Dry needling for post-ACDF hand/arm pain and numbness

Posted by birdman518 @birdman518, Jun 23 12:28pm

I started a new PT yesterday to try and get some relief from my continuing arm/hand pain and numbness, which my C3-C6 ACDF surgery has not fixed. In fact it is a little worse now. (I have explained this in more detail in other posts).
My current PT has suggested dry needling and my surgeon said "go for it", albeit with the caveat that it might not help.
People who push dry needling are very concerned to indicate that it is a "Western" medicine technique and to differentiate it from acupuncture.
But as far as I can tell, it is related to "trigger points" in the muscle (or fascia) similar to what is promoted by myo-fascial release therapy.
In any event, I still do not see how addressing trigger points would help my constant nerve pain and numbness. Shouldn't there be a specific diagnosis that can be pointed to, e.g. "your pre- and post-surgery nerve issues are related to factor X, which dry needling with correct, or at least address".
I do not see this type of direct cause-effect in any of the discussions of dry needling I have read so far.
Finally, I would love to get relief, even if there is no clear cause, but I am skeptical about people promoting something that I cannot understand.
Thanks,
Mitch

Interested in more discussions like this? Go to the Spine Health group.

Hello @birdman518. I think western medicine is often not well understood in our country but many hospitals have endorsed more and more of the practices as alternative treatment options. Here is an article from the Mayo Clinic Health System that may help you feel more comfortable with the idea of the treatment: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/on-pins-and-needles-just-what-is-dry-needling

As well, I'd like to invite @jenniferhunter to come in and share what she may know with regard to another treatment that could be worth exploring, that is myofascial release therapy. Have you heard of it?

REPLY
@amandajro

Hello @birdman518. I think western medicine is often not well understood in our country but many hospitals have endorsed more and more of the practices as alternative treatment options. Here is an article from the Mayo Clinic Health System that may help you feel more comfortable with the idea of the treatment: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/on-pins-and-needles-just-what-is-dry-needling

As well, I'd like to invite @jenniferhunter to come in and share what she may know with regard to another treatment that could be worth exploring, that is myofascial release therapy. Have you heard of it?

Jump to this post

Jennifer has written to me about myofascial release therapy. I will look at the article you provided, but I may give DN a try.

REPLY
@birdman518

Jennifer has written to me about myofascial release therapy. I will look at the article you provided, but I may give DN a try.

Jump to this post

@birdman518 Hi Mitch.
Muscles contract because of electrical impulses from the nerves, and the speed of the impulses determines if the muscle twitches and releases or stays in a sustained contraction. This was an experiment my biology class did to demonstrate that by increasing the speed of impulses, you can get it fast enough to keep a sustained contraction.

My PT also does dry needing and was suggesting it for me, however, I don't like needles and don't really want to try this. She has explained how it works. When you have a muscle that is spasming, it is holding an electric charge that is keeping the muscle contracted. When you stick a needle into it, as a conductor of electricity, it can dissipate the electrical charge and release the spasm. Sometimes, an electrical charge is applied to the needle after it is inserted into a muscle, but not every state allows this. The needles are very thin.

Another way to do something similar is a Dolphin Neurostimulator which you can find at this website. https://www.dolphinmps.com/
I have done this, and it sends an electric current between 2 handheld devices. That can block pain signals because it interrupts the neurotransmitters that are relaying the electric nerve impulses between nerve cells. Neurotransmitters are chemicals released by a nerve cell that quickly dissipate across the small gap between cells (called a synapse) and enter the next next cell to perpetuate the electrical impulse charge. The Dolphin has different settings to vary the current. It has a sound it makes that lowers in pitch as the muscle is releasing and is held there maybe up to minute. It does feel like needles sticking into the muscle often times when it's bad. I have had pain relief for a week at a time with the Dolphin and this was prior to my spine surgery and the spasms I was getting. My PT was using this at the nerve roots of my cervical spine.

