The Mistake of Treating Mental & Physical Impairments as Separate Entities, & How to Treat Both with Dry Needling & Joint Manipulation
How to Alleviate Anxiety, Decrease Pain, & Improve Mental Health with the Thoughtful Combination of Dry Needling & Joint Manipulation to Induce Autonomic Nervous System Homeostasis
Well, for starters, our healthcare system has been systematically destroyed and is getting worse. Halfway decent health insurance has skyrocketed. Personally, I went from being able to get good insurance for around $200 a month 10 years ago, to struggling to find any decent insurance plan for less than $500 a month. The result? Now anyone not able to afford $500 to $1,000 a month or more for health insurance is completely screwed and the only option is some type of government funded healthcare. Great, right? Yeah, awesome. Unless you want competent medical care… Then it’s not so awesome. You know what is not covered in the vast majority of “affordable” healthcare nowadays? You got it, mental health. Makes perfect sense, especially since we hear about the mental health crisis all time, which has gotten unnecessarily, exponentially worse over the last couple of years. Yes, the people complaining about the current mental health crisis are the same people who actively restrict mental healthcare for the vast majority of American health insurance plans.
Golly-gee, I wonder why that would be? Weird... Well, if you think about it, this actually does make sense. If you are a megalomaniacal sociopath, that is. Think about the money the government is making through their joint venture with the pharmaceutical cartel. Why would you fix or properly treat something that is making a select, small group of powerful people billions of dollars a year by keeping the general population on a steady regimen of largely unnecessary drugs? Drugs that, in the overwhelming majority of instances, do not address any underlying causative factor and, therefore, have zero chance of actually curing anything. Ever.
This is intentional malpractice combined with a complete lack of critical thinking ability and courage from the majority of medical professionals. There have been almost zero major breakthroughs in treating mental health since the 1970’s, despite the massive experimental advances we have made in understanding the structure and function of the brain. Anyone see a slight issue here? I mean, hell, let’s just bring back lobotomies and be done with it. At the very least, it makes more sense than a lot of what we do today, like putting 40 million people on amphetamines in 2021 alone. Maybe we should change our approach on this matter? We transitioned from lobotomies to selective serotonin reuptake inhibitors (SSRI’s) in the 1970’s, and have not made any significant advancements since.
Every child, on a base, instinctual level, understands that mental and physical pain are intricately interconnected. You get sad, angry, cranky, or whatever, and your body starts doing weird things, like hurting or fatiguing for no apparent reason. And anyone who has been physically injured, especially in a significant way, knows how detrimental physical discomfort / pathology is to your mental wellbeing. I am not a depressed person, but man, for a few months following some of my more intense injuries, like shattering my hip, I got good insight into what it is like to feel hopeless. It sucks. Bad. So, if young children with zero medical training understand this, how do our amazing, vaunted “public health experts” in positions of power fail to understand this simple concept?
Let’s take the most common type of mental health medication utilized today, SSRI’s. Now, pharmaceuticals certainly have their place. Things like antibiotics have improved the human condition exponentially, and SSRI’s certainly do help a lot of people. Overall, they have a good safety profile. However, they also make some people violent or suicidal and sometimes they don’t work, or make things worse. I know there has been some recent buzz about serotonin having nothing to do with mental health. This is patently false. Serotonin dysregulation is involved in almost all mental pathology. It may not be the serotonin itself that is creating the end-result. It is likely working upon other pathways we do not yet understand or even know exist. An issue with SSRI’s and most other medicine is, they typically treat a symptom or symptoms of the problem and fail to address the underlying causative factors. This guarantees you will never fully heal and will need the medicine for life.
Now, a lot of that is because we don’t understand the causative factors for stuff and at the moment, the best we can do is treat the symptoms. However, don’t forget the simple stuff. This is a main thought process I try to present to my students. We do understand general trends a lot better than specific neurophysiologic pathways. A few of those general trends we are confident about are these:
- Tissue and joint pathology, even if not consistently bothersome, stimulate sympathetic autonomic activity.
- With enough tissue and joint pathology over a period of time, you start living with chronic sympathetic autonomic hyperactivity. Again, the presentation of this may vary drastically from person to person.
- The overall effect of thoughtful dry needling and joint manipulation is parasympathetic dominance compared to baseline.
- Dry needling combined with joint manipulation are the most powerful tools we have in Physical-Therapy-Land, at the moment, to rapidly normalize soft tissue and joint deviation, depress sympathetic activity, and nudge the ANS towards homeostasis.
- Autonomic nervous system homeostasis improves all aspects of health.
The intestines, intestinal health and gut microbiome regulate a huge percentage of our serotonin production and concentrations throughout our brain and body. Pathologic tissue throughout the body elevates sympathetic autonomic activity, which, in turn, disrupts intestinal health, along with hormone and neuromodulator production, like serotonin, epinephrine, and dopamine. The mechanisms of action are largely unknown, but the overall results are indisputable. Chronic sympathetic hyperactivity, which can stem from physical or mental stress, strain, or trauma, becomes detrimental to both physical and mental health through various negative feedback loops. Physical pathology advances mental pathology and mental pathology advances physical pathology in a vicious cycle.
