Around 75% of the leading causes of death and disease in the United States are considered idiopathic, or without a known cause, which is not true in the overwhelming percentage of cases. Cardiovascular disease, cancer, obesity, diabetes, and autoimmunity are considered idiopathic for most people. Almost all these things are treated with life-long regimens of expensive pills, based on matching your subjective symptoms to a list paired with a medicine or five, on the computer, without considering the reason the symptoms are there in the first place. If you are one of the hundreds of millions of people in this situation, your health would drastically improve if all you did was alter your eating, supplement, and exercise. Adding consistent dry needling combined with joint manipulation amplifies the benefits as they all accomplish the same goal, autonomic nervous system homeostasis. These interventions are free or cheap, and extremely effective. If you add in Genetic and epigenetic testing to your program, both awesome tools I recommend to my patients and students, you can improve the ability to make health decisions from as well-informed a position as possible. Ways2Well (https://ways2well.com/), and InsideTracker (https://www.insidetracker.com/) are two companies I recommend.

Dr. Gabrielle Lyon’s podcast (https://drgabriellelyon.com/podcast/) is an awesome resource to learn about all sorts of cool stuff, including the reasons why having sufficient muscle mass is an underappreciated, vital component of health. She is excellent at discussing muscle and its astounding importance in moderating health and healthy aging. Dr. Lyon also provides awesome information about nutrition, supplementation, and a wealth of other helpful, usable, functional medical knowledge. Exercising and gaining healthy muscle while young, and maintaining a healthy mass of muscle as we age, is one of the most important things a human can do to avoid and recover from dysfunction. People who consistently exercise and eat well live over a decade longer and are far healthier, on average, than people who do not.

Dry Needling Facilitates Improved Homeostasis & Sarcomere Production

The sarcomere is the smallest contractile unit of skeletal muscle. That we know of. To build muscles, we must create new sarcomeres to add onto existing sarcomeres, in series and in parallel. It takes about 8 weeks of sufficient exercise, at least 3 times a week, to begin building new sarcomeres. This is why physical therapists should avoid spending time watching patients exercise. The average number of PT visits using health insurance in 2022 was about 8. It is scientifically impossible to build new muscle in 8 workout sessions, and our time and knowledge are better spent helping the patient accomplish things they cannot accomplish on their own.

As Physical Therapists, we should spend as much time as needed educating patients about exercise and how to do it, because it is 100% necessary if you want to be healthy, but building muscle is something that can only be accomplished if the patient is willing to put in the effort. We should be spending the majority of our time eliminating tissue and joint pathology, while at the same time targeting the parasympathetic portion of the autonomic nervous system, with the express intent of leading the nervous system toward homeostasis.

Muscles do not grow or function well in hypoxic conditions. Their mitochondria produce less energy to add the autonomic well of energy during aerobic respiration compared to anaerobic conditions. The more muscle we have, the more mitochondria we have, the deeper the well of autonomic energy we have, the more resistant to disease and impairment we are. 50% of 65-year-olds are dead within 5 years of a hip fracture. This is insane. Most hip fractures are not life-threatening. The problem is, if you are living in a chronic state of sympathetic autonomic nervous system hyperactivity and energy deficiency, especially when older, and you go through any sufficiently traumatic event, mental or physical, it can be enough to push the autonomic nervous system over its sympathetic threshold, and ability to sufficiently self-regulate is lost. The resulting downhill slide of various organ systems and neurophysiologic functions is what leads to further impairment or death. The hip is the spark that causes a forest fire.

Skeletal muscle cells contain multiple nuclei, a unique characteristic, and therefore, higher concentrations of mitochondria than other cells. Mitochondria produce the primary energy source our muscles use to function, adenosine triphosphate (ATP). Approximately 36 molecules of it per molecule of glucose processed in the presence of oxygen. In hypoxic conditions, we produce only 2 ATP. Without healthy mitochondria, cells are destined for ruin. If we run short of mitochondria to meet energy demand, or if the mitochondria dysfunction, as they do as we age and when the autonomic nervous system is dysregulated, bad stuff happens, lots of it. The mitochondria are the primary energy source inside the cell and remove waste products. I think about each new sarcomere I build from exercise as adding energy capacity and defense mechanisms against disease.

