jeudi 20 octobre 2016

DRY NEEDLING, N°3, Trigger Point-BMN

DRY NEEDLING, N°3, Trigger Point-BMN
·                 Acupuncture needle for DN
It was necessary for optimizing the needle insertion pain, to select a finer needle even compact.
·                 Karl LEWIT, 1979, published in the medical journal ‘Pain’ an article emphasizing the role in DN, of a solid filament needle as is used in the Acupuncture practice. Acupuncture needle for DN.

**- How are described acupuncture needles
By the Therapists:  Acupuncture needles are thin as a filament, sterile and effective and do not cause the searing pain of a large hypodermic needle. (This is no longer true currently).
An acupuncture needle is a device intended to pierce the skin in the practice of Acupuncture. The device consists of a solid, stainless steel needle. The device may have a handle attached to the needle to facilitate the delivery of Acupuncture treatment.
Indeed, acupuncture needles are effective for inactivating TPs.

Acupuncture Needle and the controversy
The choice of acupuncture needle as a cause of controversy is artificial now.
This choice is only the triggering event of a dispute initiated by the Acupuncturists regarding several encroachments on their Profession by the Needling therapy: Common points, field of activity extended to remote points, treatment of all pain causes except of visceral origin, insertion or injection in a skin point and more.
·                 In various countries, Acupuncturists, referring to the first texts of Travell and Simons describing the procedure of DN with hypodermic needle instead of Acupuncture needle now, argue that anytime a Therapist uses an acupuncture needle while performing a 'dry needling' session, he will be outside of his scope of practice and into the Acupuncture practice.
·                 Other authors are more intransigent
Dry Needling, intramuscular stimulation or any other method by which a needle is inserted to effect therapeutic change, is, by definition, the practice of Acupuncture.

Controversy and protocol, Acupuncture and Acupuncture needles.  
The controversy has diminished because on one hand the classical approach of DN treatment has evolved, including it in a protocol treatment encouraging coupling DN and Acupuncture, especially if it is noted a probability of confusion between TPs and APs, of location either defined or randomized as Ashi points, on the other hand the use of a disposable device classified both as acupuncture and hypodermic needle, the BMN.
**-* DN Protocol
It is interesting to note some evolution in the DN treatment favoring the lull of the controversy while DN becomes a protocol treatment including Acupuncture.
DN cannot be regarded as a full-fledged medicine that is why, partially, some Authors recommend considering DN as a protocol with a prominent place for Acupuncture in its two versions: Acupuncture and Mesopuncture (and various other treatments), for maintaining homeostasis and preventing pain to become chronic. 

DN works best when it is combined with other physical therapy interventions such as soft tissue massage, stretching, strengthening, posture training and home exercises.
DN works best, when it is combined, in front of recurrent TPs for example, with a diagnostic and therapeutic set, identical to that achieved in General Practice;
In many ways, the protocol recommended corresponds to the conduct and conclusions of the acupuncture session: Questioning and looking for personal and family history, inspection, palpation, differential diagnosis, additional tests, biological or radiological etc.

Indeed, the DN cannot be considered  as a medicine in its own right, which is, why some authors recommend integrating the DN in a treatment protocol with a place of choice for Acupuncture and its two versions: Acupuncture and Mesopuncture (and various other treatments), for maintaining homeostasis and prevention to the chronicity of pain. 
**-* Acupuncture in DN Protocol

Acupuncture is an Eastern version of Medicine, trying to determine and treat the root cause of the diseases and their symptoms, in particular:
·                 All diseases encountered in the daily medical practice.
·                 Musculoskeletal pain as well as pain due to any cause.
·                 Other medical conditions.

Acupuncture, in its two versions, Acupuncture and Mesopuncture, is an integral part of Chinese Medicine treating both the symptoms and the identified root cause of the health problem, according to a holistic approach. 
Acupuncture is thus the treatment of choice to treat all pathology involving the TPs.  
It is a fully qualified medicine, which allows eliciting a long-term relief by searching, finding and treating the underlying factors, which perpetuate, in this case, the TPs in an activity state contributing to chronic pain. 
Both Acupuncture as an eastern medicine and Dry Needling as a western medicine, use very fine, compact or hollow, needles inserted into the skin and muscle, into numerous common sites, APs/TPs.

Acupuncture needles are inserted into Acupuncture Points_ APs, located in local and distal areas connected by meridians described as cleavage planes of the connective tissue.
Acupuncture needles are inserted in Trigger points of often confused location with the APs.

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