Dry Needling and Osteopathy. What is Dry Needling?
Osteopath Dr Jess Watson explains
Dry needling is a treatment that uses fine, single-use needles, the same as those used in acupuncture. Dry needling and Osteopathy is becoming more common. Your osteopath may use dry needling in conjunction to other osteopathic techniques when they see fit. Dry needling is used to deactivate and help loosen tightened spots within the muscle. These tight spots are known as ‘trigger points’. It is also used to improve nerve conduction, blood supply, the strength of tendons and ligaments, and to stimulate reflex mechanisms within the area.
The overall goal of dry needling is to reduce muscle pain and spasm, increase range of motion of the surrounding joints, and provide an overall increase in function of the body.
When would dry needling be beneficial?
A number of conditions treated by Osteopaths can benefit from dry needling. Dry needling will normally make up only a small part of your osteopathic treatment. The following conditions can respond well to dry needling:
Back and neck pain
Rotator cuff injuries
Acute sporting injuries
Chronic pain conditions
together dry needling and osteopathy can be very helpful.
Is it painful?
As pain is a subjective experience, no patient’s experience with dry needling is the same. However, as the needle used is so fine most patients do not feel the needle pierce the skin.
Most commonly once the needle has entered the muscle, a small twitch or cramping sensation can be felt. There may be a small ache, slight numbness or heaviness. This feeling normally subsides and can be considered a good sign. The ache can indicate that the correct point has been found, and your muscle will soon relax.
Will I feel sore after?
Most patients respond very well to this form of treatment, however, similarly to all manual therapy techniques, some soreness may occur. Any sorenesss usually resolves 24-48 hours post treatment.
Is it the same as acupuncture?
No. Dry needling does use the same thin needles, but the objectives of the treatments are different. Dry needling is most commonly used to treat tight areas of muscles, known as ‘trigger points’. Acupuncture however focuses on inner body energy (Qi). Acupuncture needles are placed in very specific points to help facilitate and improve the Qi. Stimulating Acupuncture points can allow the body to properly heal.
Traditional Chinese Medicine and Acupuncture is a separate degree at university.
Dry needling is an adjunctive course for Osteopaths. Practitioners who have a degree such as an Osteopathy or Physiotherapy can do the training.
Osteopaths that utilise dry needling are, therefore, not acupuncturists unless they also hold a degree in Traditional Chinese Medicine, or a masters of Acupuncture.
The importance of Resistance Training: By Osteopath Dr Shehan
Running and walking are popular forms of exercise that we all use to help us improve our overall health and well-being! A form of exercise that is just as important, is resistance training. It comes in many forms such as lifting weights, body-weighted exercises or even using bands and medicine balls. It is any exercise that that forces the muscles to contract against an external resistance. Training is also done with the purpose of improving muscular strength, mass and endurance.
There are many benefits of resistance training for all age groups. It has also been shown to be good for children and some benefits include improving:
Body, arm and leg control
Bone structure and also decrease risk of fractures in growing children
Mood & self esteem
Muscular adaption to prevent future injuries
Resistance training may help lay the foundations for strength, power and also sporting performance in the future.
When to begin?
Resistance training is not be confused with bodybuilding. Children are encouraged to participate in supervised resistance training at least 3 times per week . Training can be safe, as long as the program is well designed, based on age, size, and existing strength levels and is supervised.
Children are also recommended to begin training with bodyweight exercises. Once they have control of over their body weight, they can progress to bands, sand tubes or medicine balls. After this children can then progress to heavier training.
In adults and the elderly the benefits are similar. The focus is on:
Increasing muscle mass, strength and also endurance.
Improving heart health & preventing chronic disease (e.g. diabetes, arthritis)
Decreasing stress levels
Increasing bone density and strength and also reduce risk of osteoporosis
Improving mobility and balance.
Two sessions a week is the recommendation for maintaining general health and wellbeing. Programs should involve all major muscle groups.
Dr Shehan Kariyakaranage (Osteopath)
Shehan is a registered osteopath and a level 1 accredited strength and conditioning coach. He is able to provide specific exercise prescription and develop programs to rehabilitate and prevent injuries.
