Chiropractor in Towson Dry Needling Treatment for Back Surgery Patient
Hey everybody, it's Doctor Blake from Doctors Adolph and Kalkstein Chiropractic. Happy Friday, we're doing a little Facebook Live and we're recording this for YouTube. We're gonna show you guys some dry needling for a patient who's had scoliotic surgery. So you can see we've got Lauren in the office, Lauren's our fall intern from Towson University. She's an athletic training student, and how long ago was the surgery? I was fifteen. She was fifteen so about three years ago. She had the scoliotic rod surgery through here but she still has back pain, so we're gonna show you how we can treat a patient with, who's already had surgery who's had a fusion on their back, but if you come in here and just touch the muscle spasms that are in her erector spinae group are really tense.
So we're gonna do a quick anatomy lesson here. We're looking for the bottom of the ribs and the top of the crest. So here's the bottom of the rib here, I'm just gonna draw on you Lauren, following that rib around okay, alright, and then here's the top of the crest. That tickles a little bit alright.
So this is sort of our safe area we're gonna work with some of the needles through here. And then again same thing over here. Here’s the top of the crest coming this way, and then the bottom of the ribs are right here. Good, so there's our safe area that we're gonna go into. So we're gonna show you, sorry pardon the cold, these allergies are killing me with this hot and cold weather that's coming through. So we always start every treatment with an alcohol swab.
We're gonna come in here and we're gonna swab the area. Just erased my X but I know where I'm going so that's okay. So we swab the area with alcohol and we're gonna start with some two inch needles. Lauren you're gonna feel a little, like a twinge.
You probably won't even feel it going in. Alright? Do you feel it? No. Ya, so there we go. So we're gonna go a little deeper here. Good. So we're using these little guys. So this is not acupuncture, okay, I am not an acupuncturist, I'm just using the same needle that an acupuncture would use. Good.
And Megan if anybody comments on the Facebook live let me know okay? Are you ticklish? Kind of. Ya so she's jumping because she's ticklish, not because... So we just used the small needles, we're gonna put two over here too, to get the muscle calmed down a little bit. You felt that, maybe a little tension there.
So I'm able to feel the quality of the muscle tissue through the needle, I can feel if it's tense or tight. Good. It acts as an amplifier almost because I can feel the quality of the tissue through the needle and I can feel if it's a tight trigger point in there or if it's chronic scar tissue, I can feel kind of almost the crystal feeling.
You know if you have, like I have an old AC joint injury, I ran into a tree when I was playing airsoft pistols when I was younger and separated my AC joint. So sometimes when I roll my shoulder you feel that crunchy, crackly noise, that's old chronic scar tissue and inflammation. It feels kinda like crystals rolling around in there.
Anyways, I can feel that, especially when I work on my dad, he's got a bicep tendon injury and a pec tear, a little bit of subscap tear, and I just, the crystals just, but you can feel that right here. So we got three easy ones in there and then we're gonna work our way up. The reason this is so cool is I'm able to go down and her erector spinae are really tight, and I probably eventually as I start to calm her back down start to work up through here, but I can go down to her QL and I can even go into her psoas if I go deep enough, which we will today. And then I wanna show you guys how we really treat this in the office. So we're gonna dry needle first, and then we're going to put some ultrasound on the area. And then I'm gonna show you how we adjust someone for someone who's fused in their back.
And Lauren you can tell me that's a little tighter than the other ones right? So Lauren just told me a little verbally, right? So as I get down to the right area when I do the treatment you feel a little bit more, you feel a bit more pressure, you can feel a little burning, a little aching. All that's normal. Ya that is a good spot for ya. So I'm deep, I'm right on that erector spinae group. I'm probably getting a bit into the multipidie as well. So these are three inches you can see and I've still got an inch to go here but we're gonna let it settle down, and she just feels like some, what would you describe it as Lauren? I don't wanna put words in your mouth. You can feel what? It's like, I don't know you just feel..
