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 He also describes exactly 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
My patient has had lidocaine trigger point injections at Kaiser Hospital with no effect. I was not surprised as he reported the MD injected only one point, and with zero physical exam.
Physical therapy, also at Kaiser, was not helpful…He also had 3 sessions of acupuncture in San Diego, which were 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 drenched in sweat. He was not used to direct needling of trigger points.
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 chicken is hiding, trembling, from the wolf whose goal is a chicken meal. She is sweating so profusely, it practically jumps off her body.
Breathing in Response Anxiety on the Table
If you are stressed by the process of needling, it it so important to slow down and work on your breathing. Breath slowly, though your nose and out your mouth a few times, like blowing out birthday candles.
Now breathe deeply and slowly into the belly, and allow your body to feel heavy, and to sink into the table. In this man’s case, after 2 more needles his entire body was trembling uncontrollably, and he was in a cold sweat.
So we slowed down even more, and he reassured me he was ok. So I 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!
Post script. I saw him 2 more times and he had a complete and total recovery!
