Hello all!
I have a client that has been to several doctors without answers. His main complaints include Rt temporalis pain that is persistent and worse with sitting still. He also presents with Rt UT and shoulder tightness and inflammation on initial evaluation.
I have been able to resolve the upper trap symptoms. Initially, he presented with limited movement with side glides and UT inflammation. His shoulder/UT pain has improved, but the only change he has had to the temporalis pain that is consistent is when performing the sharp purser test for the transverse ligament.
What are the areas you'd suggest needling first and why?
What are the cautions you'd keep in mind for this client?
At what point would you suggest sending him to a cervical spine specialist?
Thank you for any suggestions, I have my own plan, however, I wanted to get other professional opinions so I can be sure to treat him the best.
Hey Courtney,
This is a question with maybe 10 different answers all with the preface - "it Depends". 🙂
first I would not depend on the Sharp purser test for detecting upper cervical instability as that is not- reliable -what she is experiencing is an apparent C2 referral. If there is concern about upper cervical instability get an open mouth X-ray or fluoroscopy to get a definitive answer.
If there is temporals pain look at an entrapment point of the auriculotemporal by the ear tragus/zygomatic Or the zygomaticotemporal nerve:
Needling: Locate the HP area- 2 cm lateral to and 1 cm
above the lateral palpebral commissure (corner of eye).
Insert a .15-.30mm needle perpendicular to the skin or
angular needling can be performed to the temporalis
muscle.
I am not sure if you are Advanced trained but these are from that course and from my Craniocervical specialty course. These are areas overlooked for persistent temporal pain and are easily fixed when the nerve entrapment is resolved.
hope that helps.
frank
© Integrative Dry Needling 2025 | All rights reserved | Designed by Weblink
Powered by 
any IDN Course!
*Valid for new registrations only and can not be combined with other discount codes. Offer Expires: 7/7/2024
Not sure which course is right for you? No problem – we created an intuitive process to help!