Dry Needling Improves Cerebral Blood Perfusion & Neuronal Function

This is an awesome article reviewing a bunch of studies looking at the effect head and face needling has on cerebral blood flow, neuronal function, and patient outcomes.

Jin G-Y, Jin LL, Jin BX, Zheng J, He BJ and Li S-J (2023) Neural control of cerebral blood flow: scientific basis of scalp acupuncture in treating brain diseases. https://www.frontiersin.org/journals/neuroscience/articles/10.3389/fnins.2023.1210537/full

The results indicate the primary mechanism by which face and head needling works is through Brain alteration. Increased blood perfusion, decreased inflammation, and improved neuronal function were seen throughout numerous studies. improved brain function improves sarcomere production secondary to exercise by optimizing the cellular environment for growth. This is the reason I always target the parasympathetic-dominant regions of the body with my first needles, then move on to treat whatever else. These regions include the sacral plexus, pelvic floor, upper cervical, vagus nerve in the ear, Otic ganglion of the trigeminal nerve, suture lines of the skull. This immediately pushes the autonomic nervous system in the direction we want it to go, toward parasympathetic dominance, which is the overall result of needling almost regardless how you do it, in general. Targeting the parasympathetics first limits the amplitude and duration of the initial sympathetic spike elicited from being poked with sharp objects, which has been shown to last about 15 minutes on average in the studies looking into this.

I want to push my patient’s autonomic nervous system as far in the parasympathetic direction as possible, as fast as possible, for about an hour, or so. The longer the needles are left in place, to a point, with the parasympathetics dominant, the more effective treatment is. The longer the brain has to respond to a stimulus, if said stimulus just so happens to induce homeostasis, we can use it to free the brain and body of the iron shackles placed upon them by the sympathetic autonomic nervous system. The rat bastard! When this happens, Wizard-Healing-Magic happens.

I see miraculous improvements and complete recovery from impairments other typical treatments fail to change, sometimes for decades. The trick is treating the autonomic nervous system, rather than the specific impairment. If you are treating the nervous system itself, you will always be led to the area of primary complaint, as pain and loss of function are major factors disrupting homeostasis. This helps practitioners keep in mind that, in order to maximize autonomic homeostasis, we need to target the parasympathetic dominant regions, while at the same time removing as much tissue pathology from the rest of the body as possible. Pathologic tissue stimulates sympathetics. Stimulating Parasympathetics reciprocally inhibits sympathetics. Why not both push and pull the autonomic nervous system towards homeostasis?

I regard needling as a brain treatment. A path to restore our innate superpowers. We are just using the soft tissues and nerves throughout the body as access points to affect various locations in the brain. The needle is a significant-enough amount of direct tissue stimulation to induce incredible homeostatic and neuroplastic alterations in the brain. The speed of complete recovery from unusual, random, “idiopathic” neurologic impairments I have observed consistently over my ten-year career never ceases to amaze me. Particularly with people who are not in good shape, do not eat well, do not supplement, and do not exercise. Nevertheless, thoughtfully performed needling leads the autonomic nervous system back from the abyss, into a realm where it can once again effectively self-regulate and maintain homeostasis.

I continuously have to remind myself the results I am seeing are real. I grew up in a medical household, and society in general, including most medical practitioners, have been duped into erroneously believing mainstream medicine is providing the best avenue of care to improve health and longevity. This assumption falls into stark opposition with reality, where about three quarters of the United States population is dealing with some type of idiopathic impairment and 75% of the US is overweight or obese. We currently have the technological capabilities and sufficient scientific understanding to absolutely decimate the number of mental and physical health impairments in our country. Unfortunately, the mindset and structural set up of our healthcare system and medical schools incapacitates all but the most courageous, open-minded, strong-willed medical practitioners from exploring alternative treatments.

