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Under the Needle

By Kevin Dupzyk

Roger DiBrito suffers from pain in his neck and shoulders and a severe fear of needles. He and his wife, Sharon, regularly receive massage therapy to treat chronic pain.

Recently, Sharon tried something new. She let physical therapist Rachel Sherba insert small, thin needles into tender points on her body. It relieved Sharon’s pain, but Roger had two concerns about trying it. The first: needles. The second: it seemed an awful lot like acupuncture, and Sherba is not an acupuncturist.

The technique, called trigger-point dry needling, uses acupuncture needles and is offered in Helena, Bozeman, Missoula, and many smaller communities across Montana. Current state law allows physical therapists to use it at their discretion, with no required training. And that has some acupuncturists up in arms. They contend that it is a form of acupuncture, and should require the same education and licensing.

But Western medicine practitioners argue that what goes on beneath the skin isn’t a secret that requires years of training. When dry needling is done successfully, the needle used to penetrate clenched muscle tissue triggers a twitch response, releasing tension in the muscle and providing relief.

According to Eastern medicine, the twitch response is the arrival of energy, which flows through the body on paths called meridians. Brenda Kaser, president of the Montana Association of Acupuncture and Oriental Medicine, said Eastern medicine seeks to prevent illness by keeping energy flows in balance. This approach can be used for a variety of ailments, but Kaser said, “Pain is the gold standard.”

In contrast, Kaser called Western Medicine “heroic.” “It sneaks in at the last minute and — ‘Here I come to save the day!’” she said. To her, the issue with letting physical therapists practice dry needling is that they are not trained in Eastern concepts.

The first problem this leads to is a professional contention with education and licensing. It is the source of controversy that has kept needles out of the hands of therapists in some states.

The second problem is existential, having to do with our understanding of the body itself. It prompts a question for Western practitioners: If unseen meridians traverse the body, carrying the power to promote good health, why does the body keep them secret?

Sherba suggested dry needling to the DiBritos after completing three days of strictly Western training in the technique. “The only similarity between acupuncture and dry needling is the needles we use,” she said. She offers dry needling at separate practices in Florence and Missoula to treat a variety of conditions, including tendonitis, runner’s knee, lower-back issues, and headaches.

The DiBritos acknowledged they do not know what defines acupuncture, but they believe it is different from dry needling. Kaser said while the patient may not know it, “The difference is that the acupuncturist has over 2,500 hours of education behind that needle.”

Sherba believes the education she received in the process of becoming a physical therapist, along with her dry needling training, qualifies her as a practitioner.

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