Integrative Dry Needling Forum - Recent Topics

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

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.

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

Dry Needling for Gout

Rebecca Rosenborough — Mon, 13 Apr 2026 01:03:13 +0000

Hello!

I have a patient coming in for dry needling with a diagnosis of gout in his big toe. Has anyone had success in patient symptoms with dry needling for gout? If so, what specific anatomical landmarks should I focus on to improve symptoms?

Thank you!!

IDN for pain related to Shingles

ashley.k.williams — Wed, 08 Apr 2026 14:52:54 +0000

Is there a dry needling protocol for a patient with current, severe pain from Shingles? Should I avoid dry needling near the rashes or avoid dry needling all together while the virus is active?

Heart Valve Considerations

Brooke Karl — Mon, 06 Apr 2026 12:05:01 +0000

Hello,

I have a patient that I was considering trying IDN with. The patient reported that she has 3 heart valves that are damaged and the doctors are watching. The patient reported that she is not currently needing surgery for valve replacements yet, they are watching the valves. She is on a blood thinner medication. She did also mention that when she goes to the dentist she has to take antibiotics prior due to her risk of infection. Would this patient be a candidate for dry needling?