In this Clinical Relevance video, we explore how neurologic dry needling can resolve chronic lumbopelvic dysfunction by addressing the nervous system’s role in pain and movement patterns. Below, we break down the patient’s journey, treatment strategy, and the outcomes that highlight the power of this approach for long-standing musculoskeletal issues.

The Patient: A 34-Year-Old Dancer with Chronic Hip and Low Back Pain 💃💪

A former dancer, our patient developed hip pain at age 16. Over time, three pregnancies and vaginal deliveries compounded her symptoms, leading to:

✅ Diastasis recti (abdominal separation)
✅ Mild umbilical hernia
✅ Persistent low back pain

Despite pelvic floor physical therapy, she struggled with:

🔸 Chronic soreness in the lower abdomen and back
🔸 “Popping” and catching sensations in the hip (suggestive of labral involvement )
🔸 Weakness and poor muscle recruitment during functional movements

“I can feel the catch,” she explained. “My hip flexors take over, and I just can’t smooth out the movement.”

The Problem: Neuromuscular Imbalance & Neurological Dysfunction ⚠️🧠

Her symptoms revealed a deeper neurological cause:

🔹 Inhibited core muscles – Years of compensatory movement patterns left her abdominals underactive, forcing hip flexors to dominate.
🔹 Nociceptive overload – Chronic irritation in the ilioinguinal and femoral nerves created a cycle of pain and guarding.
🔹 Poor coordination – Asynchronous activation of core and pelvic stabilizers led to instability and joint stress.

The Treatment: Precision Dry Needling to Reset Neuromuscular Communication 🪡🧠

Our protocol focused on rebooting nerve signaling through precise dry needling:

1. Lower Abdominal Region

🩸 Intercostal nerve exits – Needling between rectus abdominis segments to calm hyperactive nociceptors.
🩸 Pubic insertion of rectus abdominis – Stimulating motor points to reactivate dormant muscle fibers.

2. Posterior Iliopsoas Approach

💥 Deep needling near L4 to access the psoas posteriorly , paired with gentle electrical stimulation to modulate nerve activity.

3. Femoral & Ilioinguinal Nerve Distributions

🔄 Gentle rotational needling to reduce hypersensitivity in nerve-rich zones contributing to lower abdominal pain.

🚫 No aggressive techniques—just precision and control.

The Results: Restored Function & Sustained Improvement ✅🔥

Immediately Post-Treatment:

✔️ Stronger abdominal activation – “I’ve never felt my lower abs activate like this during exercises.”
✔️ Smoother hip movement – Reduced catching and pain during squats and hip flexion.
✔️ Enhanced coordination – Core muscles fired synchronously, replacing dysfunctional patterns.

Nine Days Later:

✔️ Sustained improvements in movement quality and reduced hip symptoms.
✔️ Increased confidence in functional activities like loaded squats.

Why This Works: Neurologic Dry Needling as a System Reset 🔄🧠

This approach doesn’t just treat symptoms—it removes neurological roadblocks to proper movement:

🧩 Reduces nociceptive noise – Calming irritated nerves (ilioinguinal, femoral) eliminates pain signals that inhibit muscle activation.
🧩 Reboots motor control – Stimulating motor points helps the brain “relearn” how to recruit core stabilizers.
🧩 Resets proprioception – Improved sensory feedback restores coordinated movement patterns.

💻 Think of it as a “Control-Alt-Delete” for neuromuscular dysfunction.

Key Takeaways for Clinicians 🎯📘

🔑 Prioritize neurology – Chronic instability often stems from nerve dysfunction, not just structural damage.
🔑 Target nerve-dense zones – Intercostal nerve emergent points and iliopsoas attachments are key neuromuscular control points.
🔑 Precision over force – Sensory-focused needling yields significant results without aggressive techniques.

Explore More Clinical Insights 🔍🎥

This case is part of our Clinical Relevance series, where we translate complex neuromuscular science into actionable strategies.

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#dryneedling #IDN #neurologicdryneedling #neurogenicinflammation #lumbopelvicpain 🚀