What have been the long term results when dry needling for tension and neurological HAs
I have a patient who I just started dry needling (her neurologist suggested Botox and she did not want to do this)
she is curious if the dry needling helps, will this be something she needs to continue long term? If so how often?
also any suggestions for homeostatic or other places to dry needle for neurological HAs?
thanks
Hi Amy,
Can you clarify what you mean by neurologic HA- in my mind they are all neurologic HA's so want to understand what you are referring to specifically
So agree - the patient called it a neurological HA - I think what she meant was she also has "tension" HA with muscle tightness, and she states this feels different, that it goes up the side of her head -
so probably should have just said HA in general!
thanks
Amy
Ok just did not want to miss an intracranial presentation or one that is the result of an Upper Motor neuron issue. All peripherally based HA benefit from Trigeminal needling (3 points in the face done in foundation), Certainly the Greater Occipital Nerve Homeostatic. Since she mentioned side of the head could be Lesser Occipital or Auriculotemporal (advanced course). Address UT and any cervical paraspinals would be the starting points to see how she does- from a manual therapy standpoint check C1-2 rotation as well-
Hope that helps
Frank
Thank you Frank
this is helpful! What has been your experience long term when needling for HA’s? Is it something that usually resolves, and treatment is no longer needed?
thanks
Amy
Hi Amy!
Prognosis with headaches can be tricky because they are so multifactorial. A tool that may be helpful to you would be the QST exam. That will give you an idea of her healing potential and prognosis.
What I have found is people with chronic headaches and higher QST scores respond well to needling but need a maintenance regimen. For instance, one of my patients gets headaches every menstrual cycle. I needle her during the week of her period to mitigate those headaches/migraines.
Another patient I needle 1x a month preventatively.
What is your experience with how long results last for HA or Migraine relief? and what are your thoughts on the timeline to needle the same points for HA/Migraine? For example, I needled a patient Thursday for migraine (greater occipitals, suboccipital, and 1 paravertebral) almost instant relief from an 8/10 down to a 2/10, say she comes back on Monday with another HA or Migraine, would you needle the same points? Thanks for any input.
I don't have a lot of "real" answers for time line. I think I would go more based on the patient's subjective information-
If HA is back on Monday- maybe needling again, but if she is still good I would wait until Thursday?
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