Acupuncture and dry needling are powerful, yet often overlooked, complementary therapies that can significantly enhance post-operative recovery. Despite substantial evidence supporting their benefits in pain relief, inflammation reduction, and improved healing, these treatments are not yet standard in post-op care.

Key Points

• Pain Relief: Acupuncture and dry needling reduce post-op pain by releasing endorphins and improving blood flow.

• Inflammation Reduction: These therapies decrease inflammation, speeding up the healing process.

• Improved Mobility: Acupuncture and dry needling enhance range of motion and alleviate muscle tightness.

• Enhanced Circulation: Improved circulation from these treatments supports faster recovery and tissue repair.

• Pre- and Post-Surgery Benefits: Acupuncture and dry needling can prepare the body for surgery and enhance post-op rehabilitation.

Why Isn’t Acupuncture and Dry Needling Part of Post-Op Surgery Care?

In the current landscape of post-operative care, patients often face a recovery process that heavily relies on pharmaceuticals and standard rehabilitation protocols. Despite advancements in medical technology, many patients still struggle with pain, inflammation, and prolonged recovery times. Acupuncture and dry needling, however, offer promising complementary therapies that could enhance the standard post-op care regimen. This blog post explores why these therapies should be integrated into post-operative care and how they can benefit patients both before and after surgery.

Current Standard of Post-Op Care: A Critical Look

Discussion on the prevalent reliance on pharmaceuticals for pain management

The current standard of post-operative care heavily relies on pharmaceuticals, particularly opioids, for pain management. While these medications can be effective in alleviating severe pain, they come with significant risks and side effects. Opioids, for instance, are known for their potential to cause dependence and addiction, which has led to a widespread opioid crisis. Non-steroidal anti-inflammatory drugs (NSAIDs) are also commonly used but can cause gastrointestinal issues, cardiovascular problems, and renal impairment when used long-term. The heavy reliance on these pharmaceuticals often overlooks the potential of integrative treatments like acupuncture and dry needling, which can provide effective pain relief without these adverse effects.

Overview of typical post-op rehabilitation protocols

Post-operative rehabilitation protocols typically include physical therapy, rest, and gradual reintroduction of movement and exercise. These protocols aim to restore function, strength, and mobility while minimizing pain and preventing complications such as blood clots or infections. Physical therapy often involves exercises to improve range of motion, strength, and flexibility. Patients might also be advised to use ice and compression to reduce swelling. However, these protocols can sometimes fall short in providing comprehensive pain relief and promoting optimal healing. Integrative treatments like acupuncture and dry needling can enhance these rehabilitation efforts by addressing pain, inflammation, and muscle tightness more holistically.

Critique of the gaps in the current post-op care approach, particularly in addressing pain, inflammation, and functional recovery

The current approach to post-operative care has several gaps, particularly in effectively addressing pain, inflammation, and functional recovery. Pharmaceuticals, while effective for pain relief, do not address the underlying causes of pain or promote healing. They also come with risks of side effects and dependence. Moreover, typical rehabilitation protocols may not fully address issues like muscle tightness, trigger points, and chronic inflammation, which can impede recovery and prolong the rehabilitation process.

• Pain Management

  • Pharmaceuticals mask pain rather than addressing its root causes.

  • There is a risk of side effects and addiction with opioid use.

  • Integrative treatments like acupuncture and dry needling can provide effective pain relief by targeting the source of pain and promoting the body’s natural healing processes.

• Inflammation Reduction

  • NSAIDs and steroids used for inflammation have side effects with long-term use.

  • Acupuncture and dry needling can reduce inflammation naturally by improving circulation and promoting anti-inflammatory responses in the body.

• Functional Recovery

  • Physical therapy is essential but may not be sufficient alone.

  • Muscle tightness and trigger points can impede rehabilitation progress.

  • Dry needling and acupuncture can release muscle tension, enhance range of motion, and accelerate functional recovery.

