Here is an interesting case of a well nourished 34 year old male whose chronic low back pain was treated successfully with dry needling…
This is a man who has suffered from unpleasant low back pain for 7 years. But, he is strong and able to lift heavy things without causing pain. He has none of the symptoms associated with a disc injury.
The Intense Burning Ache of Trigger Point Pain
Rather, he describes with great specificity the kind of intense, burning, ache associated with trigger points, and also the referral pattern one expects to see from trigger points in the Quadratus Lumborum, and also Quadratus femoris. This is his first treatment.
Failed Lidocaine Injections
He has had lidocaine trigger point injection at Kaiser which was a complete failure, and not surprisingly as the MD injected only one point, and that, with zero physical exam…. Physical therapy, also at Kaiser, was, again, not surprisingly, unhelpful…He also had 3 sessions of acupuncture in San Diego, that was not helpful, again because you cannot release trigger points with channel acupuncture..
This Patients Reaction to Dry Needling
Although he claimed to be comfortable with needles, when I began needling him, he became quickly drenched in sweat. So not actually comfortable, but, in fact, very anxious in the moment.
The Fight or Flight Nervous System Response
Sweating in response to needles is a nervous system response. It is the fight or flight response, generally flight. Remember those Disney cartoons when the little chickie is hiding, trembling, from the wolf whose goal is a chicken meal, and is sweating so profusely, it practically jumps off its body.
So I paused, and worked with him on letting his body sink into the table, relaxing, and also breathing deeply and slowly thru the nose on inhale and forcefully out of the mouth on the exhale. After 2 more needles his entire body was trembling uncontrollably, and he was in a cold sweat.
So we slowed down, he reassured me he was ok, and I also switched to a thinner needle for the remainder of the treatment. I was able to complete my task, and once the needles were in the trembling and sweating stopped. His nervous reaction resided.
Cupping and Heat Therapy After the Dry Needles
He rested for 5 minutes, and then I removed the needles and applied cupping, followed by topical liquid magnesium and heat packs. On rising, he described a dramatic reduction in his pain, and increased mobility.
I then taught how to stretch his QL muscles effectively. I look forward to seeing him again, next week. I imagine he will need not more than 3 treatments. Compare that to PT twice a week for 3 months, or 12 visits to the Chiro or Acupuncture!