There is no denying that pregnancy is one extremely daunting experience for many women (especially the first-time round, am I right?) and that is OKAY. Comparing the parenting advice from your friend Jane at lunch who has 3 kids under the age of 6, to your mother’s advice which usually revolves around “oh, I never worried about that with you” can be extremely stressful and can make you feel as though you need to pour coconut oil over your entire life to survive. However, there are many support systems in place to help you along the way for both your physical and mental health. This blog article is aimed at shedding some light onto how Osteopathy can assist you on your pregnancy journey. It is NEVER too late to see an Osteopath along your journey, whether you plan to deliver vaginally or by C-section. During pregnancy, there are many structural changes that occur, which can impact on your daily functioning. Due to biomechanical changes experienced during pregnancy, this can result on additional pressure on the spine and pelvis. This may lead to certain musculoskeletal pain and additional ailments which can impact on a woman’s wellbeing. Changes that you are likely to see
Shift in your centre of gravity
Softening of ligaments
Increase in blood volume by almost 50%
Conditions that you might experience.
Pelvic Girdle Pain
Lower Back Pain
Upper Back Pain
Swelling of the legs
Fatigue and Exhaustion (you are growing life remember!)
High or Low Blood Pressure
Who are we? I hear you say it in your mind, “Ost-E-O-path…it’s something to do with bones, isn’t it?” correct, BUT we consider all your body systems and how they impact on your wellbeing through our wholistic approach to your health.
Government registered allied health care professionals, who attend 5 years of accredited university study inclusive of clinical practice, anatomy, physiology, pathology, neuroscience and osteopathic studies.
Osteopathy is covered by most private health funds and by Medicare’s Chronic Disease Management Plans, DVA patients, State Worker’s Compensation schemes and motor accident insurers (1).
We take a thorough medical history, perform an extensive musculoskeletal examination and any other special orthopaedic or neurological testing if deemed necessary in the consultation.
Hands-on treatment approach to suit your individual wellbeing goals and alleviate pain.
We are highly skilled in supporting women throughout their pregnancies. Our role is to be supportive, aid in maternal biomechanics to help reduce pain and possible difficulties with labor.
So, how can Osteopathic treatment during pregnancy help my journey? With limited medication considered safe to take in pregnancy this leaves very few options for pain control. Osteopathic treatment in pregnancy is safe for both mothers and babies and uses non-invasive and gentle techniques that are carefully selected to minimise any risk and to assist the body to adapt to pregnancy-related changes. Pregnancy brings dramatic musculoskeletal changes that alter normal biomechanics, accompanied by ligamentous strain, increased muscle tension and decreased range of joint motion which can cause pain (2). In a recent study, the most common pregnancy related health conditions that women reported were musculoskeletal complaints including back pain at 39.5% (3). A study of 430 pregnant women found that feelings of depression, anger, anxiety and raised cortisol levels were associated with back pain and leg pain during pregnancy (6).
As Osteopaths, one of our main philosophies is that structure and function are interrelated and symbiotic. Our treatments aim to normalize the structure so that it functions as efficiently as possible. We use techniques that will assist the natural process of pregnancy and birth by aiding the body to adapt, adjust and align as the pregnancy progresses.
We use manual therapy techniques such as soft tissue massage, mobilisation of joints, myofascial stretching and joint manipulation (when deemed safe and appropriate), visceral techniques and Osteopathy in the Cranial Field. Osteopathic Manipulative Treatment (OMT) is a body-based treatment that offers a conservative, non-invasive option for relieving pregnancy-related LBP while increasing back-related function (2).
