Deans' stroke musings: Radial nerve injury following dry needling

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Wednesday, February 21, 2018

Radial nerve injury following dry needling

I know Jo Murphy does this for her recovery. Be careful out there.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5786962/

BMJ Case Rep. 2018; 2018: bcr2017221302.

Published online 2018 Jan 26. doi: 10.1136/bcr-2017-221302

PMC5786962

Acupuncture in Medicine case report

Radial nerve injury following dry needling

Article notes ► Copyright and License information ►

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Abstract

A 27-year-old secretary presented to an orthopaedic outpatients department with a 1-month history of left wrist drop following dry needling. On insertion of a needle, she reported spasms in her left hand followed by a wrist drop. An MRI scan was normal. Electromyogram and nerve conduction studies showed a neuropraxia of the left radial nerve. She was referred to a hand therapist for splinting and intensive hand therapy; however, her symptoms remain unchanged.

orthopaedics, physiotherapy (rehabilitation), rehabilitation medicine, disability

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Background

Dry needling and acupuncture are commonly practised methods of pain management. In Ireland dry needling is performed by physiotherapists. It is considered a safe treatment.¹

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Case presentation

A 27-year-old secretary presented to an orthopaedic outpatients department with a 1-month history of left wrist drop following dry needling.

The patient attended physiotherapy occasionally for deep tissue massage and dry needling for shoulder pain. On this particular occasion, as the physiotherapist inserted a needle, she reported that she felt spasms in her left hand followed by a wrist drop. The needle was inserted in the lateral aspect of her arm, approximately at the level of the junction of the middle and distal third of her left humerus. The patient reported that the needle was applied with equal vigour to other needles applied that day. A filiform needle 0.25 mm in diameter and 50 mm in length was used.

The patient attended the emergency department where an MRI scan of her arm showed no evidence of pathology at or around her left humerus.

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Investigations

Nerve conduction studies and an electromyogram (EMG) were performed following orthopaedic review. This revealed a neuropraxia of her left radial nerve at the spiral groove. EMG of the left triceps muscle was normal. She was referred to a neurologist, who could find no contributing neurological conditions or cervical radiculopathy. Follow-up nerve conduction studies and an EMG showed no signs of recovery. The patient continues to have symptomatic weakness.

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Treatment

The patient was referred to a hand therapist for splinting. Despite intensive hand therapy, she continues to show no signs of improvement and has consistent left wrist drop (figure 1).