The Top Four Benefits of Orthopedic Dry Needling and Why You Should Consider it.

September 29, 2023/in Movement/by Carrie Jose

Orthopedic dry needling is a modern therapeutic treatment technique that has been adopted by physical therapists and medical professionals to alleviate pain and improve muscle function. But despite its escalating popularity, I’m still surprised at how many people are unaware it even exists.

What exactly is orthopedic dry needling?

Orthopedic dry needling involves the insertion of fine, sterile acupuncture needles into myofascial trigger points (“knots”), tendons, or muscles that are typically painful, stiff, or causing discomfort. Unlike acupuncture, which aims to balance and restore the flow of energy (“chi”) in your body, dry needling focuses on restoring your muscles and soft tissue back to their optimal state. During a dry needling treatment, a needle is inserted into specific areas to encourage blood flow and homeostasis, sometimes eliciting a ‘twitch’ response in the muscles. The needles may remain in place for a short duration, or may be removed quickly, depending on the condition being treated. Dry needling is backed by scientific research and has been shown to work effectively. It’s thought to turn off trigger points, ease muscle tension, reduce inflammation, and relieve pain – all to help improve how your muscles perform and work.

Here are the top 4 benefits of orthopedic dry needling and why you should consider this treatment technique if you haven’t already:

1. Pain Relief

Dry needling can quickly alleviate pain, which means you can get back to your regular activities sooner. While the treatment itself can sometimes be painful, and lead to residual soreness 24-48 hours after your treatment, you’ll find that the positives far outweigh the negatives. Most of my clients find that a little bit of soreness right after the treatment is well worth the pain relief they experience afterwards. Dry needling works best for pain relief when it’s performed alongside functional and integrative therapies such as corrective movement strategies – which will result in long-lasting pain relief instead of more short-term.

2. Better Mobility

Dry needling does more than just relieve pain – it helps to enhance how you move. When muscles are tight, they can restrict movement and create a lot of discomfort. By releasing tension in tight muscles, increasing blood flow, and reducing inflammation – dry needling facilitates more comfortable and more extensive range motion in your joints. This allows you to move more freely and perform your favorite activities with less pain and restriction. In conjunction with corrective exercises and stretches, dry needling can be an extremely valuable tool for enhancing and maintaining good mobility.

3. Enhanced Muscle Function

Good mobility is just one aspect required for optimal muscle function. Your muscles also need to know how to activate properly and together. Sometimes – when you’ve been suffering from pain for a while – the muscles surrounding the problem area can “fall asleep at the wheel”. While you may be able to successfully get rid of your pain in a particular area, getting rid of and correcting the problem is a different story. I often say: “just because your pain is gone – does not mean your problem is gone”. If you don’t address underlying muscular compensations, your pain will eventually come back and sometimes it’s worse. The stimulation provided by orthopedic dry needling can help get your brain to pay more attention to the affected area, thus, helping “sleepy” muscles come back to the party and work like they’re supposed to.

4. Faster Recovery

When you’re injured, your body needs all the help it can get to heal. Dry needling not only enhances blood flow to the targeted area, but helps to create an environment for muscle regeneration as well – thus – helping to speed up the recovery process of injured or damaged soft tissue. Additionally, the improved blood flow aids in the removal of metabolic waste products and the delivery of nutrients to the tissues, fostering faster healing of the injured areas and less inflammation. This accelerated recovery is particularly valuable for athletes or weekend warriors aiming to return to their sport faster, as well as anyone looking to get back to their favorite activities as quickly as possible.

Should you consider orthopedic dry needling?

When I think of orthopedic dry needling, I think of it like a helping hand to feel better, move more freely, and enhance just about any other treatment you’re using alongside it. For example, a corrective exercise is only going to work if you can execute it properly. If you’ve got stiff, painful muscles that prevent you from performing your exercise or stretch that you know you need to do to help a particular problem – dry needling can be the magic in between.

It’s important to note that dry needling is not necessary or right for everyone. So it’s important that you know what it is and when it can be used to improve your health. If after reading this article you think orthopedic dry needling could be something that you’re missing – talk to a qualified physical therapist or health care practitioner who practices dry needling – and ask if you’re a good fit for this treatment technique.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To get in touch, email her at [email protected].

Battling Sciatica? Here’s what to Avoid and what you should do Instead

September 14, 2023/in Movement/by Carrie Jose

Did you know that nearly four out of five people will suffer from a debilitating back pain episode at some point in their lives and that it can result in sciatica?