You feel some of that tension right? Ya, it feels good though. Ya that's like good example of how when you get right on that spot, you know occasionally when we get on a spot that's really, really tender you kinda get a burning, aching, that's normal. You know when you're working on a firefighter I tweaked his wrist and we put a needle right into that ligament that was strained, and he was like feeling some burning. And you know that's the normal response when we're getting right into that tissue that's irritated. So, two, three, we're going four next. Put another one in there. And you'd be surprised how much tissue there is, that was a little twinge on that one too hunh Lauren? Little bit.
The first one. We're just gonna let that set on you okay? Clean up my mess as we go. I sometimes get yelled at for having a mess. We're gonna do one more right there. So this is not, like I said before, this is not acupuncture.
This is miofascial trigger point dry needling. We just use the same instrument, the same type of needle. The difference is, I'm not trained as an acupuncturist, I'm not an acupuncturist, acupuncture is a technique where you are looking at different meridians, you're looking at different acupuncture points, and you're inserting needles to affect those points. This is not that.
It's just using the same needle, but I did a diagnosis, I examined, I did a consult on Lauren, and I examined her, I've got a diagnosis form, I'm treating miofascial trigger points, and miofascial pain points. So it's a treatment that allows me to do diagnostic and treatment at the same time, so it's not acupuncture. You know and we had another video of us doing Jonathan’s traps on YouTube and a guy was like this is acupuncture, no this is not acupuncture. I'm not an acupuncturist.
I’m a chiropractor who's trained in dry needling. Good. Alright let's see if we can get these other ones to drop in a little bit more. Ya, there we go. And the nice thing about these is here's her, her spine's right here, right, so I'm off her spine, her facette joints run right through here, so these ones right here are probably down to the TPs and the multipidie. And all my chiros and PTs out there that are watching know that if you can affect the multipidie you're gonna take a lot of pressure off the low back. So multipidie treatment are great.
And if I can get into the QLs and the psoas and the multipidie I'm hitting all three major players when it comes to back pain. You're looking at, how many times have you seen me do ART on YouTube videos or on a Facebook Live video where I do a psoas, ART, that is such a huge player on your back. But if I can affect it with some needles here, first of all it saves my thumbs, which I am very happy for so I can continue to practice and do what I do without going home and putting an ice bag on my hands at night. Second I'm able to go deeper with the needles than I am with just my hands, right? I'm able to pass through, think of it like an iceberg, right? The trigger point's like an iceberg. You can feel it superficially on here, but that trigger point goes north to south right, it goes deep into the body. And if I do some active release or some stim I can get the superficial stuff, but if I do these needles I can go right down to the bottom of that iceberg and affect change right through the system.
So we're gonna drop a couple of four inchers in here. And you'll see, there's a good one hunh Lauren. Lauren says yes that's a sore spot, and I say yes that's a good one. You know if we're sitting on something sore or achy or if you feel the tension in there that's normal. Lauren's being a trooper because I mean look at that scar, that is not an easy surgery that she had. But when we were doing some ART on a patient I found out her back was bothering her I was like oh your back still hurts? You had surgery? Which is not an uncommon response, people have surgery but they still have pain. So we're just gonna do two right there.
Now once this settles down, keep an eye on those, I'm not touching the system. Just don't move Lauren, just relax. If you guys can see this one, how it's twitching a little bit. That is normal, that oscillating, that means we're in a good area.
Look at this one right here where it's just kinda going back and forth. It's settled down, like if I touch it, get it to settle down. Look that one's going right there, this one's twinging over here, that's a good sign.
That's some oscillation that we're getting, that means we're right on the right area. So I'm gonna grab a sharps box, we're gonna pull those out, and we're gonna do an ultrasound on that area and then we're gonna show you an adjustment for how we adjust someone who's got a back surgery. How do you feel Lauren? It feels pretty good actually. It was a little like alarming, like I never had that twingy feeling in my low back. Speak up. Oh, it was, it felt pretty good.
