I had a physical therapist stop by my office last week and try and sell me on dry needling. I said heard all about dry needling and that I thought that like the force, it can have a strong influence on the weak minded. I said I thought dry needling sounded a lot like acupuncture and said I agreed with Colquhoun and Novella’s position that acupuncture is theatrical placebo.
She said dry needling was better because it had Western rather than Eastern justifications. I said the Western justifications I had heard thus far were different, but to me, no more convincing. She said lots of physical therapists do it, and I said critical thinking isn’t most therapists strong suit. She said she had a lot of great testimonials, I said so do I and I don’t have to stab my patients. That was the gist of the conversation, but before she left I printed off a copy of Colquhoun and Novella’s paper to take with her.
So anyway that got me thinking I ought to do some more investigating of this whole dry needling thing to see if I’m missing out on anything, and this was the first newer paper I found, which was fascinating and almost comedic with full text AND VIDEO available.
The paper was considerably more juicy than I anticipated. I expected it to be a complication of some inexperienced dry needling practitioner performing a risky technique, or a patient rolling over their needle. However, what it was was one doctor performing a demonstration on another doctor, while teaching ‘safe’ and ‘correct’ technique. Right after the instructor “emphasized the danger of pneumothorax” and explained, at length, how to perform the movement safely to avoid such he then pushed the needle 4 centimeters into the man’s chest cavity. As promised HERE’S THE VIDEO.
All’s well that ends well, the victim later complained of chest pain and had difficulty breathing and a chest x-ray confirmed the pneumothorax with his left lung collapsed 20%. He was treated conservatively, after 2 weeks breathlessness lessened, and at 6-8 weeks he was back to normal. That’s more than you can say for another patient for which another dry needling mishap resulted in a epidural hematoma and emergency spine surgery. The authors later went on to emphasis safety techniques when performing dry needling over the thorax. Strangely abstinence of dry needling, particularly over the rib cage, was not one of their ideas. I would imagine Traditional Chinese Medicine practitioners might say acupuncture is better but they have similar horror stories, almost as if dry needling and acupuncture were in effect the same thing.
As always, if you have any further questions or need for clarifications, please don’t hesitate to ask. Being aware that some of my blog ideas are contentious and occasionally a bit out of the field of my expertise, I encourage my readers to come forth with any questions/comments that are of interest or concern. Your comments are valued and welcomed.
Chad Reilly is a licensed physical therapist, located in North Phoenix, practicing science based medicine (and not dry needling) with treatment protocols unique and effective enough to proudly serve patients from Phoenix, Scottsdale, Mesa, Chandler, Tempe, Peoria, and Glendale.