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March 28, 2017
What’s the Difference Between Dry Needling and Acupuncture?
Many people want to know what’s the difference between dry needling and acupuncture and what do they offer? North Boulder Physical Therapy is here to help explain it. As you know, the search for pain relief brings us to therapies from all over the world. Learning about therapy styles is important to us so that we can pass along information to our patients and potentially find new ways to treat your pain and help you restore function.
Developed over 5000 years ago, acupuncture is based on the idea that health is affected by a balanced flow of chi, which is believed to be the vital life energy present in all living organisms. Acupuncture is the stimulation of determined acupuncture points along the skin of the body that can involve methods like penetration by thin needles or the application of laser light, heat, or pressure.
Here’s how the therapy works: chi circulates in the body along twelve major pathways, that are called meridians. Each meridian is linked to identified internal organs and organ systems. The acupuncture needles are put into distinct locations called acupoints, which are found on 12 meridians on the body. The meridians connect the 360 primary acupoints.
By inserting very fine, sterile single-use needles into specific points along the meridians, it redirects and repositions the flow of the chi energy for the purpose of relieving tension, stress, and pain. The thought is that the uninterrupted and balanced flow of energy along these meridians can improve your health and that it is the blockages and imbalances of the chi in the meridians that cause pain and illness.
Acupuncture is often used to relieve muscle and joint pain, but most commonly back pain. It can also be used to help neck pain, headaches, shoulder pain, elbow pain, hip and leg pain, knee pain, hand and wrist pain, back pain, ankle pain and fibromyalgia and many other illnesses.
The World Health Organization (WHO) notes that acupuncture can be used to treat a lot of different medical conditions, including allergies, gastrointestinal disorders, gynecological problems, respiratory conditions, nervous conditions, and disorders of the eyes, nose and throat, and childhood illnesses, among others. Acupuncture is sometimes used in the treatment of alcoholism and substance abuse. It is most often associated with treating headaches and chronic pain associated with problems like back injuries and arthritis.
Dry Needling Therapy
A treatment of muscular pain and myofascial dysfunction, dry needling or intramuscular stimulation (IMS) relaxes overactive muscles, which contain trigger points. Basically, it is needling a muscle's trigger points without injecting anything. Dry needling uses rapid, short-term needling to tissues in order to improve and restore its function. This may include myofascial trigger points, periosteum and connective tissues as well as others. It uses an acupuncture needle or an injection needle without the injection of a fluid.
Dry needling often relieves pain almost immediately after the procedure. Then process uses small sterile solid needles to deactivate trigger points and relax shortened muscles. Trigger points are local points within a taut band of muscle in the fascia of the muscle. The trigger point can experience pain from the compression and palpation.
The goal is to desensitize these supersensitive structures, and restore motion and give back muscle function. It induces a healing response in the muscle or tendon tissue by creating a local inflammation. It causes microtrauma with microbleeding and the release of platelet derived growth factor into the local tissues to produce inflammation and healing.
The most common areas for dry needling are:
- The suboccipital area and cervical spine for headaches and neck pain.
- The piriformis and gluts
- The ITB and Vastus laterals
- The scapular area, particularly the upper trap, levator scap, teres and rhomboids.
- The lumbar paraspinal muscles and the quadratus lumborum.
- The whole shoulder area
- Hip adductors/high groin sprains
- Lateral and medial epicondyles—needling the bone and tendon for microtrauma (also the points in the extensors).
- Gastrocnemius, peroneals, post ti
- Achilles (needling the tendon for microtrauma)
- Plantar fascia
Dry Needling comes from a medical origin and uses a syringe with nothing in it to alleviate pain. Sometimes, the same type of filament needles are used in dry needling and acupuncture.
The techniques of dry needling and acupuncture are different.
Dry Needling is focused on treating a single tissue, which causes pain. Acupuncture is based on treating broader health conditions.
In addition, the procedure the physical therapists use for finding a myofascial trigger point or taut band in muscle tissue depends on manual palpation skills. These manual skills are used along with a physical examination, testing and case history. Physical therapists are trained extensively in these areas.
Acupuncturists use many different examination skills from Traditional Chinese Medicine (TCM) like pulse and tongue examination. Palpation over tender muscle areas like for dry needling is not part of a normal TCM examination.
