1. Presented by: Christina Sweet

2.  Describe what dry needling is and what type of pain it can be used to treat.  Describe the physiological theory of how dry needling works.  Explain the basic technique used to administer a dry needling treatment.  Discuss the efficacy of dry needling and the current evidence for and against its use in PT practice.  Know where to go to get trained in dry needling and where certification is necessary.

3.  It is a technique of inserting small filament needles into muscle trigger points to treat myofascial pain and dysfunction. Can be used to treat: Headaches Frozen Shoulder Tennis Elbow Muscle Spasms Fibromyalgia Sciatic Pain Hip Pain Knee Pain Repetitive Strain Injuries Acute & Chronic Pain

4. TRIGGER POINT RELIEF  A trigger point is an area of elevated neurological activity located in muscle or fascia that may refer pain in a localized or peripheral manner.  These trigger points are believed to be the results of motor neurons becoming stuck in a feedback reflex arc, facilitating muscle spasm.  Introducing a new stimulus (i.e. the needle) impedes the reflex arc and has the effect of relaxing the muscle.

5. Technique: Materials Required: -Gloves -Dry Needles of Varying Length Technique: -Find the trigger point -Insert needle into tissue -Feel for a twitch response http://www.youtube.com/watc h?v=xem1TOal2f0

6. FOR DRY NEEDLING  Insertion of needles into muscle tissue has been shown to elicit a slow twitch response.  Patients report it working for them.  It is a quicker alternative to message. AGAINST DRY NEEDLING  Studies have shown that it has the same effect as a placebo treatment.  It mimics acupuncture, but requires much less training.  There is potential to damage nerves or puncture a person’s lung.

7. STATES THAT HAVE ISSUED OPINIONS AFFIRMING THAT DRY NEEDLING IS WITHIN THE PHYSICAL THERAPIST SCOPE OF PRACTICE INCLUDE, BUT ARE NOT LIMITED TO:  Alabama  Colorado  Georgia  Kentucky,  Maryland  Montana  Louisiana  New Hampshire  New Mexico  North Carolina  Ohio  Oregon  South Carolina  Tennessee, Texas  Virginia  Wisconsin  Wyoming. SIX STATE BOARDS HAVE STATED IT IS NOT WITHIN THE SCOPE OF PRACTICE  Idaho  Nevada  New York  Pennsylvania,  South Dakota  Utah  It is not part of the scope of practice in Hawaii, as the Hawaii physical therapy statute contains language prohibiting physical therapists from puncturing the skin for any purpose.

8. True or False: Dry needling interrupts a pain/motor reflex arch. True or False: Dry needling is the same as acupuncture. True or False: Physical Therapist are allowed to use dry needles in every state.

9.  http://www.apta.org/StateIssues/ http://www.apta.org/StateIssues/  http://www.maherpt.com/IMT.aspx http://www.maherpt.com/IMT.aspx