Never, ever attempt this technique

Never, ever attempt this technique

One of the most common areas in which I am asked to provide a professional opinion, is in regards to needling and pneumothorax or haemopneumothorax. The cause is poor or no technique and is usually due to a lack of specific training. If you have learnt manipulation of the thoracic spine, you would not then assume you have the skills to manipulate the cervical spine. Different anatomy, Different precautions. In much the same way practitioners, that have learnt to needle supraspinatus are not qualified to move an extra couple of centimetres to needle upper trapezius or levator scapulae.

Now, if this picture had occurred in just about any other publication and not the Australian Physiotherapy Association' s 'flagship' publication (InMotion: page 39 December 2016 edition), I wouldn't rate the effort of a comment. However, with it going out to 20,000 + professionals, I certainly don't want those professionals to think that just because it is published by the APA, it is should be taken as the truth. Far from it. A vertical insertion of a needle/pin, dry or wet is simply very poor technique and asking for trouble. Would you cross the road with your eyes closed? Same answer goes for the technique being condoned in this picture. Don't do it. Never.

Manual acupuncture for myofascial pain syndrome: a systematic review and meta-analysis

A newly published paper available here, searched for randomised controlled trials (RCTs) comparing MA versus sham/placebo or no intervention in patients with MPS in the following databases from inception to January 2016. Two reviewers independently screened the literature, extracted data and assessed the quality of the included studies according to the risk of bias tool recommended by the Cochrane Handbook.

Results Ten RCTs were combined in a meta-analysis of MA versus sham, which showed a favourable effect of MA on pain intensity after stimulation of myofascial trigger points (MTrPs; standardised mean difference (SMD) −0.90, 95% CI −1.48 to −0.32; p=0.002) but not traditional acupuncture points (p>0.05). Benefit was seen both after a single treatment (SMD −1.05, 95% CI −1.84 to −0.27; p=0.009) and course of eight sessions (weighted mean difference (WMD) −1.96, 95% CI −2.72 to −1.20; p<0.001). They also found a significant increase in pressure pain threshold following MA stimulation of MTrPs (WMD 1.00, 95% CI 0.32 to 1.67; p=0.004). Two of the included studies reported mild adverse events (soreness/haemorrhage) secondary to MA.

Conclusions Through stimulation of MTrPs, MA might be efficacious in terms of pain relief and reduction of muscle irritability in MPS patients. Additional well-designed/reported studies are required to determine the optimal number of sessions for the treatment of MPS.


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