The most effective treatments we have available today to reduce tissue pathology throughout the body to induce autonomic nervous system homeostasis, the key to health, are dry needling combined with joint manipulation. The problem with these treatments is, they are cheap, safe, and super effective. Yes, these things are problems in our medical system. If it is not on patent and incredibly expensive, even if safe and effective, it is witchcraft. Just ask the experts, they will tell you.
No mental health impairment can be resolved to the maximum potential without specific, targeted treatment of pathologic tissues throughout the body, along with targeted sympathetic depression and parasympathetic elevation. Remember, the natural response of the mind and body to stress, strain, or trauma is to elevate sympathetics. Almost all mental health and physical therapy patients present with sympathetic hyperactivity. Depressing autonomic sympathetic hyperactivity should be a major goal of most physical and mental health treatment.
Regardless of the cause of mental impairment, especially in chronic conditions, the body develops tissue pathology secondary to dysregulation of brain function. This tissue pathology can, and often does, become the driving factor behind chronic mental conditions. Here is the way I think about this. Mental trauma creates physical dysfunction via autonomic dysregulation. The cause-and-effect relationship between these pathologies become irreversibly conjoined. At this point, treating either mental or physical stress alone is only addressing half the current problem and is destined for failure, at least failure to improve patient health to the maximum potential. Physical pathology drives mental pathology and vice versa.
Thoughtful dry needling, including auricular electrical vagus nerve and parasympathetic-specific stimulation, especially when combined with joint manipulation, has a powerful homeostatic effect on the autonomic nervous system. One of the problems with a lot of current medicine is, many practitioners undervalue the awesome, innate healing power of the human mind and body. Therefore, this magic, it really is magical, is overlooked in favor of using medicines that focus on inhibiting or facilitating certain neurophysiologic pathways. Again, there is nothing wrong with this. However, overlooking simple, safe, cheap and potently effective tools, like thoughtfully performed dry needling combined with joint manipulation, is detrimental to maximizing patient recovery.
As mentioned above, all living humans have some sort of tissue and joint pathology somewhere throughout their body. The more pathology you have, the more your sympathetics are stimulated and the more dysregulated the autonomic nervous system becomes. This holds true with pathologic tissue that does not cause conscious awareness, like pain. Whether you feel it or not, pathologic tissue sends negative afferent, bothersome signals to the brain. The more annoying signals the brain receives, the less capable it becomes at properly regulating our neurophysiology.
Think about sitting outside eating and having 1 hell-spawned mosquito flying around your head. I almost died from Malaria in a jungle in Central America, so mosquitos and I don’t get along. Anyway, you can handle 1 mosquito while eating, probably, as long as the little bastard doesn’t attack your face. Now, imagine 10,000 mosquitoes flying around your head and attacking you. Eating, without also eating bugs, or choking on them, becomes impossible. Trust me, I was a fly-fishing guide in the Alaskan tundra for a decade, this happens frequently. It's all about mind control. The bugs are insane. Anyway, this is exactly what happens to our nervous system. Think of each tiny piece of pathologic tissue, painful or not, as sending a bug buzzing around in your brain. Like Ant-Man. Great movie. The more pathologic tissue, the more Ant-Mans in your brain. Too many Ant-Mans in the brain, bad stuff happens.
Related: Check out my short video on the link between dry needling and psychotherapy
There is an intricate relationship between increased tissue pathology, increased neurophysiologic pathology, and impaired mental health. I’m talking everything from slight anxiety to multiple personality disorder and everything in between. Short muscles are a good example. Most people are not nearly flexible enough. Now, just because you are not flexible, does not mean you will be in pain or suffer obvious impairment. What short muscles do indicate, however, is they are pathologic, in some way or other. Decreased blood flow and hypoxia are common in almost all shortened muscles, for example. Trigger point, knots, can occlude over 90% of the blood that typically flows through the now hypercontracted bundle of sarcomeres. Another thing shortened muscles do is compress joints. Normalizing tissue length and decompressing joints is one of the simplest and most effective ways to improve tissue and joint health throughout life. Improved tissue and joint health improve autonomic nervous system homeostasis. ANS homeostasis helps improve all mental and physical impairments, as far as I am aware. The best tools physical therapists have at their disposal to accomplish this are thoughtfully combined dry needling and joint manipulation.
Thanks for reading, let me know if anyone has any questions about anything. Talk to you soon.
Jason
DISCLAIMER: The content on the blog for Intricate Art Spine & Body Solutions, LLC is for educational and informational purposes only, and is not intended as medical advice. The information contained in this blog should not be used to diagnose, treat or prevent any disease or health illness. Any reliance you place on such information is therefore strictly at your own risk. Please consult with your physician or other qualified healthcare professional before acting on any information presented here.
References
Vagus Nerve Stimulation
Butt, M.F., Albusoda, A., Farmer, A.D. and Aziz, Q., 2020. The anatomical basis for transcutaneous auricular vagus nerve stimulation. Journal of anatomy, 236(4), pp.588-611.