The effects of this may be temporary if a problem exists that keeps sending electric impulses, but it did take my pain away for a week. Nerves may be firing because of compression or damage. I would be interested to know if these therapies help your pain symptoms. You can do all of this and myofascial release too.

What I understand about trigger points is that they are hardened drier areas in the muscles that form in the stressed areas. The tissue is holding a lot of waste products and not getting much circulation to clear it away. Sometimes working on trigger points is simply mashing them with hard massage, and if you get the trigger points out, the muscle gets longer and more relaxed. Trigger points can reform. Myofascial release helps too because it brings back circulation as you work through fine layers of fascia. If your nerve pain is related to functional alignment that is stretching or compressing a nerve, un-kinking the muscles will make them longer and can release the tension which could allow the nerve to just settle down without being poked or yanked by their neighbors. It certainly takes patience and time to work through this. I think the C5 palsey that you described before is related to stretching of the nerves in that location because they are shorter than other spinal nerve roots. All the muscles that connect your spine with your head, neck, shoulders and scapula can shorten increasing tension, and pull on the spine and insult the nerves that are still trying to heal. I still get neck spasms 5 years after spine surgery, but not nearly as bad as before spine surgery. What I do also can trigger spasms, and slouching with a forward head position using a computer aggravates this. Just picture a turtle sticking its neck out to see a computer screen, and you get the picture. The more I do other activities that strengthen the core (like barn chores and riding my horse), the better my back and neck feels as long as I maintain correct mechanics and posture, and don't overexert myself and start using neck muscles to help lift things.

Sometimes there are no clear cut answers, and that's OK. Just pay attention to what helps in your therapy and discuss that with your PT. Ask lots of questions about why it helps. Put your mind toward understanding it and believe that you can do it.

Do you think you might want to try the Dolphin?

REPLY
@jenniferhunter

@birdman518 Hi Mitch.
Muscles contract because of electrical impulses from the nerves, and the speed of the impulses determines if the muscle twitches and releases or stays in a sustained contraction. This was an experiment my biology class did to demonstrate that by increasing the speed of impulses, you can get it fast enough to keep a sustained contraction.

My PT also does dry needing and was suggesting it for me, however, I don't like needles and don't really want to try this. She has explained how it works. When you have a muscle that is spasming, it is holding an electric charge that is keeping the muscle contracted. When you stick a needle into it, as a conductor of electricity, it can dissipate the electrical charge and release the spasm. Sometimes, an electrical charge is applied to the needle after it is inserted into a muscle, but not every state allows this. The needles are very thin.

Another way to do something similar is a Dolphin Neurostimulator which you can find at this website. https://www.dolphinmps.com/
I have done this, and it sends an electric current between 2 handheld devices. That can block pain signals because it interrupts the neurotransmitters that are relaying the electric nerve impulses between nerve cells. Neurotransmitters are chemicals released by a nerve cell that quickly dissipate across the small gap between cells (called a synapse) and enter the next next cell to perpetuate the electrical impulse charge. The Dolphin has different settings to vary the current. It has a sound it makes that lowers in pitch as the muscle is releasing and is held there maybe up to minute. It does feel like needles sticking into the muscle often times when it's bad. I have had pain relief for a week at a time with the Dolphin and this was prior to my spine surgery and the spasms I was getting. My PT was using this at the nerve roots of my cervical spine.

The effects of this may be temporary if a problem exists that keeps sending electric impulses, but it did take my pain away for a week. Nerves may be firing because of compression or damage. I would be interested to know if these therapies help your pain symptoms. You can do all of this and myofascial release too.

