique complements them perfectly and will support non-force techniques quite well. Current research, clinical trials, case studies and my own personal experience all attest to the power of dry needling.
Dry Needling is well reimbursed by insurance companies. Even if our healthcare system moves to global-fee or bundled service basis, Dry Needling is a smart tool. It is time efficient, clinically successful, and less strenuous on the provider then other forms of treatment. So you see, when limited by reimbursement, it makes even more sense to choose treatment options that bring about a faster longer lasting response.
Consider how you will position yourself in the changing healthcare environment. The federal government and Medicare are focusing on outcome measures and “comparative effectiveness.” They want to know how efficient and effective we are in dispensing care. The more diagnostic and treatment tools we have at the ready, the more successful we will be at helping our patients and at maneuvering through the system on behalf of our patients and our practice.
Recently, Chiropractors with PT privileges were able to expand their scope of practice to include Dry Needling in the State of Maryland in part because of my efforts and those of the of the MCA. Please don’t waste this newly acquired right. Opportunities to gain treatment and diagnostic options are few and far between. You paid dearly in time and money to become a chiropractor, don’t let others by intention or ignorance dictate your future.
For the younger practitioner looking to incorporate cutting edge technique –this is it. For the older practitioner seeking to ease the physical strain, Dry Needling can add energy to your practice life.
This technique is a natural practice builder. You don’t have to pay ongoing fees. Once trained, you own it for your lifetime of practice. Patients who respond better refer better than any other marketing plan you have. Whether making house calls, sports field calls or battlefield calls, this technique is an indispensable tool.
We now have the knowledge we need to come full circle and create a very integrated model of the dynamic subluxation complex to include both the spinal subluxation and the peripheral soft tissue subluxation. Dry needling is the technique necessary to tie the model together. I hope you will consider becoming a pioneer in shifting this paradigm and become trained and proficient in Dry Needling.
David B. Fishkin, D.C., MPH
Dry Needling Institute
301-444-4890 Rockville MD