It's just a little, it's a new experience, I didn't know how that would feel, but it's not bad. It actually feels pretty relaxing. Ya, and on someone like you who's so tense and tight that probably feels pretty good to have some relief off those muscles, so... Good alright here they come out, they might be a little twingy coming out. And so we had what sixty people, seventy people this morning that came through the office. We probably dry needle twenty percent of them. Fresh gloves on every patient, everyone gets alcohol swabbed, everyone's wearing gloves when we pull the needles out.
What conditions can we treat? We treated a labral tear, we treated wrist, lot of suboccipital headaches, lot of migraine headaches that we're treating, and seeing some great results. A couple of runners that were coming in, a lot of calf treatments, a lot of glute hip treatments for back pain, a couple of psoas, what can I think, anything else that we did that was fun. So see this, a little bit of blood right here, that's the extent of what you're gonna see when you have, you have just a little drop coming to the surface. Nothing alarming Lauren. So we're just gonna get a little tissue, dab that off, and look at that. We just pulled fifteen needles out, nine, eighteen, right? Someone asked why not palpate for a trigger point or points and needle back and forth to break up the tissue and increase new fresh blood supply? So why don't I piston, right? Palpate and piston? So I palpated her already, I already knew where things were going on, so I palpated before I put the needles in.
But pistoning where you drive the needle up and down, sometimes that aggravates the patient. My goal is not to aggravate the patient. I can create a stimulus and a response with just dropping the needles in without pistoning. Now if she's been coming to me for awhile and we've needled her a bunch of times and we really calmed the trigger points down, ya maybe in the future I may go into that driving, that pistoning, that twisting, but in this present time it's not necessary. I don't want to over-aggravate someone who's had, look at this surgery, this is a traumatic surgery on the tissue here. I mean she's probably had chronic hyper spasms in these muscles for three years. So my main goal right now is to calm down trigger points, is to calm down muscle spasms. I don't need to go in there and aggravate the systems, so that's why I'm not pistoning.
All she needs is really you know three or four or five or six needles on either side in the erector spinae down to the multifitie, the QL, and if we can get down into the psoas as well, and then let it sit there for fifteen minutes and let the muscles relax. And then afterwards come back in, we throw a little ultrasound on there, and bring some heat to the area. That's cold, I'm sorry.
Warm that head up for her, there you go. Ya, Doctor Jeff say hi, we're on Facebook live. Hi everybody. You know that the young lady who came in the other day with headaches, if you haven't seen the video go check it out.
You know things happen in threes, well she fell and she cracked her fibula some time ago right? So her headaches by the way are gone, right? She feels awesome. And so she said will you take a look at my ankle, right? Because she had an inversion sprain on her ankle, I think it was still swollen up after six weeks, she's getting some PT but not getting anywhere. So we dry needled her ankle today and we adjusted her cuboid and gave her some range of motion exercises, and she tap-danced out of here. You know, so it's really helping a lot of people. So go back to the ultrasound stuff. So we're just doing some ultrasound right now. So a great treatment after we do the dry needling is we wanna put some heat on the area. The heat helps bring some fresh blood to the area.
And so ultrasound, the sound waves go in, they bounce off the hardest substance which is usually bone, and they come back up. Those sound waves going down meet the sound waves coming back up, they rub together and create friction which creates heat. So we're doing some deep heat treatment here and just right over that muscle site, right over that needle site. And so that's gonna bring some fresh blood to the area in addition to what the needles do, and allow the healing process to speed up a little bit. So Lauren you're not feeling much besides me just massaging you like with the wand, right? Ya, so when we do ultrasound you're not gonna feel a lot.
You may feel a little humming or a little warmth or a little vibration, that's normal. So here and there, we're gonna come over and get this side. I made a mess on your shirt, I'm sorry Lauren. It's cool. So any Towson University students that are watching us, wanna intern here, we've got Megan and Lauren, both exceptional students, and we're booking up fast.
