Good Afternoon, 

I wanted to see if I could get a little bit of guidance and education. I have a patient who was in a severe car accident a little over a year ago (15 months ago) that had to replace 5 of her Ribs (Ribs 3-7) with Titanium. For the last 3 months, she's been getting lots of pain and numbness in her nipple so I wanted to try dry needling interventions to help reduce the referral pain. I know that the nipple is innervated by the 4th intercostal nerve, so I did 30mm needles into the posterior cutaneous points of T2-T7, but also wanted to do some superficial slide needling along the ribs.

What are your thoughts on this? The titanium ribs aren't solid, but rather look like a chain where if I went too deep you could easily go through the rib. I did it today with 15mm needles but felt like I wasn't deep enough. Too much risk to use 30mm?

Also, can I use ENS around the titanium ribs with needling?