DN-1: Dry Needling for Craniofacial, Cervicothoracic & Upper Extremity Conditions: an Evidence-Based Approach (Part 1 of the Certification in Dry Needling)
No prerequisites are needed for this three-day 27-hour course in dry needling; however, registrants must be a licensed physical therapist (or 3rd year DPT student), osteopath, medical doctor, naturopathic doctor, chiropractor, nurse practitioner, athletic trainer, occupational therapist or acupuncturist in their respective state or country. Certification in Dry Needling™ (Cert. DN) will be awarded upon successful completion (i.e. written and practical examination) of both the DN-1 & DN-2 courses, giving 54 hours of hands-on dry needling education in total.
Participants will learn superficial and deep dry needling techniques for the treatment of craniofacial, cervicothoracic and upper extremity musculoskeletal conditions. This course does include, but is not limited to, needling of taut bands of muscle (i.e. trigger points) as originally introduced by Travell & Simons. That is, peri-neural needling and needle puncture of tendons, ligaments, musculotendinous junctions, teno-osseus junctions, and bone (i.e. “periosteal pecking”) will also be taught as essential components of musculoskeletal needling practice. More specifically, peri-neural and peri-vascular needling will be instructed for the purpose of improving microcirculation and disrupting fibrosis in chronic neurogenic pain conditions (e.g. an impacted median nerve in carpal tunnel syndrome). Dry needling is certainly a lot more than sticking needles in trigger points!
Dry needling will be taught within the framework of western musculoskeletal diagnoses, not within the theoretical framework of traditional Chinese medicine (TCM), and not for the purpose of altering the flow of Qi or energy along traditional Chinese meridians. More specifically, the participant will learn evidence-based guidelines, recommended “point” locations, and dosages for the use of dry needling in the treatment of specific neuromusculoskeletal conditions (not just individual muscles!) including: whiplash associated disorders, cervicogenic headaches, tension type headaches, migraine headaches, rib syndromes, facet joint syndromes, cervical radiculopathy, mechanical neck pain, carpal tunnel syndrome, shoulder impingement syndrome, lateral epicondylalgia, and temporomandibular dysfunction. In addition, the most recent evidence underpinning the mechanical, hypoalgesic (central, segmental, peripheral), neurophysiologic, chemical, and hormonal effects of dry needling will be presented.
Brain imaging studies have demonstrated that needling of “key” distal points (not trigger points), that are not “onsite” with the patient’s symptoms, stimulates the descending pain inhibitory systems or cortical areas of the brain that are involved in pain control. Furthermore, much of the literature that “dry needling” draws from uses the term “acupuncture” in its title, and many of these studies have used both traditional acupuncture points and myofascial trigger points in their treatment regimes. Thus, a foundational knowledge of the nomenclature and the location of several key traditional acupuncture points will be discussed on this course to help the clinician understand and interpret the existing biomedical acupuncture and dry needling literature within the context of neuromusculoskeletal conditions. However, this course in dry needling does not constitute training, of any kind, in the practice of traditional Chinese acupuncture or Oriental Medicine. More specifically, this course does not teach participants to needle acupuncture points within traditional Chinese meridians.
For the management of headache, cervical, thoracic, and upper extremity pain syndromes, dry needling will be taught as one part of the treatment package, but not the only part. That is, the most recent literature clearly supports the inclusion of cervical and thoracic HVLA thrust manipulation for the effective treatment of cervicothoracic pain and disability (Dunning et al, 2012; Cross et al, 2011; Lau et al, 2011, Gross et al, 2010; Cleland et al, 2007). Likewise, upper cervical manipulation has been found to reduce headache frequency, intensity, duration, and disability associated with cervicogenic headaches in the short and long-term (Dunning et al, 2016; Jull et al, 2002; Haas et al, 2010); and moreover, cervical, elbow and wrist manipulation have each been shown to reduce forearm pain in chronic lateral epicondylalgia syndrome (Fernandez-Carnero et al, 2008, 2009, 2011; Struijs et al, 2003). Nevertheless, within the emerging literature, the combination of spinal manipulation and dry needling is showing the most promise for “best practice” models in a variety of musculoskeletal conditions. This is the “Osteopractic” approach in essence—the combination of spinal manipulation (SMT-1, SMT-2, SMT-3 & SMT-4), extremity manipulation (EMT-1), and dry needling (DN-1 & DN-2) for the evidence-based treatment of neuromusculoskeletal conditions.