Sunday, April 5, 2015

Sunday Stroke Survival: Dry Needling- The New Hope

It seems I can't quit talking about dry needling. It has been my greatest blessing so far this year. It has almost consumed my blog since December 2014 and I first heard about it for post stroke spasticity.  Yes, it is still considered "voodoo therapy" as my old occupational therapist calls it. There are no concrete studies to categorically prove that this works for post stroke spasticity  patients. Studies are currently being done. BUT for me it's working. That's saying a lot!

Before the dry needling, my spasticity was BAD and almost constant even with 400cc of Botox (350 units in just my arm alone). When the Botox wore off before the next series of injections, I was in horrendous pain. Try bending your wrist with finger clenched into a fist, and then cock it inward until you fingers touch your inside forearm. Now bring the whole forearm up to your chest and hold it in that position. Bet you can't do it for long.
My spastic, post stroke arm

That's how bad my muscle spasms were. Not for minutes. Not for hours. Not for days, but think weeks. To move it more than a couple of inches away from my body was near impossible not to mention painful. Imagine how much fun it was putting on a simple shirt. It brought tears to my eyes and blood from my lip to keep from screaming each and every time. Even with the Botox my wrist would only straighten to mid line (straight) with my therapist using force and my elbow bent. I've never been thankful for my Clonus, but the clonus is now back in my wrist and I'm glad to tolerate it.

This picture (below) represents my progress to date. With the therapist still doing all the work because my wrist and hand are still spastic and they are paralyzed (no voluntary movement). Keep in mind this is with the fingers stretched out to the first joint and the elbow is straight. I also have dry needling twice a week.
Blue-1st session. Red-4th session. Green-5th session
I'd call this progress! This new treatment modality is firing up motor response neurons that haven't fired in two years since the spasticity set in almost nonstop. He (the therapist) isn't really pulling hard to hold it in this position either. He is also able the do the other range of motion exercises too. The best part is I'm NOT in pain any more.

In March, my dry needling therapist started working on my inverted foot. On his measurement before the needle sticks in the trigger points, the foot was inverted 32 degrees. to give you an idea of what that looks like I pulled this image from biology-forums.com.
Credit
After ONE session and about a dozen trigger points hit, the angle of inversion was 10 degrees! Better yet, As I felt my foot drifting back into the inverted pattern, I MOVED it back straight! My foot is not paralyzed. Granted I was only able to do it twice, but it's a start. Last session was five times, so there is improvement. The muscle is strengthening and the neurons are rewiring. I continue to do the exercise program Amy suggested.There is hope that one day I will walk pseudo-normally without my AFO again. I say pseudo-normally because I do have a hip and knee replacements on my FUBAR (If you do not know this acronym look here) er, um, non-functioning leg.

Me doing the Snoopy dance!
After every session of dry needling, I'm sore and exhausted, but exhilarated at the same time. New pathways are being awakened in my brain. I'm seeing results rather than the passive (on my part) stretching for therapy. I mean for the most part it's passive on my part during these session, but I'm focusing real hard on making the limb movement while he's doing it.

These days I've added the quantifying word "when" I get this or that part back. That a big boost. It's wonderful not having your muscles saying "Go this way!" "No I want to go that way" like a couple of kids fighting over which way to go...because that's really what spasticity is. Now when my spasticity is gone, I can start recovering.

A couple helpful tips if you are considering this treatment...
  • You will need a referral or prescription from your doctor if the person doing the treatment is not one.
  • Call every doctor, chiropractor, pain management, rehab place in your town to find out who is certified to do this procedure. If there is more than one, shop each one and go to the one you like the best.
  • Is there a therapist who is training or awaiting their certification? Offer to be their practice dummy. I know that the National Institute of Health (NIH )offered some studies but they may be complete now.
  • Wear loose clothing. Easy on and easy off. You may have to change into a gown.
  • Take a shower before the needling. Common sense. Even before your first appointment. Don't be surprised if the therapist wants to start needling right away.
  • Designate bags of frozen peas or some such vegetable to use as cold compresses for the first 6 hours after a treatment. You are stretching muscles you haven't used in a while and the needling spots may bruise and/or swell.
  • Drink plenty of fluids after your treatment. I eat before a treatment to dissipate the nausea I'm prone to.
  • Medicare and some insurance companies may pay for this treatment is listed as a modality or treatment therapy. Talk to the business office. Nine times out of ten they will know how to word it for coverage.

Nothing is impossible with determination.

3 comments:

  1. When! What a glorious word! {{{{hugs}}}} I love all the news, Jo. Keep it coming. :-)

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  2. I am thrilled that you are seeing such dramatic progress. I am glad you posted photos and a diagram. This is such a powerful way to document progress. Keep us posted.

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  3. Happy Easter to you Rebecca! Pictures show it much better than words can.

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