“Sciatica” is a term used to describe searing pain, burning, or numbness that runs from your back and down your leg, often below your knee and into your foot. It occurs because something in your lower back is irritating the nerve that sends signals to your leg. It can be caused by anything that puts pressure on and/or irritates your sciatic nerve – such as herniated or bulging discs.

What a lot of people don’t know is that you can have sciatic symptoms without actually having any back pain. Sciatic symptoms can occur just in one place in your leg – like your knee and/or foot – or run down the whole leg as described above. Regardless of how your sciatica is behaving – there are some general “best practices” that almost all versions of sciatica will respond to.

Here’s what you should avoid when you’re battling sciatica – as well as what to do instead:

What to Avoid:

1. Soft beds and couches

While it may feel better in the moment – lying in soft beds or couches will ultimately aggravate your sciatica. When you lie in soft beds or couches – it forces you into a slouched posture – which puts unwanted pressure on your already irritated nerves. What’s tricky is that you often won’t notice the aggravation while you’re in the slouched position. It won’t be until later, perhaps when you get up to walk or move around, that you’ll feel worse. Because of this, people mistakenly attribute the aggravation of their sciatica to the activity they just did instead of the prolonged, slouched position they were assuming perhaps just minutes or hours before.

2. Child’s pose and stretching forward.

Just because a stretch feels good, doesn’t mean it is good – another big misconception when it comes to sciatica. Since sciatica is often caused by a bulging or herniated disc that is putting pressure on your nerve – you want to avoid anything that is going to increase that pressure. When you stretch forward – like in child’s pose – you’re opening up the space in between your vertebrae (intervertebral space). In between each vertebrae lies your discs. Although it feels good “in the moment” when you’re stretching forward – and may even temporarily relieve your sciatica – this relief won’t last. By opening up your intervertebral space – you’re making it easier for your discs to protrude out and irritate your nerves – unknowingly prolonging or worsening your sciatica.

3. Letting your MRI dictate treatment.

As already mentioned, sciatica often involves bulging discs – and an MRI will typically confirm this. But here’s what you might not know… Research has shown us that lots of folks (more than 60%) have bulging discs showing up on their MRI’s, but they don’t all have back pain or sciatic symptoms. What that means is that while sciatica is often caused by a bulging disc, a bulging disc doesn’t always guarantee you’ll have sciatica. Why is this important? Because when you allow your MRI findings to dictate your treatment plan, you’re more likely to undergo a procedure or surgery that might not be necessary. Removing the bulging disc material or fusing your spine together might take the pressure off the nerve temporarily, but if the underlying issue is a movement or mechanical problem, and it’s not addressed, it’s only a matter of time before your problem comes back and/or shows up in a different area of your spine.

What to Do:

1. Go for Walks.

Walking is one of the best things you can do for back pain – even though it may seem counterintuitive to do so when you’ve got pain running down your leg. Walking is an upright activity that is generally good for sciatica versus the slouched, curved posture you have when sitting. When you walk, pay close attention to what happens in your leg. Do your symptoms worsen or start to get better? If they worsen, certainly stop and seek professional guidance. But if your leg starts feeling better – then the walking is likely good for your sciatica.

2. Pay attention to your Posture.

This may seem trivial – but maintaining good posture is critical when you’re suffering from sciatica. When your sciatic nerve is irritated, it becomes highly sensitive to postural changes in your lower back (especially slouched postures). Whether you’re sitting or standing – you want to maintain the natural S-curve of your spine as best as you can. I recommend to my clients they use a lumbar roll whenever they are sitting to make maintaining this posture easier. Correcting your posture alone is often not enough to get rid of your sciatica, but it can keep you from getting worse, and prevent it from coming back if you’ve successfully eliminated your sciatic symptoms.

3. Talk to a Mechanical Pain Specialist.

Did you know that 70-80% of all musculoskeletal pain is mechanical in nature? Both back pain and sciatica can fall into this “mechanical pain” category – which is caused by slowly developing movement problems or habits that eventually result in stiffness and mobility restrictions in your spine. These restrictions can lead to irritated structures, such as nerves. So if your sciatica is due to a mechanical problem – it’s not going to permanently improve with pills, procedures or surgery. You’ll need to find a mechanical pain specialist who can help correct and restore your movement patterns for a long-term solution you can maintain on your own.

Dr. Carrie Jose, Physical Therapist and Pilates expert, owns CJ Physical Therapy & Pilates in Portsmouth and writes for Seacoast Media Group. To request a free copy of her guide to back pain CLICK HERE or to get in touch, email her at [email protected].