Studies suggest that Osteopathic treatment provided during the third trimester of pregnancy lessens or halts the deterioration in back-specific functioning that often characterizes the third trimester of pregnancy and thereby provides an important clinical benefit when used as a complementary therapy (4). They also indicate that providing OMT as a complement to conventional obstetrical care during the third trimester of pregnancy has beneficial outcomes (5). Benefits of Osteopathic Treatment in Pregnant Women
Decreased Duration of labor
Decreased Sacroiliac Dysfunction
Decreased Low Back Pain
Decreased Carpal Tunnel Symptoms
Decreased Use of forceps during delivery
Decreased Likelihood of having a preterm delivery
Decreased Blood Pressure
Decreased Fluid Overload
Decreased Probability of having meconium-stained amniotic fluid (8)
Download our free “Basic Pregnancy Stretches” HERE– Before commencing, remember to take this to your Osteopath, GP, Obstetrician to get clearance. How can Osteopathy help on your post-partum journey? Regardless of the type of labour and birth, women can experience a wide range of postnatal issues that can impact their function. Like pregnancy, there are limited medications deemed safe for breastfeeding. Your Osteopath may advise you to make return visits with your newborn to help prevent or manage conditions to help you meet your baby’s needs, whilst caring for your own. Conditions you may experience post-partum;
Back and neck pain due to postural challenges relating to breastfeeding.
Fatigue, anxiety or depression due to sleepless nights and the constant changes you experience as a new mum.
Incontinence and constipation due to changes in the pelvic floor and pelvic mechanics
Lifting babies, prams and capsules causing musculoskeletal strains and sprains.
Pelvic imbalance from pregnancy and labour (including C-Sections).
osteopathy.org.au, (2017). Retrieved 12/11/2017. Osteopathy: About Us. From www.osteopathy.org.au.
Hensel, K., Buchanan, S., Brown, S., Rodriguez, M., Cruser, D. (2015). Pregnancy Research on Osteopathic Manipulation Optimizing Treatment Effects-The PROMOTE study A Randomized Controlled Trial. The American Journal of Obstetrics and Gynaecology, V (212), p1-16.
Frawley, J., Sundberg, T., Steel, A., Sibbritt, D.,Broom, A., Adams, J. (2016). Prevalence and characteristics of women who consult with osteopathic practitioners during pregnancy; a report from the Australian Longitudinal Study on Women’s Health (ALSWH). The Journal of Bodywork and Movement Therapies (available via Science Direct subscription). V (20). p.168-172.
Licciardone, J., Buchanan, S., Fulda, K., Stoll, S. (2010). Osteopathic Manipulative Treatment of Back Pain and Related Symptoms During Pregnancy: A randomized Controlled Trial. American Journal of Obstetrics and Gynaecology. V (202). p.1-15.
Licciardone, J. (2017). Osteopathic Manipulative Treatment During the Third Trimester of Pregnancy. The Journal of the American Osteopathic Association. V (117). P.289-290.
Field, T., Hernandez-Reif, M., Diego, M., Schanberg, S., Kuhn, C. (2006). Stability of mood states and biochemistry across pregnancy. Infant behaviour and Development Journal. V (29). p262-267.
Saurel-Cubizolles, MJ., Romito, P., Lelong, N., Ancel, PY. (2000). Women’s health after childbirth: a longitudinal study in France and Italy. International Journal of Obstetrics & Gynaecology. V (107). P 1202-1209.
Lavelle, J. Osteopathic Manipulative Treatment in Pregnant Women. The Journal of the American Osteopathic Association. V (112). p343-346.
Keeping that New Year commitment to looking after yourself
The most beneficial thing you can do for yourself is engage in a daily movement routine. I say movement, because sometimes ‘exercise routine’ can conjure up thoughts of needing to ‘smash’ oneself by engaging in some sort of gruelling, physical activity where no pain, no gain is the mantra. This does have a place, but most people don’t need to do that to become mobile, happy and healthy.
Typically, if you are on ‘the comeback,’ or even starting from a pretty good base and looking to maintain, I always advised a regular mechanical check over to make sure all the moving parts are moving to their optimal. We look out for restricted areas that need to be released to allow you to return to activity and assess the functional capacity of the tissue to screen for injury risk and ultimately to prevent from injury in the first place.
If you have not regularly exercised in a while and you are starting back, remember slow and steady – build up! You have as much time as you need. There is no point going hard in January only to have to rest up in February and March….then struggle to get the motivation to start up again in April, which gets put off until May!
Along with appropriately warming up, cooling down, stretching and rolling, you can reduce your risk of injury, improve your recovery and performance by regularly attending a yoga class that is right for you and getting some regular massage treatment, especially in the early days…just like the professionals do.