Having a proper amount of healthy skeletal muscle is key to improving healthspan and lifespan, and a lack thereof is a leading cause of impairment. If your goal is to build muscle to improve health, you are going to be seriously inhibited from doing so by a baseline lack of oxygen in your tissues and autonomic dysregulation. You will have to work harder than you should to achieve results, with a higher likelihood of aggravation. This is a major barrier to consistent exercise for many. Thoughtful dry needling combined with joint manipulation dramatically improve autonomic nervous system homeostasis all on their own. If people receive competent treatment consistently, the likelihood those same people would consistently exercise skyrockets. Brain health markedly improves, leading to decreased pain, improved mental health, and more energy, increasing the likelihood people will consistently exercise.

Thanks for reading everyone, let me know if anyone has any questions about anything.

Dr. Lyon, I would love to speak with you about this!

References

• Wen, Y., Dungan, C.M., Mobley, C.B., Valentino, T., von Walden, F. and Murach, K.A., 2021. Nucleus type-specific DNA methylomics reveals epigenetic “memory” of prior adaptation in skeletal muscle. Function, 2(5), p.zqab038.
• Hood, D.A., Memme, J.M., Oliveira, A.N. and Triolo, M., 2019. Maintenance of skeletal muscle mitochondria in health, exercise, and aging. Annual Review of Physiology, 81, pp.19-41.
• Genders, A.J., Holloway, G.P. and Bishop, D.J., 2020. Are alterations in skeletal muscle mitochondria a cause or consequence of insulin resistance?. International Journal of Molecular Sciences, 21(18), p.6948.
• Grevendonk, L., Connell, N.J., McCrum, C., Fealy, C.E., Bilet, L., Bruls, Y.M., Mevenkamp, J., Schrauwen-Hinderling, V.B., Jörgensen, J.A., Moonen-Kornips, E. and Schaart, G., 2021. Impact of aging and exercise on skeletal muscle mitochondrial capacity, energy metabolism, and physical function. Nature communications, 12(1), p.4773.
• Chen, X., Ji, Y., Liu, R., Zhu, X., Wang, K., Yang, X., Liu, B., Gao, Z., Huang, Y., Shen, Y. and Liu, H., 2023. Mitochondrial dysfunction: roles in skeletal muscle atrophy. Journal of Translational Medicine, 21(1), p.503.
• Li, Y., Gao, X., Huang, H., Zhou, X., Zang, Y. and Chou, L.W., 2022. Effects of Fu’s subcutaneous needling on mitochondrial structure and function in rats with sciatica. Molecular Pain, 18, p.17448069221108717.
• Peng, Y., Guo, L., Gu, A., Shi, B., Ren, Y., Cong, J. and Yang, X., 2020. Electroacupuncture alleviates polycystic ovary syndrome-like symptoms through improving insulin resistance, mitochondrial dysfunction, and endoplasmic reticulum stress via enhancing autophagy in rats. Molecular Medicine, 26, pp.1-13.
• Clancy, JA, Mary, DA, Witte, KK orcid.org/0000-0002-7146-7105 et al. (3 more authors) (2014) Non-invasive Vagus Nerve Stimulation in Healthy Humans Reduces Sympathetic Nerve Activity. Brain Stimulation, 7 (6). pp. 871-877. ISSN 1935-861X https://doi.org/10.1016/j.brs.2014.07.031.
• Bonaz, B., Sinniger, V. and Pellissier, S., 2019. Vagus nerve stimulation at the interface of brain–gut interactions. Cold Spring Harbor Perspectives in Medicine, 9(8).
• Jin, G.Y., Jin, L.L., Jin, B.X., Zheng, J., He, B.J. and Li, S.J., 2023. Neural control of cerebral blood flow: scientific basis of scalp acupuncture in treating brain diseases. Frontiers in Neuroscience, 17.
• Suzuki, T., Waki, H., Imai, K. and Hisajima, T., 2020. Electroacupuncture of the ophthalmic branch of the trigeminal nerve: effects on prefrontal cortex blood flow. Medical Acupuncture, 32(3), pp.143-149.
• Li, Y.W., Li, W., Wang, S.T., Gong, Y.N., Dou, B.M., Lyu, Z.X., Ulloa, L., Wang, S.J., Xu, Z.F. and Guo, Y., 2022. The autonomic nervous system: a potential link to the efficacy of acupuncture. Frontiers in Neuroscience, 16, p.1038945.