Perhaps one of the biggest differences is that dry needling targets a painful muscle trigger point, which is variable in location and not connected to other areas of pain. On the other hand, acupuncture treatment is separate from the pain location. It depends on a TCM diagnosis and needling a combination of acupoints based on that specific diagnosis. The acupuncture needles are left in place for generally a much greater period that those used in dry needling.
Pain reduction and regaining motion range are treatment outcomes of dry needling that are often seen immediately after removal of the needles. The results of acupuncture are normally seen after a period of time after the treatment.
Trained acupuncturists perform acupuncture and physical therapists practice dry needling.
If you are searching for a pain relief therapy and have an interest in dry needling, we can answer what’s the difference between dry needling and acupuncture and what do they offer? Our physical therapists at North Boulder Physical Therapy can work with you and your doctor to find the best therapy for you. We want to help you get back to a pain free life.
February 16, 2017
Physical Therapy Benefits for Back Pain
If you have back pain, you know it affects almost everything you do. If the back pain has lasted over two weeks, is very severe, or it keeps coming back, you may want to try physical therapy at North Boulder Physical Therapy. There’s no need to suffer back pain when there is relief available. Physical therapy benefits for back pain can also help improve your function and help you learn how to prevent back pain in the future. Physical therapy can even assist in improving your mobility, equilibrium, health, strength and help decrease inflammation or irritation.
Over 80 percent of the population suffers from lower back pain at some point. Lower back pain usually comes from muscle strain, injury, overuse, or a specific condition of the spine, such as osteoarthritis, spinal stenosis, spondylolisthesis, degenerative disease, and herniated discs. Some other conditions can cause lower back pain like sacroiliac joint dysfunction, spinal tumors, fibromyalgia, and piriformis syndrome.
We know that when you have back pain your first instinct might be to rest, but taking it easy can actually undermine the entire healing process. We recommend passive therapy along with active forms of exercises to rehabilitate the spine and help alleviate your back pain. Your physical therapy benefits for back pain at North Boulder Physical Therapy will normally have two components, passive therapy to reduce your pain to a more manageable level and active exercises both at therapy and at home. We will work with your doctor, but getting into a regular routine of lower back exercises often helps you avoid stiffness and weakness, minimizes recurrences of lower back pain, and reduces the severity and duration of future episodes of lower back pain.
An article in Spine Health discusses the physical therapy benefits for back pain.
Passive Physical Therapy
Your therapist may focus on decreasing pain with passive physical therapy, meaning the therapy is done to you, and may include: heat and cold packs, ultrasound, iontophoresis, and transcutaneous electrical nerve stimulator (TENS).
Heat and Cold Therapy
Heat and ice packs are often used to help reduce muscle spasms and inflammation. Some people use heat packs and others find a cold pack or ice therapy helps relieve their back pain the best. It can be effective to alternate the hot with the cold every 10-20 minutes every few hours. This can be particularly useful the first few days that you experience back pain.
Ice massages also provide relief for back pain by slowing inflammation and swelling, numbing sore tissues, slowing the nerve impulses, and decreasing tissue damage.
Ultrasound sound waves are applied to the skin and penetrate into the soft tissues in a form of deep heating. Ultrasound is often used in therapy to relieve acute pain and help heal the tissue.
A transcutaneous electrical nerve stimulator (TENS) unit takes advantage of electrical stimulation to modulate the sensation of low back pain. It does it by overriding the painful signals that are sent to the brain.
You can try electrotherapy with a TENS unit to see if you get pain relief from it. You can experiment with various electrode placements. They can be placed on the areas of your back that are experiencing pain, on the nerve at the painful area, or even on the opposite side of the body. If it works for you, you may be able to get a TENS unit for use at home.
Iontophoresis delivers steroids through your skin. The steroid is applied to the skin and then an electrical current causes it to migrate under the skin. The steroids give an anti-inflammatory effect in the general area that is causing pain. This therapy often works well at reducing acute episodes of pain.
Active Physical Therapy
In addition to the passive therapies we talked about, you’ll also receive active therapies, which are basically exercises that can help rehabilitate your spine and help relieve your back pain.
