Treatment Techniques

Featured Therapies and Exercises

TRIGGER POINT DRY NEEDLING

Trigger point dry needling (TDN) is a highly effective therapy method for the treatment of myofascial trigger points. Combining the trigger point dry needling techniques with other manual and rehabilitative methods has shown to be very effective in the treatment of chronic pain and speeding up the recovery time.

How does trigger point dry needling work?

Trigger point dry needling utilizes a very thin filament needle. The needle used is similar to an acupuncture needle but this treatment is not considered acupuncture and is based on Western physiologic approaches. The needle is inserted into the trigger point and a local twitch response is ideally elicited. This twitch response is an involuntary contraction of the muscle that allows the muscle to relax. Sometimes electrical stimulation is applied to the needle to elicit these twitches to help the muscle relax as well. Dry needling is thought to work by disrupting a reflex arc of contracted tissue as well as stimulating biochemical changes to allow improved blood flow and healing to the area.

What does it feel like?

The filament needle is very different than the hypodermic needle you would see at a doctor's office. A filament needle is very thin, solid, and flexible vs. a hypodermic needle which is relatively thicker, hollow and has a blade tip. The filament pushes through the skin vs. cutting through the skin like a hypodermic needle would. The filament needles' properties lend themselves to a much more comfortable entry. After the dry needling treatment, immediate improvement can be noted. However, soreness is usually accompanied, which can last on average 1-2 days, followed by relief of symptoms.

What conditions can be treated?

Neck and mid-back pain
Headaches and migraines
Hamstring and lower back problems
Muscle tightness
Chronic pain syndrome
Sports injuries
Many other pain-related symptoms that may not have resolved through traditional treatment methods

Trigger point dry needling requires highly specialized training and not all medical professionals are trained in the evaluation and treatment of trigger points. Joseph M. Eschman, PT, GCS has specialized training in this treatment. Trigger point dry needling can be very effective in treating pain of a myofascial origin. Dry needling has been the difference maker in many patients' conditions and we would urge one to consider this treatment as an option for the relief of pain.

How will I feel after a session of TDN?

• You may feel sore immediately after treatment in the area of the body you were treated, this is normal but does not always occur. It can also take a few hours or the next day before you feel soreness. The soreness may vary depending on the area of the body that was treated as well as varies person to person, but typically it feels like you had an intense workout at the gym. Soreness typically lasts 24-48 hours. If soreness continues beyond this please contact your provider.

• It is common to have bruising after treatment; some areas are more likely than others. Some common areas are shoulders, base of neck, head and face, arms and legs. Large bruising rarely occurs, but can. Use ice to help decrease the bruising and if you feel concern please call your provider.

• It is common to feel tired, nauseous, emotional, giggly or “loopy”, and/or somewhat “out of it” after treatment. This is a normal response that can last up to an hour or two after treatment. If this lasts beyond a day contact your provider as a precaution.

• There are times when treatment may actually make your typical symptoms worse. This is normal. If this continues past the 24 hour – 48 hour window, keep note of it, as this is helpful information and your provider will then adjust your treatment plan based on your report if needed. This does not mean TDN cannot help your condition.

What should I do after treatment, what can I do, and what should I avoid?

It is highly recommended that you increase your water intake for the next 24 hours after treatment to help avoid soreness.
It is recommended that you soak in a hot bath or hot tub to help avoid post treatment soreness.
After treatment you may do the following based on your comfort level, if it hurts or exacerbates your symptoms then stop;

Work out and/or stretch
Massage the area
Use a heating pad
Avoid ice unless you are icing a bruise, heat is better for muscle soreness.
Drink alcohol, but it is recommended you do not do so excessively.
Take Tylenol, Ibuprofen/Motrin, aspirin etc.

Graston Technique®

Eschman Physical Therapy, LLC is a preferred provider through Graston technique.

This remarkable procedure allows us to detect and treat areas of “scar tissue” or adhesions in muscles, tendons and ligaments that can reduce our range of motion and cause pain. In the healing process, our body attempts to repair those areas by creating “scar tissue,” much like the scar that forms on the skin when you have scraped or banged your knee.

Dysfunction

In time, we can have a build up of this fibrous scar tissue, particularly in the muscles, tendons and ligaments that get a lot of use. This can lead to pain and dysfunction because this replacement tissue lacks the strength and flexibility of healthy tissue (in some areas it may even mat down

and entrap a nerve).

GT Instruments

The Graston Technique® allows us to better detect and treat these areas because it uses a stainless steel instrument that glides along a patient’s muscle, tendons or ligaments, with the right amount of pressure to detect just where the scar tissue or restrictions are located. When these knots or bands of scar tissue are encountered, both the clinician and the patient sense a restriction, almost like a speed bump or a granular feeling. The instrument can then be used to identify and treat areas exhibiting soft tissue fibrosis or chronic inflammation. Stretching

exercises are used to promote re-alignment of the fibers into the normal pattern of healthy tissue.

What conditions can be treated?

Neck and mid-back pain
Headaches and migraines
Hamstring and lower back problems
Muscle tightness
Chronic pain syndrome
Sports injuries
Many other pain-related symptoms that may not have resolved through traditional treatment methods

Auriculotherapy

Often described as reflexology for the ear, there are hundreds of points on the ear that are believed to represent a micro system of the body, with points for areas both physical and emotional. The stimulation of these points is known as Auriculotherapy. Ear seeds stimulate these points natural and non-invasively.

Here at Eschman Physical Therapy, LLC we have seen some great results for pain relief from Auriculotherapy using ear seeds. We have earseed kits available for back pain, sciatica, headaches, migraines, stress, weight loss and so many more. Purchase these kits using our affiliate link or by scheduling an appointment with us.

Pelvic Floor Physical Therapy

Dr. Eschman will have time reserved and devoted exclusively for you. We promise to provide a friendly, comfortable and private atmosphere. We provide continuity using the same therapist throughout your care. This helps to minimize your visits which helps to cut your out of pocket costs. We strive to make your physical therapy a valuable, personal experience from the moment you walk in and we hope you recognize the clinical excellence we provide.

What to expect from Pelvic Floor Physical Therapy