Integrative Dry Needling Forum - Recent Posts

Possible T4 Syndrome/Consistent Left UE Distal Arm/Hand Numbness Case

Joseph Schneider — Wed, 15 Jul 2026 14:30:55 +0000

Hello fellow IDN providers: So I have a more complex case that I would like your input on in terms of possible root cause as well as treatment options for this patient. He is a 38 y.o. male who presents with occasional neck and upper back pain (in between his Left Scapula and Thoracic Spine at the T3-T5 levels) and Left UE numbness/tingling as well only in his left forearm and left hand. He only has the Left UE symptoms when he is in a slumped posture and when he places pressure/weight through his left ulnar side of his forearm which will create an "achiness" and then will cause numbness in his left pinky finger, then his ring finger, and then in his other digits until the entire left hand becomes numb. When he sits with proper posture and ergonomics, then his symptoms improve. I have dry needled cervical spine as well as his thoracic spine, dorsal scapular and suprascapular neurotrigger points, pec major and minor (thinking more TOS involvement), as well as his ulnar, median, and radial nerve pathways. He subjectively reports that he feels 70-80% better since the start of skilled PT with the incorporation of dry needling, trigger point releases, postural correction exercises, and ulnar nerve glides. But I, of course, still want to get to the "root cause" and want to get 100% elimination of symptoms. He has only had 6 sessions of skilled PT thus far and is compliant with HEP. He is fully active with consistent workouts at the gym and does not have any functional limitations. Any advice would be greatly appreciated.

Pennsylvania State Board Accepting IDN as part of CEUs

Eduardo — Fri, 10 Jul 2026 18:52:26 +0000

Hello! I am applying for PA licensure and submitted my IDN course work as part of the application. The board said they would not accept this as "they do not license in dry needling therefore they would not accept it". Pennsylvania IS on the list of the IDN approved CEU courses

(https://integrativedryneedling.com/courses/ceu/?_gl=1*17ykbac*_up*MQ..&gclid=Cj0KCQjwqPLOBhCiARIsAKRMPZpADKM2LkwIaW1pCTTsYwZbLFClHRq7G0oedw9oPA3q6jeycdKvkVAaAtj2EALw_wcB&gbraid=0AAAAAB_5TZFOkQQXSbfDSLxBrDvjujj9X)

. Anyone have any advice for getting them to allow the IDN courses to be approved by the board?

Tinnitus, fullness, deep ear pressure. Needling Tensor Veli Palatini.

Dan — Thu, 02 Jul 2026 14:44:48 +0000

I have a TMJ patient who I have already dry needled trigeminal nerve distribution, upper cervical and majority of TMJ (lateral and medial pterygoids, masseter, temporalis) and they still have this complaint of deeper ear pressure, fullness and tinnitus. I am wondering about dry needling the tensor veli palatini as I have done some reading that suggests this could be beneficial for stubborn TMJ presentation with those additional symptoms. Could I get some guidance on needling this area or a referral to someone in northeast Ohio who is trained in needling this area.

Thanks,

Dan

RE: Thumb pain-thenar eminence

Cody — Mon, 15 Jun 2026 19:10:35 +0000

Hi Danielle, I would needle the following areas: superficial radial homeostatic point/adductor, first dorsal interossei, the surrounding tissue around the base of the CMC joint. you can add light stim to this area which can help further mitigate her pain. If she continues to have pain you could add the AIN as well as the forearm flexors (FDS,FDP, FPL) to help reduce the stress load on the thumb. Hope this helps.

Cody Metropoulos, OTR/L, CHT, CIDN

Thumb pain-thenar eminence

Danielle Sandstrom — Mon, 15 Jun 2026 17:33:30 +0000

Hello all,

I have a patient that has thenar eminence pain and CMC joint pain. She does a lot of sewing and pinching tasks. Where do you all DN for those symptoms? TIA.

Reimbursement for DN

Hector — Sun, 07 Jun 2026 18:33:46 +0000

Is anyone working at a clinic that charges out-of-pocket for dry needling and then gets reimbursed for their dry needling services per patient?

Thoracic Outlet Decompression Surgery

Torri — Wed, 27 May 2026 21:38:49 +0000

Has anyone had any success integrating DN into your post-op TOS patients? Any guidelines, specific points, neural tracts and considerations are welcome! I have taken the advanced course.

RE: Needling with cervical and lumbar fusions

Brian Lee — Tue, 05 May 2026 20:45:18 +0000

I have a patient who has a multi-level spinal fusion c2-t12 who has developed significant radicular symptoms stemming from lower lumbar spine. How far away from the fusion site does needling with ENS need to be in order to be safe?

RE: Dry needling post CVA

Dan — Mon, 27 Apr 2026 18:42:40 +0000

Marisa,

I've dry needled the areas of high tone and found that it temporarily decreases tone to allow for a better response to the following treatment. I use estim with it as well, usually 2-4 minutes (depending on patient tolerance). With CVA's I've found using the median nerve points has helped a lot but you can go several different ways depending on patient specifics.

Hope this helps,

Dan

Dry needling post CVA

Marisa Hammond — Wed, 15 Apr 2026 14:17:36 +0000

Hello!

I'm treating someone in a private home care setting tomorrow with s/p CVA x5 (4 in November, 1 in March) and I'm wondering if he would be a good candidate for DN in RUE. He does not have numbness or tingling, he's just trying to regain function of RUE. I'm wondering if I could/should try DN with ESTIM for greater muscle activation at the beginning of his session prior to exercise/therapeutic activities? I know there's limited research so I wanted to get anyone's opinion that has any experience with CVAs and DN.

Thanks!

Marisa