6 Reasons Your Back Surgery Failed

September 8, 2023/in Movement/by Carrie Jose

Back surgery, often viewed as a last resort for those suffering from debilitating back pain, has become increasingly common in the last 15 years.

A quick Google search reveals that an estimated 1.5 million spinal fusions are performed annually in the United States alone. When you consider that 70-80% of all back pain is considered “non-specific” and does not require surgery – that number is staggering. Additionally, it’s been well documented that 20-40% of all back surgeries fail, resulting in what we call “Failed Back Surgery Syndrome”. So why then – do we continue to operate?

If you or a loved one is considering back surgery – I highly recommend you do your due diligence and research first.

To give you a head start – here are 6 reasons why back surgery often fails:

1. Incorrect Diagnosis

If the wrong diagnosis leads you to an unnecessary surgery – then your back surgery is going to fail. How does this happen? All too often we blame aging structures in the spine as the main source of our pain. But what many fail to understand is that arthritis and degenerating discs (for example) are a normal part of aging. Everyone has it – but not everyone has back pain. An aging spine is not a reason to get back surgery – so be cautious anytime someone blames arthritis or disc degeneration for your pain. It’s typically not the full story.

2. Surgical Complications

Surgical complications are a risk when you undergo any type of surgery – even when it’s coined “minimally invasive”. From anesthesia reactions, to accidentally nicking a nerve, to the possibility of infection – complications can occur – and some of them irreversible. Conservative therapy and natural treatments involving movement and exercise come with virtually no risk – and have better outcomes than surgery according to research. You want to make absolutely certain that a back surgery is warranted before you put yourself at risk for complications.

3. Scar Tissue

Scar tissue is an unavoidable consequence of any surgery and a necessary part of the healing process – but its impact is significantly underestimated. For some, scarring can get out of control and be excessive, manifesting itself similar to an auto-immune condition. For others, they simply have no clue that scars need to be managed and mobilized. Unmanaged scar tissue will become adhesive and may cause problems with your nerves, fascia, and general mobility. While there are treatments such as Shockwave therapy that can help regenerate damaged soft tissue from scarring – unmanaged scar tissue can be one reason your pain doesn’t resolve after back surgery

4. False Expectations

A lot of folks go into back surgery with false expectations. They think they’ll be out of pain and back to their activities in no time. But proper healing from back surgery is deceivingly long. While most incisions will technically heal in about 2 weeks – your body has a different timeline. Most people grossly underestimate the impact their condition prior to surgery will have on their recovery. Your pain may be gone after surgery, but all of the underlying, compensatory problems that developed leading up to your surgery have not magically disappeared. For example, it takes a minimum of 6-8 weeks to build and retrain muscle. If you had nerve impingement that was inhibiting a muscle from performing properly, it’s going to take several months to get that strength back. When this is not considered, and you jump back into activities too soon, you’re asking for trouble. False or mismanaged expectations about recovery after back surgery is a big reason for poor outcomes.|

5. Images are Misleading

X-rays and MRI’s do not tell the full story when it comes to back pain. And in most cases, they are misleading and can result in an incorrect diagnosis. For example, I already mentioned to you that most things you see in your images – such as arthritis, degenerative disc disease, and even bulging discs – occur naturally as you age. But they don’t always lead to back pain. Studies have shown that 60% of folks in their 50’s will have bulging discs on X-ray and 80% will have disc degeneration – regardless of whether back pain is present or not. These statistics only increase with age. If you allow your imaging alone to dictate your decision to get back surgery – you’re increasing your risk of it failing because it may not have been necessary in the first place.

6. Back Surgery Makes Money

At the end of the day, healthcare is a business. And back surgeries are among the most lucrative procedures in the medical industry. According to studies and statistical data, common back surgeries like lumbar fusion cost anywhere from $50,000 to $90,000. But it only costs hospitals a fraction of that amount to actually administer. Plus, despite its unethical nature, some surgeons have been reported to receive kickbacks for using certain medical devices and performing more surgeries. While this is an indirect reason for your back surgery failing, it’s not something you can ignore. The profitability of back surgery naturally lends itself to being overutilized when there could be better, natural solutions instead.

After all this, I hope you can see that back surgery isn’t a decision you should take lightly, and a good outcome should not be assumed.

Consider the statistics. Anywhere from 20-40% of all back surgeries fail and it could be due to any of the reasons we just looked at. Most back pain (70-80% to be exact) is considered non-specific and mechanical in nature, and can be resolved naturally with prescriptive exercises, lifestyle changes, and corrective movement strategies. It’s worth exhausting all of these options first before jumping into a surgical procedure that has a good chance of failing you.