What I understand about trigger points is that they are hardened drier areas in the muscles that form in the stressed areas. The tissue is holding a lot of waste products and not getting much circulation to clear it away. Sometimes working on trigger points is simply mashing them with hard massage, and if you get the trigger points out, the muscle gets longer and more relaxed. Trigger points can reform. Myofascial release helps too because it brings back circulation as you work through fine layers of fascia. If your nerve pain is related to functional alignment that is stretching or compressing a nerve, un-kinking the muscles will make them longer and can release the tension which could allow the nerve to just settle down without being poked or yanked by their neighbors. It certainly takes patience and time to work through this. I think the C5 palsey that you described before is related to stretching of the nerves in that location because they are shorter than other spinal nerve roots. All the muscles that connect your spine with your head, neck, shoulders and scapula can shorten increasing tension, and pull on the spine and insult the nerves that are still trying to heal. I still get neck spasms 5 years after spine surgery, but not nearly as bad as before spine surgery. What I do also can trigger spasms, and slouching with a forward head position using a computer aggravates this. Just picture a turtle sticking its neck out to see a computer screen, and you get the picture. The more I do other activities that strengthen the core (like barn chores and riding my horse), the better my back and neck feels as long as I maintain correct mechanics and posture, and don't overexert myself and start using neck muscles to help lift things.

Sometimes there are no clear cut answers, and that's OK. Just pay attention to what helps in your therapy and discuss that with your PT. Ask lots of questions about why it helps. Put your mind toward understanding it and believe that you can do it.

Do you think you might want to try the Dolphin?

Jump to this post

What I do not get about all of this is how muscle knots and/or tension have anything to do with my nerve pain that seems to be related to (what was thought to be) pressure from a cervical disc or bone spur. I think that *any* treatment should be able to posit what is wrong (based on some evidence) and also show how the treatment corrects it. I have not really been able to put this together with my nerve pain (either before or after my ACDF surgery) for either MF release or DN. I am trying to stay open, and I realize that chronic pain makes people sometimes try *anything*.
I also prefer not to do treatments with a very short window of relief..
I am going back to PT on Monday and will continue the conversation.

REPLY
@jenniferhunter

@birdman518 Hi Mitch.
Muscles contract because of electrical impulses from the nerves, and the speed of the impulses determines if the muscle twitches and releases or stays in a sustained contraction. This was an experiment my biology class did to demonstrate that by increasing the speed of impulses, you can get it fast enough to keep a sustained contraction.

My PT also does dry needing and was suggesting it for me, however, I don't like needles and don't really want to try this. She has explained how it works. When you have a muscle that is spasming, it is holding an electric charge that is keeping the muscle contracted. When you stick a needle into it, as a conductor of electricity, it can dissipate the electrical charge and release the spasm. Sometimes, an electrical charge is applied to the needle after it is inserted into a muscle, but not every state allows this. The needles are very thin.

Another way to do something similar is a Dolphin Neurostimulator which you can find at this website. https://www.dolphinmps.com/
I have done this, and it sends an electric current between 2 handheld devices. That can block pain signals because it interrupts the neurotransmitters that are relaying the electric nerve impulses between nerve cells. Neurotransmitters are chemicals released by a nerve cell that quickly dissipate across the small gap between cells (called a synapse) and enter the next next cell to perpetuate the electrical impulse charge. The Dolphin has different settings to vary the current. It has a sound it makes that lowers in pitch as the muscle is releasing and is held there maybe up to minute. It does feel like needles sticking into the muscle often times when it's bad. I have had pain relief for a week at a time with the Dolphin and this was prior to my spine surgery and the spasms I was getting. My PT was using this at the nerve roots of my cervical spine.

The effects of this may be temporary if a problem exists that keeps sending electric impulses, but it did take my pain away for a week. Nerves may be firing because of compression or damage. I would be interested to know if these therapies help your pain symptoms. You can do all of this and myofascial release too.