Back Pain Exercises
We recommend you maintain a moderate back pain exercise regimen at home as well, including activities focused on stretching, strengthening, and aerobic conditioning. These exercises are meant to reduce your back pain.
Part of your active physical therapy is stretching. There are a lot of benefits from stretching the soft tissues, including the muscles, ligaments and tendons in the back, legs, buttocks, and around the spine, including increasing your range of motion. There are many stretches recommended for back pain but one that many people forget is to stretch your hamstrings once or twice every day.
Your back pain exercises will include ones to strengthen the back muscles. Conditioning through flexibility and strengthening back exercises can reduce the severity of the spine injury, relieve pain, and help avoid future injuries.
Make time in your day to do about 15 to 20 minutes of dynamic lumbar stabilization. Exercises will also focus on core muscle strengthening in the lower back. Your physical therapist at North Boulder Physical Therapy will show you how to do these exercises.
For your goal of long-term pain reduction, low impact aerobics may be a part of your therapy. These kinds of activities include swimming, walking, bicycling, or water therapy. Low impact aerobics should be done for about 30 to 40 minutes three times weekly, on alternate days from the strengthening exercises.
Aerobic exercise benefits your rehabilitation, eases your pain, strengthens your lower back, and reduces episodes of low back pain. It will help your functioning, weight control to reduce stress, increase endorphins which can decrease pain and elevate your mood.
Our physical therapists will concentrate on the passive physical therapy benefits for back pain, but we will also go through exercises with you and suggest activities that you can do at home. We’ll also provide time frames to ensure a gradual regimen that doesn’t risk reinjury. With the help of North Boulder Physical Therapy, you have the opportunity to improve your motion and function, and help prevent back pain. We’ve been serving Boulder County for more than 35 years. We take a personal and direct approach by developing an individual therapy plan.
Contact us today for more information or to schedule your appointment.
January 11, 2017
Physical Therapy for Shoulder Pain
Do you suffer from shoulder pain due to an injury, overuse, or surgery? Our team of specialists at North Boulder Physical Therapy offer physical therapy for shoulder pain and can put together an individualized plan with the goal of making your shoulder stronger and more mobile. We’ll help you work towards restoring the use of the injured or repaired shoulder so that you can more quickly return to your job and simply enjoy life without ongoing shoulder pain.
The Anatomy of a Shoulder
A Very Well article explains how the shoulder is a complex ball and socket joint made up of the arm bone (humerus), the shoulder blade (scapula) and the collarbone (clavicle). In order to be able to reach and move in many directions, the shoulder has to be an extremely mobile joint. Many ligaments help support the shoulder and while muscular attachments move the shoulder.
• Overuse: There are many activities, such as swimming, painting, or throwing a baseball that may cause the pinching of the rotator cuff or biceps tendons. Sometimes just sitting with poor posture can put an increased stress on the shoulder and cause pain.
• Injuries: Trauma such as falls or auto accidents can also injure the shoulder.
• Surgery: After shoulder surgery, lingering pain can be both bothersome and a hindrance to everyday activities.
Kinds of Shoulder Problems
• Rotator Cuff Tendonitis: The rotator cuff holds the ball of the arm bone in the socket when the arm moved. It’s a group of four muscles that support and move the shoulder. The rotator cuff tendons are attached to the arm bone directly underneath a bony prominence of the shoulder blade. The tendons can get inflamed and sore when they are pinched underneath this bone.
• Biceps Tendonitis: There is a biceps tendon that attaches your biceps muscle in your upper arm to the front of the shoulder. This tendon gives stability to the front of the shoulder but can get pinched by the bony part of the shoulder blade or by ligaments that are attached to the collarbone and shoulder blade.
• Shoulder Bursitis: A bursa is a fluid-filled sac that helps structures in the body glide smoothly over one another. The bursa that lies between the humerus bone and the shoulder blade can be pinched in the shoulder.
• Frozen Shoulder or Adhesive Capsulitis: Frozen shoulder occurs when the shoulder becomes painful and gradually loses motion. This loss of motion can last for up to 18 months. It often leads to a significant loss of function.
