JFK knows Dry Needling

LIVING WELL: Kennedy's back problems led to treatments today

By: DR. MARK KESTNER, Post Columnist

Posted: Monday, December 2, 2013

Many readers know that President John F. Kennedy was plagued by chronic back pain.

The little known story of how he found helpful treatment has ramifications in the treatments available today.

50 When Kennedy was a senator, he was introduced to an unconventional medical doctor named Janet Travell.

At the time, Travell was busy researching common and uncommon treatments to help with back pain as well as other sources of chronic pain.

Travell had discovered that much of chronic pain originates from hardened, tender knotty areas in the muscles.She had been experimenting with various forms of injections into these localized nodules. At one point she discovered that certain methods of stimulating the nodule with a dry needle (one that contained no medication) actually worked well to alleviate pain.

When Kennedy came to see Travell in the late 1950s, this was the treatment that he was provided.

Travell’s treatment was so effective that when Kennedy was elected president, he asked Travell to become the first female White House physician.

Travell’s pioneering work with Kennedy is still relevant today. The treatment has been refined and become known as dry needling or intramuscular stimulation. Earlier this month while teaching a seminar for doctors learning to use dry needling as a treatment for chronic pain, I mentioned that those of us gathered in the training room would not be there except for the work of Travell.

Perhaps her work would have become as widely know if she had not provided care for such a famous patient as Kennedy, or perhaps not.

Today chiropractors, physical therapists and other pain practitioners around the world can attribute a major part of their successful treatment for chronic pain directly to Travell.

When a patient undergoes dry needling therapy today, hypodermic syringes are no longer used.

To perform trigger point dry needling, I gently insert a very fine, solid, sterile needle directly into the most sensitive area of the affected muscle.  Amazingly to patients, it is surprisingly comfortable.

When the needle is inserted, it has several benefits. Some responses are immediate while others take a few hours or days.

For the seminar I taught at my office, I asked several current patients if they would mind being videoed for demonstration purposes. In each case, the patient was able to demonstrate an increased pain-free range of motion within seconds of receiving the dry needling therapy.

This is due to a neurological effect of the needling that affects the spinal cord and the brain. In most cases, patients will continue to see gradual improvements over the next few days after receiving trigger point dry needling.

This is believed to be due to the fact that the needling creates new minute lesions within the chronically affected tissues, and the body initiates a new healing response that is effective in reducing the painful restrictions caused by the chronic condition.
There are several important keys to successful treatment of chronic pain using dry needling. The first is arriving at an accurate diagnosis.

One might think that diagnosing chronic pain would be a straightforward process. It is not. Over the years I have found many cases in which the diagnosis that a patient has been given is inaccurate. In many cases, chronic pain may appear to be arising from a particular structure, when in fact a different nearby structure is the main culprit.
This is commonly the case when dealing with muscular trigger points.

Trigger points are notorious among clinicians for referring pain to an adjacent location. This make diagnosis more confusing if the doctor is not well-trained in evaluating and treating myofascial trigger points.

The second important aspect of successful trigger point treatment is in precise and proper needling. Dry needling need not be painful in most cases. Precision and specificity in determining the exact location and angle of needle insertion can alleviate much if not all of the discomfort.

Thanks to the innovative work of Kennedy’s private physician, Travell, trigger point dry needling is now widely available and often highly successful for patients with chronic pain.

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