What I understand about trigger points is that they are hardened drier areas in the muscles that form in the stressed areas. The tissue is holding a lot of waste products and not getting much circulation to clear it away. Sometimes working on trigger points is simply mashing them with hard massage, and if you get the trigger points out, the muscle gets longer and more relaxed. Trigger points can reform. Myofascial release helps too because it brings back circulation as you work through fine layers of fascia. If your nerve pain is related to functional alignment that is stretching or compressing a nerve, un-kinking the muscles will make them longer and can release the tension which could allow the nerve to just settle down without being poked or yanked by their neighbors. It certainly takes patience and time to work through this. I think the C5 palsey that you described before is related to stretching of the nerves in that location because they are shorter than other spinal nerve roots. All the muscles that connect your spine with your head, neck, shoulders and scapula can shorten increasing tension, and pull on the spine and insult the nerves that are still trying to heal. I still get neck spasms 5 years after spine surgery, but not nearly as bad as before spine surgery. What I do also can trigger spasms, and slouching with a forward head position using a computer aggravates this. Just picture a turtle sticking its neck out to see a computer screen, and you get the picture. The more I do other activities that strengthen the core (like barn chores and riding my horse), the better my back and neck feels as long as I maintain correct mechanics and posture, and don't overexert myself and start using neck muscles to help lift things.

Sometimes there are no clear cut answers, and that's OK. Just pay attention to what helps in your therapy and discuss that with your PT. Ask lots of questions about why it helps. Put your mind toward understanding it and believe that you can do it.

Do you think you might want to try the Dolphin?

Jump to this post

Jennifer,
I finally have have a referral for an MRI on my lower back and thorax. I asked my doctor to include my thorax because the CT scan showed issues there as well.
After months of waiting for an MRI in Ontario, I asked my doctor to refer me to Michigan.

REPLY

Jennifer, your explanation of the connections between nerves and muscles is helpful. My MRI appointment is scheduled for July 9. After waiting for several months I still don't have an appointment for my facet joint injection.
Thanks,
Diana

REPLY
@jenniferhunter

@birdman518 Hi Mitch.
Muscles contract because of electrical impulses from the nerves, and the speed of the impulses determines if the muscle twitches and releases or stays in a sustained contraction. This was an experiment my biology class did to demonstrate that by increasing the speed of impulses, you can get it fast enough to keep a sustained contraction.

My PT also does dry needing and was suggesting it for me, however, I don't like needles and don't really want to try this. She has explained how it works. When you have a muscle that is spasming, it is holding an electric charge that is keeping the muscle contracted. When you stick a needle into it, as a conductor of electricity, it can dissipate the electrical charge and release the spasm. Sometimes, an electrical charge is applied to the needle after it is inserted into a muscle, but not every state allows this. The needles are very thin.

Another way to do something similar is a Dolphin Neurostimulator which you can find at this website. https://www.dolphinmps.com/
I have done this, and it sends an electric current between 2 handheld devices. That can block pain signals because it interrupts the neurotransmitters that are relaying the electric nerve impulses between nerve cells. Neurotransmitters are chemicals released by a nerve cell that quickly dissipate across the small gap between cells (called a synapse) and enter the next next cell to perpetuate the electrical impulse charge. The Dolphin has different settings to vary the current. It has a sound it makes that lowers in pitch as the muscle is releasing and is held there maybe up to minute. It does feel like needles sticking into the muscle often times when it's bad. I have had pain relief for a week at a time with the Dolphin and this was prior to my spine surgery and the spasms I was getting. My PT was using this at the nerve roots of my cervical spine.

The effects of this may be temporary if a problem exists that keeps sending electric impulses, but it did take my pain away for a week. Nerves may be firing because of compression or damage. I would be interested to know if these therapies help your pain symptoms. You can do all of this and myofascial release too.

What I understand about trigger points is that they are hardened drier areas in the muscles that form in the stressed areas. The tissue is holding a lot of waste products and not getting much circulation to clear it away. Sometimes working on trigger points is simply mashing them with hard massage, and if you get the trigger points out, the muscle gets longer and more relaxed. Trigger points can reform. Myofascial release helps too because it brings back circulation as you work through fine layers of fascia. If your nerve pain is related to functional alignment that is stretching or compressing a nerve, un-kinking the muscles will make them longer and can release the tension which could allow the nerve to just settle down without being poked or yanked by their neighbors. It certainly takes patience and time to work through this. I think the C5 palsey that you described before is related to stretching of the nerves in that location because they are shorter than other spinal nerve roots. All the muscles that connect your spine with your head, neck, shoulders and scapula can shorten increasing tension, and pull on the spine and insult the nerves that are still trying to heal. I still get neck spasms 5 years after spine surgery, but not nearly as bad as before spine surgery. What I do also can trigger spasms, and slouching with a forward head position using a computer aggravates this. Just picture a turtle sticking its neck out to see a computer screen, and you get the picture. The more I do other activities that strengthen the core (like barn chores and riding my horse), the better my back and neck feels as long as I maintain correct mechanics and posture, and don't overexert myself and start using neck muscles to help lift things.