• Shoulder Fracture: With significant trauma, the shoulder may fracture. A frequent occurrence is a fracture caused by falling on an outstretched arm. The scapula, the collarbone, and the humerus may be injured.
Treating Shoulder Pain
If your shoulder pain has lasted for more than two to three weeks and you also have significant function loss, you should see your doctor. As your physical therapist, we will work with your doctor to make sure your physical therapy benefits your recovery.
Usually, with shoulder pain, it is recommended for you to rest for two or three days. You should apply ice to the shoulder to help stop inflammation and provide temporary relief. Apply the ice for 15 to 20 minutes. Working with a physical therapist, you may start gentle pendulum exercises which can improve the range of motion of the joint and improve the strength of the rotator cuff muscles which stabilizes the ball in the socket when you lift your arm. By trying to keep your shoulder mobile, you can hopefully avoid a frozen shoulder.
Physical Therapy Helps Relieve Shoulder Pain
Along with the medical information from your doctor, our physical therapists will evaluate and treat your shoulder pain. You will receive an initial evaluation where we will assess your needs and discuss with you the severity of your pain. We will take into account your range of motion and strength of your shoulder, and monitor the quality of your shoulder motion. We will perform tests on the shoulder to determine what is causing your pain. This information along with your doctor’s reports will help us determine what course of treatment to pursue. In addition, you may be instructed on home exercises to help you improve the strength and mobility of your shoulder.
How Long Should the Pain Last?
Normally your shoulder pain should not last longer than about four to eight weeks. With a few weeks of treatment, you should notice an improvement in your pain. But if you still have shoulder pain you may want to follow up with a medical specialist who may be able to provide more invasive treatments like injections or surgery.
Injections and Surgery
If you get an injection in the shoulder, you may want to schedule physical therapy after the injection to help keep your shoulder’s mobility. If you need surgery, we will work with your surgeon’s follow-up care to help you recover. Post-operative physical therapy can help regain normal motion and strength after your surgery.
We know the shoulder is a mobile joint and we depend on it to reach and move in many directions but the mobility it requires makes it susceptible to injury and pain. Our goal is to get your shoulder mobile and strong and reduce your pain.
North Boulder Physical Therapy and Sports Rehabilitation has provided our community and neighbors with the highest quality of physical therapy care in Boulder, Colorado for over 30 years. We can help you get on the right path with physical therapy for shoulder pain. Our therapists will work closely with you to create a unique, holistic program that will enable your shoulder to get stronger and more mobile so you can return to an active life with less pain.
If you’re experiencing shoulder pain from overuse, an injury or trauma, or even a recent surgery, please give our team at North Boulder Physical Therapy a call to schedule an appointment.
December 13, 2016
Is Virtual Reality Coming to Your Physical Therapy Session?
Our physical therapists are always looking for new therapeutic methods to help our patients. Is virtual reality coming to your physical therapy session? Our staff at North Boulder Physical Therapy in Boulder says it could be.
According to a Live Science article, examples of how virtual reality can be used in physical therapy may include:
- A stroke patient exercises their weak arm by reaching for virtual spaceships within their reach.
- A patient suffering from chronic pain uses their head to bat virtual balls at virtual cartoon bears.
- A veteran with post-traumatic stress disorder helps deal with his battlefield experiences in a safe virtual environment.
These examples of how virtual reality can be used, show how treatments that used to be offered only to severe cases in clinical settings because it was so expensive, can now be offered to almost everyone.
Just a short time ago, virtual reality therapy required expensive headsets, and motion-tracking sensors along with a dedicated game console or a fast-processing PC with a heavy-duty graphics card and it could end up costing thousands of dollars. The cost prohibited many from using it.
But now the virtual reality hardware, including the new headsets that can use a smartphone, are going down in price, making it more affordable to more people. For example, according to the Life Science article:
- Samsung's Gear VR costs around $99.
- Google's new soft Daydream View, which comes with a Bluetooth controller and limited motion-tracking controller, currently sells for $79.
- The Mi VR Play from Chinese tech giant Xiaomi is only $29.
- Mobile VR startup, VicoVR, which is developing an affordable full-body tracking system, is expected to ship their first units by the end of the year.
For a long time, people have been looking forward to the time when virtual reality could be used at home to help people with chronic pain or with physical therapy. Now it’s here. The potential for helping people with physical and mental problems is wide open.