I've got three emails in my inbox of Towson students they wanna intern in the summer and wanna intern in the fall, so any TU students watching this get your emails in because I wanna lock down those spots ASAP. So nice, easy ultrasound over here. Another great way to do this is do some manual massage, you know I can come in here and kind of massage this area to bring some blood back into the area. Cupping is another thing that can bring some fresh blood into this area. So in ideal treatment settings I do two, I do three to four minutes on this side, I do three to four minutes on this side, but I just wanna give you guys a taste of the ultrasound.
And next we're gonna go right next door and we're gonna use a drop technique to adjust you okay, alright? So if that stops there, if you guys have questions about ultrasound leave a comment, if you have questions about dry needling or chiropractic or scoliosis, if I can't answer your questions I'll put you in the right direction of someone who can. So I've had this done on me for, I've got a, I don't know if you guys seen my video on YouTube, if you haven't seen it check out YouTube I go over my actual X-rays, I've got C5, C6 disc thinning with some spurs and I get numbness coming down through here, and I get needled up through here and it lights me up, but the next day the pain is out of my elbow, I can barely feel it in my fingertip. Which is great because I've been running a lot, running and stuff like that my head tends to, if I get lazy in my running posture I really feel it the next day down here, and I have not felt it with any severity. Alright Lauren let's go next door okay? So since we're doing this Facebook live at the same time as we're recording for YouTube I'll try to speed up that little sequence. Maybe I will, maybe I won’t. Lauren you coming? So you're gonna go face down okay? Alright so with someone with a fusion we can't put a lot of rotation or torque into them, so we've got specialized tables in the office where we do a little Thompson drop technique.
The table's gonna lift up underneath her hips and pelvis and it's gonna drop down, I'm gonna have you slide down just a little for me, there you go. So I'm able to put some mechanical movement into the facette joints and the sacroiliac joints without putting a lot of rotation and stressing those rods that are in there. So the table's up, I come into that joint, drop down. Now I know all my YouTube fans are gonna be like where's the crack doc? You're not gonna hear me crack or pop when we do this technique. It's more of a mobilization slash adjustment for the sacroiliac joint, that L5, S1 joint.
We're gonna move on this side. I can, depending on her presentation apply torque or rotation into the pelvic joint, I can drop down more this way or this way depending on her presentation. So it's not just one push solves all of them, it's based on presentation.
Okay, so there's the treatment, how we treat her low back. Roll on your back I'm gonna pull your legs too okay? So roll on your back for me Lauren. Discharge instructions for someone who's gone through this full treatment with us in the office: drink plenty of water, okay, don't be surprised if you're sore. Don't be surprised with any redness or bruising on your back, all that's normal from dry needling. Especially if we're getting adjusted for the first time and having some ultrasound for the first time soreness is not uncommon, right? It shouldn't last more than twenty four, forty eight hours. I'd put a heat pack on your back when you get home tonight, right, and then wake up in the morning, put a little ice on it, do some stretches. That would be typical discharge instructions for the patient.
Let this hip relax. There ya go. Now let this one relax, there you go. Nice and easy. Those are fuzzy socks. It was cold this morning, it was cold. So there you guys have it, a full treatment for a patient who's been surgically fused from scoliosis. So if you guys are dealing with back pain, if you've had back surgery but you're still having pain, right, this is a great example here, we can affect change on that body right? Is this a permanent solution? No.
You know, she's been fused from a scoliotic surgery, she's had a major back surgery. There's no magical fix to fix that, right Lauren? So what do we do? We do everything we can to manage that. Diet, nutrition, exercise, positive mental health choices, good chiropractic treatment, dry needling to affect the muscles and ultrasound, some good core rehab, I mean do whatever we can to manage this patient, and then we treat them symptomatically as they start to present. So if you guys have any questions, I'm looking at two cameras, it's kinda weird a little bit today, comment to the video, comment to the video, you can find me on Facebook, Doctor Blake DC, and I'll see everybody next time. Thanks for watching, bye.
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