Sometimes there are no clear cut answers, and that's OK. Just pay attention to what helps in your therapy and discuss that with your PT. Ask lots of questions about why it helps. Put your mind toward understanding it and believe that you can do it.

Do you think you might want to try the Dolphin?

Jump to this post

I have used dry needling for my sciatica and it did work wonderfully for a month. When they get the right spot it can be painful but that’s easy to deal with compared to chronic pain. I think if I could have continued going to the same practitioner I might have continued seeing the positive results that I have not had with conventional PT but the practitioner moved away and subsequent ones were not effective and didn’t seem to even take it seriously. The great practitioner was able to explain eloquently what DN did and why it worked. Conventional PT made my sciatica worse. My myofascial therapist is also helping but that takes time. I highly recommend both.

REPLY
@birdman518

What I do not get about all of this is how muscle knots and/or tension have anything to do with my nerve pain that seems to be related to (what was thought to be) pressure from a cervical disc or bone spur. I think that *any* treatment should be able to posit what is wrong (based on some evidence) and also show how the treatment corrects it. I have not really been able to put this together with my nerve pain (either before or after my ACDF surgery) for either MF release or DN. I am trying to stay open, and I realize that chronic pain makes people sometimes try *anything*.
I also prefer not to do treatments with a very short window of relief..
I am going back to PT on Monday and will continue the conversation.

Jump to this post

@birdman518 I think the question is what is causing the nerve pain? It may be a damaged nerve. It may be a compressed or stretched nerve, and you want to release the pressure on it so it stops complaining. The nerves can travel through really small spaces between bones or joints or between bundles of tight or enlarged muscles that press on them and that happens with muscle spasms. If the nerves are triggered by compression or stretching, physical therapy has a chance to try to improve that. Sometimes nerves just need to heal on their own and that takes time, but they also need to avoid further pressure from muscles and poor body alignment. I do remember prior to spinal fusion, when my C5/C6 was collapsed about 50%, so the vertebrae were closer than normal. If I side bent my neck, it caused sharp electrical type pains because the space in the foramen was compressed so the vertebrae bones could touch the nerve roots in that position. Those were very sharp nerve pains due to compression, and they stopped when I straightened my neck. I also had the same type of stabbing electric pain in my hand after a spine epidural injection caused by the injection itself. It may have been an inflammation reaction to the injected material or physical pressure of fluid injected that had nowhere to go. That was an insult to the nerve and my hand was cold sensitive for over a year and a half. That is how long it took the nerve to heal from that injection. That was a new pain that was different.

The second question is, does your painful nerve that is sending electric impulses also trigger a muscle spasm? The Dolphin can calm a nerve down and can help as you heal. My PT used it on the nerve roots where they exited the spine once a week. It helped buy time for me during the time when I could not find a surgeon willing to help me. Calm the nerve, and the muscles it serves will be happier too. Dry needling is treating the muscle, but not stopping the impulses that caused it. Ask your therapist if the spasm would continue if the nerve stops firing an alarm. There is always communication between nerves and their muscles, if not, the muscle withers away, so there must be some communication. There are a lot of neck, shoulder and spine muscles involved that could add to the symptoms and start moving bones around, certainly not your fused levels, but other places along a nerve's path or other spinal levels that can pull on their neighbors because some muscles connect multiple cervical levels to the shoulder blade for example. Those muscles may not be happy about the fusion either.

I will be interested to hear what your physical therapist says.

REPLY
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