Garner, B.K., Hopkinson, S.G., Ketz, A.K., Landis, C.A. and Trego, L.L., 2018. Auricular acupuncture for chronic pain and insomnia: a randomized clinical trial. Medical acupuncture, 30(5), pp.262-272.
Jaić, K.K., Turković, T.M., Pešić, M., Djaković, I., Košec, V. and Košec, A., 2019. Auricular acupuncture as effective pain relief after episiotomy: a randomized controlled pilot study. Archives of gynecology and obstetrics, 300(5), pp.1295-1301
Johnson, R.L. and Wilson, C.G., 2018. A review of vagus nerve stimulation as a therapeutic intervention. Journal of inflammation research, 11, p.203.
Kang, H.R., Lee, Y.S., Kim, H.R., Kim, E.J., Kim, K.H., Kim, K.S., Jung, C.Y. and Lee, J.K., 2017. A clinical study of electroacupuncture and auricular acupuncture for abdominal pain relief in patients with pancreatitis: A pilot study. Korean Journal of Acupuncture, 34(1), pp.47-55.
Moura, C.D.C., Chaves, E.D.C.L., Cardoso, A.C.L.R., Nogueira, D.A., Azevedo, C. and Chianca, T.C.M., 2019. Auricular acupuncture for chronic back pain in adults: a systematic review and metanalysis. Revista da Escola de Enfermagem da USP, 53.
Sator-Katzenschlager, S.M., Szeles, J.C., Scharbert, G., Michalek-Sauberer, A., Kober, A., Heinze, G. and Kozek-Langenecker, S.A., 2003. Electrical stimulation of auricular acupuncture points is more effective than conventional manual auricular acupuncture in chronic cervical pain: a pilot study. Anesthesia & Analgesia, 97(5), pp.1469-1473.
Shah, A.N., Moore, C.B. and Brigger, M.T., 2020. Auricular acupuncture for adult tonsillectomy. The Laryngoscope, 130(8), pp.1907-1912.
Sprouse-Blum, A.S., Smith, G., Sugai, D. and Parsa, F.D., 2010. Understanding endorphins and their importance in pain management. Hawaii medical journal, 69(3), p.70.
Taylor, S.L., Giannitrapani, K.F., Ackland, P.E., Thomas, E.R., Federman, D.G., Holliday, J.R., Olson, J., Kligler, B. and Zeliadt, S.B., 2021. The Implementation and Effectiveness of Battlefield Auricular Acupuncture for Pain. Pain Medicine.
Tsai, S.L., Fox, L.M., Murakami, M. and Tsung, J.W., 2016. Auricular acupuncture in emergency department treatment of acute pain. Annals of emergency medicine, 68(5), pp.583-585.
Usichenko, T.I., Dinse, M., Hermsen, M., Witstruck, T., Pavlovic, D. and Lehmann, C., 2005. Auricular acupuncture for pain relief after total hip arthroplasty–a randomized controlled study. Pain, 114(3), pp.320-327.
Usichenko, T.I., Kuchling, S., Witstruck, T., Pavlovic, D., Zach, M., Hofer, A., Merk, H., Lehmann, C. and Wendt, M., 2007. Auricular acupuncture for pain relief after ambulatory knee surgery: a randomized trial. Cmaj, 176(2), pp.179-183.
Usichenko, T.I., Lehmann, C. and Ernst, E., 2008. Auricular acupuncture for postoperative pain control: a systematic review of randomised clinical trials. Anaesthesia, 63(12), pp.1343-1348.
Yeh, C.H., Chiang, Y.C., Hoffman, S.L., Liang, Z., Klem, M.L., Tam, W.W., Chien, L.C. and Suen, L.K.P., 2014. Efficacy of auricular therapy for pain management: a systematic review and meta-analysis. Evidence-Based Complementary and Alternative Medicine, 2014.
Prescott, S.L. and Liberles, S.D., 2022. Internal senses of the vagus nerve. Neuron.
Badran, B.W., Brown, J.C., Dowdle, L.T., Mithoefer, O.J., LaBate, N.T., Coatsworth, J., DeVries, W.H., Austelle, C.W., McTeague, L.M., Yu, A. and Bikson, M., 2018. Tragus or cymba conchae? Investigating the anatomical foundation of transcutaneous auricular vagus nerve stimulation (taVNS). Brain stimulation, 11(4), p.947.
Bonaz, B., Sinniger, V. and Pellissier, S., 2021. Therapeutic potential of vagus nerve stimulation for inflammatory bowel diseases. Frontiers in neuroscience, 15, p.300.
Burger, A.M., D’Agostini, M., Verkuil, B. and Van Diest, I., 2020. Moving beyond belief: A narrative review of potential biomarkers for transcutaneous vagus nerve stimulation. Psychophysiology, 57(6), p.e13571.
Ottaviani, M.M., Wright, L., Dawood, T. and Macefield, V.G., 2020. In vivo recordings from the human vagus nerve using ultrasound‐guided microneurography. The Journal of physiology, 598(17), pp.3569-3576.