Here is how virtual reality can be effective.
With the affordability of virtual reality equipment and the opportunity to use it almost anywhere, it will be able to offer full immersion. The virtual reality sensors can be placed in the hardware, in clothing, and in other places. It’s possible now for alternate realities to be achieved with temperature-changing gloves, full-body suits that vibrate for physical sensations, and devices that give realistic smells and virtual tastes. This is truly groundbreaking.
With virtual reality being used not just visually immersive but sensory immersive as well, its hope is that the technology will assist with the recovery of patients. For example, if someone had a stroke, they may suffer from physical and cognitive impairments that make everyday movements and activities very difficult. For a stroke patient, buying groceries involves lots of skills, including mobility, planning, organization, and decision-making that may be extremely difficult to master.
A stroke patient could use virtual reality to practice the skills needed to shop in a store, like reaching for food on shelves, navigating the aisles, asking for help, and going through the checking out lane. This allows the stroke patient, used in this example, to practice their skills in virtual reality that they will need in their lives.
What’s interesting is that gaming companies are working on algorithms that can create virtual interactions in real time to match the patient's capabilities. It could allow therapists to set the virtual reality program on a beginning level and then increase the difficulty level until the person feels confident enough to visit an actual store.
Engaged and Interactive
In an interactive virtual reality experience, it engages the brain. Instead of the boring, repetitive exercises in rehab, the patient is now involved in fun and challenging virtual reality adventures and games. Virtual reality has shown that it can get people to interact and push themselves to move in ways that they may not be able to accomplish in traditional physical therapy sessions. When they’re engaged and it’s a fun interactive experience, they often forget it’s therapy.
Of course, virtual reality therapy isn’t effective for everyone. This new technology is difficult for some people to embrace. Simulation sickness doesn’t happen a lot, but for some people, it’s a real problem.
One solution may be augmented reality, where familiar surroundings are overlaid with holographic images. Like the popular augmented reality game Pokémon Go, you are still somewhat present in the real world. You don’t have that heavy headset over your eyes and that’s all you see. For some people, that can be scary or they feel claustrophobic.
The new wearable devices like Microsoft’s anticipated Hololens and Magic Leap’s planned 3-D device may relieve some of that awkward, overbearing feeling that makes some people reluctant to use virtual reality.
Virtual reality is not quite there yet, but on the threshold of being more accessible and less intimidating so augmented reality can be used for physical therapy on a big scale.
But for many people, virtual reality is exciting and they are anxious to try it. Physical therapy can use this new technology for measurable therapeutic purposes.
The goal is for virtual reality developers and researchers to create asystematic, clinical approach to creating these new immersive therapies. Their goal within the virtual reality technology is to make programs that keep people engaged and by measuring brain activity during the tasks they can actually measure how engaged they are and with that information they can improve the design for virtual reality treatments that can be more effective.
Our staff at North Boulder Physical Therapy in Boulder is excited to see how the benefits of virtual reality technology in physical therapy can assist our patients. The potential is huge to have a positive impact on helping our patients reach their goals. Is virtual reality coming to your physical therapy session? The answer is probably yes.
December 11, 2016
GREAT NEWS from North Boulder Physical Therapy!
As many of you know, in 2016 North Boulder PT leased a new office across the hall from our second outpatient orthopedic office at 3000 Center Green Drive (Foothills and Valmont) for the purpose of expanding our practice of PT care for:
• neurological patients (stroke, MS, Parkinson’s, etc)
• gait dysfunction patients (balance, fall risk, ataxic, etc)
• vestibular patients (BPPV, dizziness, post op)
• lymphedema patients (mastectomy, post op, chronic leg swelling)
To give stellar neurological PT care, North Boulder PT hired two neurological trained physical therapists.
• Lauren Staton, DPT is one of a handful of residency trained neurological PTs in all of Colorado.
• Libby White, DPT grew up in Boulder county.
Our FOTO outcomes data has “filled our stockings with holiday cheer”
• 92% outcomes ranking nationally for neurological patients
• 98.21% patient satisfaction score from our neurological patients
Thank you for your referrals. We look forward to helping your patients in 2017!