Ultrasound Guided Dry Needling Boosts Pain Relief for Patients with Knee Osteoarthritis

PainRelief.com Interview with:
Dr PANG Chun Yiu Johnson
Assistant Professor
School of Health Sciences
Caritas Institute of Higher Education
Hong Kong

Mr PANG

PainRelief.com: What is the background for this study?

Response: As a practicing physiotherapist for over 20 years in an outpatient setting at a government-based hospital, I had encountered difficult situations where patients were suffered with long-term pain that pervious treatments were ineffective or wasn’t long lasting.

Dry needling is a treatment technique that I had always been interested and practicing even during my college times. With years of practice, it has become a skill that I specialized in and received promising results from most of my patients.

However, like most techniques, it has its limitations. Microtrauma inducted by the puncturing of the needles elicit inflammatory response that activate mast cells proliferation to promote tissues healing. As a result, the effectiveness of dry needling depends on the expertise and skill of the practitioners to accurately locate the problematic structure for the insertion of needles.

The inconsistency results of studies with dry needling can be attributed to the absence of a standardized approach and inaccuracies related to needle targeting and advancement.

With that in mind, I wanted to investigate and validate a method that can enhance the accuracy of needle advancement and improve the effectiveness of dry needling. Through constantly researching evidence-based publications, coincidently I came across an article that incorporated ultrasound guidance into dry needling on treating shoulder impairments. The results were promising, both in patient’s feedback and ultrasound imaging, since the practitioner was able to clearly identify the problematic structure under ultrasound guidance. This had inspired me to further investigate the effectiveness of ultrasound-guided dry needling on different musculoskeletal conditions.

Low Back Pain: Early Physical Therapy Associated with Reduced Imaging, Invasive Procedures and ER Visits

PainRelief.com Interview with:
Richard L. Skolasky, Jr., Sc.D.
Professor, Orthopaedic Surgery and Physical Medicine & Rehabilitation
Vice Chair of Research, Orthopaedic Surgery
Director, Surgical Outcomes Research Center
Johns Hopkins University
601 North Caroline Street, Room 5244
Baltimore, MD 21287

Dr. Skolasky

PainRelief.com: What is the background for this study?

Response: Low back pain (LBP) affects a sizeable proportion of the US population (from 1.4 to 20%), and accounts for substantial healthcare expenditures (between $12 billion and $91 billion, not accounting for indirect costs associated with loss of productivity and unemployment). Current recommendations for initial treatment of acute low back pain include physical therapy. Earlier initiation of physical therapy has been associated with less healthcare utilization and spending; however, these studies have been limited to single institutions or health systems. Research is needed to evaluate the effects of early physical therapy on healthcare use, particularly within the first 30 days after initial presentation for acute low back pain, when they are most likely to experience pain and seek care.

Telerehabilitation Found Effective for Low Back Pain Relief

PainRelief.com Interview with:
Mark W Werneke, PT, MS, Dip. MDT
Net Health Systems, Inc.
Pittsburgh PA

Mark W Werneke

PainRelief.com:  What is the background for this study? 

Response: Coronavirus pandemic (COVID-19) has had a profound effect on changing health care delivery systems and resulted in a rapid growth of telerehabilitation care models. In addition, patients experiencing chronic low back pain increased during the pandemic which was confounded by mandatory lockdowns and lack of physical activity. There is scant literature demonstrating telerehabilitation’s effectiveness and efficiency for patients with low back pain seeking rehabilitation services during COVID-19 pandemic compared to traditional in-person office visit care.

The primary aim of our study was to examine the association between telerehabilitation treatments administered during every day clinical practice and functional status, number of visits, and patient satisfaction with treatment result outcomes compared to in-person care observed during the height of the pandemic. Using Focus on Therapeutic Outcomes (FOTO) database, our sample consisted of 91,117 episodes of care from 1,398 clinics located in 46/50 US states. Propensity score matching analytics was used to match episodes of care with or without telerehabilitation and standardized differences (S-D) were used to assess whether successful matching between telerehabilitation and no-telerehabilitation subgroups allowed for valid outcome comparisons.