Exercise that focuses on awareness and control of your movement, such as Clinical Pilates, is a necessary part of your regime along with adequate recovery and preparation. Clinical Pilates is one of the best movement regimes to help you understand and become aware of how you move, to re-learn movement that may be ‘out of sync’ and need improving and to strengthen your muscles and joints at angles just not achievable with ‘regular’ training.
It is important to move beyond ‘re-training’ and to work with someone like an Exercise Physiologist, to take what you have learnt about your movement through pilates and apply it to movement tasks of everyday living. It is important to start to replicate usual movement and challenge with load so that you become stronger to perform your ‘tasks of daily living’ – It’s like training for a sport. You break the game or activity into ‘drills’ and practice until your capacity to perform them improves and feels natural…….most people, with recurring or chronic pain, simply need to do something like this, but really, to do this properly, you need help and coaching from a group of experts. Preferably experts who work closely with each other and know who is the best person to be working with at any given time.
Finally through out, it is important to maintain nutrition. A great place to start is with hydration and electrolytes, where Water and Magnesium are the main ‘go to’s’. These will help to keep your energy up, reduce training soreness and maintain your muscle health and suppleness. A great deal of injury prevention and recovery can be achieved with diet and strategic supplementation.
Dr Giulian Di Venuto is principal Osteopath and Director of MOVE Osteopathy and is available for Osteopathic consultations at both Brisbane City and New Farm Clinic. Move Osteopathy also offers, Remedial Massage, Myotherapy and consultations with our Exercise Physiologists, personalised exercise programs in our own rehabilitations gyms and clinical pilates.
Spinal manipulation endorsed as ‘best practice’ for back pain.
3rd leading disease burden in Australia with an estimated cost of over $9 Billion per year. The majority of sufferers will consult their GP seeking care in the first instance with half being prescribed medication as a first line treatment. In the past 5 years, prescription of pain relieving medication has increased from 5 million to 7 million prescriptions.
Paracetamol is the 4th most prescribed drug in Australia. The number of deaths from prescription pain medications – opioids – has increased 61% between 2004 – 2014. 58% of non–cancer pain medication prescriptions are for musculoskeletal issues The founder of Osteopathy, American Physician Dr Andrew Still, became disillusioned with the effectiveness of the medicines available to him in the 1800’s and developed an approach to health care to circumvent or at least complement drug prescription. Over a century later, after a relentless campaign to discredit the ‘hands on’ approach that Dr Still popularised, the American Medical Association has finally agreed with him and revised their best practice guidelines for managing back pain, endorsing spinal manipulation, massage and heat as first line treatments before medication is prescribed.
These recommendations are welcomed by Brisbane based Osteopath, Dr Giulian Di Venuto, who said ‘there seems to have been a ‘turf war’ for the back pain patient for a long time. Osteopaths have been advocating the use of spinal manipulation, massage, heat and exercise to help people with back pain since the 1800’s. It is good that the evidence base for what we do is starting to catch up and that eminent leaders in health care, such as the American Medical Association, are recommending with confidence that we are amongst the best people to assess and treat musculoskeletal pain such as back pain in the first instance.’ Osteopath, Dr. Di Venuto advises that most cases of back pain resolve within 6 weeks and whilst pain can be sever at times, it is best to try and keep moving.
‘People are vulnerable when they are in pain. They are often anxious and scared and believe that their pain will persist. I agree with drug therapy and the role it plays in pain medicine, but it is more important than ever that patients are referred to the most appropriate people for examination and treatment because the ‘quick fix’ is not working.
Medication dependency is real and so are the side effects. When there is evidence for interventions that are better and safer than medication, they should be used in preference and that is what the AMA is also saying. Osteopaths, physiotherapists and chiropractors have been advocating for a long time now that therapies such as spinal manipulation, massage and exercise, should be preferred to medication in the short and long term treatment of back pain.’
Osteopaths, Chiropractors and Physiotherapists are University trained, registered health care professionals, regulated by government agency, the Australian Health Practitioners Registration Authority (AHPRA) and specifically trained to assess, diagnose and manage musculoskeletal issues such as back and neck pain. Osteopaths and Chiropractors are trained in spinal manipulation during their undergraduate university training. If you are interested in seeking advice from a registered Osteopath, or you want to learn more about us you can learn more on our website or Osteopathy Australia.