Friday, April 07, 2006

Acupuncture & Dry Needling #3

Today was Visit No. 3 with my mean physiotherapist, the one who sticks needles in me.

After last week's session (several million acupuncture needles plus some dry needling), I had a miserable evening and was practically disabled the whole weekend. My back and neck ached like mad both Saturday and Sunday and my headache, not to be out-done, rose to the occasion with great fervour. It was like my body was saying "you think you can hurt me? think again lassie".

But shockingly, I've had a pretty good subsequent week, headache-wise.

Consulting my daily pain diary, I see that most of the week I've been in the realm of 2-4 (out of 10) during the day, meaning fairly bearable head pain. I'll explain my pain scale in a future blog, but suffice it to say that anything 4 or less I can live with. I did have a couple of evenings at 5 or 7, and yesterday afternoon was killer. But, over the week, I was fairly functional during the work day and felt relatively good in the mornings. And if I can leave the office at less than a 4 a few days in a row, it's worth noting since I generally flare up to a 5-7 in the late afternoon (stress, computer work, busy office) and that ruins my evening.

So, maybe this acupunture stuff is working.

I was skeptical, and it just the forced relaxation mid-day? After all, I'm laid out on a heating pad, made comfy with pillows, and left alone with my acupuncture needles for a full 20 minutes, allowing my chi ample time to re-configure itself. After I reach zen status, I get dry needled in a few spots.

Dry Needling: It's also labelled "Intra-Muscular Stimulation" (IMS) or other such names, and was invented by a masochist. It's basically an invasive technique which forces a tight muscle to relax by jabbing it deeply with a needle until it gives up and relaxes.

The therapist finds a trigger point (tight, tender spot) in the muscle (for me, my traps, neck or pecs), and then stabs it with this epi-pen-like device which contains a thin needle (about the gauge of an acupucture needle). The needle punctures the skin and enters the muscle, up to an inch or two, I suppose, depending on the depth of the muscle/knot, etc. Now, being a muscle, and not liking things sticking in it, the muscle (especially if tight) contracts angrily around the needle, causing a sharp charley-horse-like sensation. Then the muscle suddenly relaxes and the needle is withdrawn. Basically the muscle decides contraction isn't working, and since it isn't capable of much else, it relaxes.

The whole thing takes a mere second or less, although I've had one therapist leave the needle in and wiggle it until I writhe in pain and scream "give!"

I do find it hurts like the dickens, but the sensation is brief. Basically, it lasts long enough for me to say "ow! ow! ow!", wince, and wiggle around a bit. If your therapist is nice, he or she will alleviate the situation by saying "oh sorry..." meaningfully, and repeatedly, after each scream.

You're supposed to relax (and breathe) during the needling, but I forget to do both especially as I start to clench up in anticipation of the charley-horse pain.

For me, the results haven't been monumental. But I will give it a longer try. I find my muscles still feel tight and hard to the touch. But the second time I ever had it (in a previous life), my headaches relented considerably for a whole week. So I'm still waiting for that train to arrive again.

The brilliant minds who study this stuff are still unclear of what the role of the muscles is in chronic tension-type headache (CTTH), but many of us with CTTH have excruciating neck and shoulder/upper back pain to go along with the headaches. Yet it does seem that the muscles do have some triggering role in the headache, because all these muscle-oriented therapies can give some relief. Like massage, dry needling can give you a brief respite from your headaches, if you're lucky, and also combine it with Being Perfect (going to bed on time, staying away from no-no foods, not getting stressed, not doing anything interesting, not living).

I find that nothing gives me permanent relief.

Maybe it's because headache is a complex witch's brew of triggers, and mending one doesn't take the pain away. I guess that's why headache sufferers have to try many things, together and individually, to try to bring their cumulative trigger load below the headache threshold.

All I know is, it's a lot of work, time, and money spent running around to appointments and keeping tabs on every dimension of you life. Salvation doesn't come cheap.


  1. I'd never heard of dry needling before. But in theory, it doesn't sound like a bad idea. I will be interested to see if this helps you.

    Hope you have a great weekend!

  2. My neurologist actually recommended it. He was working with a physiotherapist at a chronic pain clinic, and together they found that it might help some people. My neuro was actually the one who referred me to the first physio I saw to do dry needling. That physio later left town to pursue further studies, leaving me to find another physio trained in this field, which I have. Apparently many physio's are aware of this technique, but not all will have training.

  3. OMG I'm cringing just reading about the dry needle method!!

    I had accupuncture a loooong time ago for tendonitis and it worked fabulously. If I can ever afford the co-pays I want to try it for my headaches.

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