By incorporating acupuncture and dry needling into post-operative care, these gaps can be addressed more effectively, leading to better overall outcomes for patients. These treatments offer a holistic approach that not only relieves pain but also enhances the healing process and supports comprehensive recovery. They don’t replace the current standard of care, but rather can enhance it by helping patients get off pain medications faster, and progress through PT and rehabilitation with less dramatic ups and downs.

Research Supporting Acupuncture and Dry Needling

Relieving Pain

Acupuncture and dry needling have been extensively studied for their pain-relieving properties. Research indicates that these therapies can significantly reduce pain levels by stimulating the release of endorphins, the body's natural painkillers. A study published in the Journal of Pain found that acupuncture reduced chronic pain more effectively than standard care alone, highlighting its potential for post-op pain management.

Improving Circulation

Enhanced circulation is crucial for post-surgical healing, as it ensures adequate oxygen and nutrient delivery to the tissues. Acupuncture has been shown to improve blood flow and microcirculation, which can accelerate the healing process. A 2016 study demonstrated that acupuncture increased blood flow in the treated areas, supporting faster recovery and reduced complications.

Reducing Inflammation

Inflammation is a natural response to surgery but can become problematic if it persists. Acupuncture's anti-inflammatory effects are well-documented. According to a 2021 study, acupuncture reduces inflammatory markers, which means it can also help to mitigate post-op inflammation, swelling, and pain.

Improving Range of Motion

Post-surgical stiffness and limited mobility can hinder rehabilitation efforts. Acupuncture and dry needling can help restore range of motion by relieving muscle tension and promoting flexibility. A 2013 study found that dry needling improved mobility and function in patients with musculoskeletal conditions, suggesting similar benefits for post-op care.

Releasing Myofascial Trigger Points

Myofascial trigger points can cause significant post-operative discomfort and restrict movement. Dry needling specifically targets these hyperirritable spots within muscles to provide relief. A 2015 systematic review and meta-analysis supports dry needling's effectiveness in deactivating trigger points and reducing associated pain.

Mechanisms of Action: How Acupuncture and Dry Needling Aid Post-Op Recovery

The physiological mechanisms through which acupuncture and dry needling aid post-op recovery are multifaceted:

• Endorphin Release and Pain Modulation: Acupuncture and dry needling stimulate the release of endorphins, which help to modulate pain and improve the patient's comfort.

• Enhanced Blood Circulation: By increasing blood flow, these therapies ensure that more oxygen and nutrients reach the healing tissues, facilitating faster recovery.

• Reduction of Cytokines and Inflammatory Markers: Acupuncture reduces the presence of cytokines and other inflammatory markers, decreasing swelling and pain.

• Neurological Stimulation: These therapies stimulate nerve pathways that promote healing and muscle relaxation, which is crucial for effective rehabilitation.

• Releasing Myofascial Trigger Points: Needling into taut bands of muscle that cause local and referred pain can help to relieve pain and improve range of motion.

• Integration with Physical Therapy: Acupuncture and dry needling complement physical therapy by reducing pain and muscle tension, making therapeutic exercises more effective and tolerable.

Preparing the Body for Surgery: Proactive Healing

Acupuncture and dry needling are not just beneficial post-surgery; they can also play a crucial role in preparing the body for surgery. Pre-operative acupuncture can reduce anxiety, enhance immune function, and improve overall physical condition, making the body more resilient to surgical stress. Studies such as those presented at the 2020 Anesthesiology Annual Meeting have shown that patients who receive pre-operative acupuncture experience better post-operative pain levels and require less pain medications after surgery.

When to Get Acupuncture and Dry Needling Before and After Surgery

• Pre-Surgery Timing: It is recommended to start acupuncture and dry needling treatments a few weeks or a few months before surgery to optimize physical condition and immune response.

• Post-Surgery Timing: Acupuncture and dry needling should be initiated once the risk of infection has decreased, typically after the initial healing phase. While direct needling at the surgical site should be avoided until fully healed, treatments can begin immediately in areas distant from the surgical site to manage pain and inflammation.

• Infection Risk: Avoiding direct needling at the surgical site for a period recommended by clinical guidelines, often around 4-6 weeks, can minimize infection risks while still providing the benefits of these therapies.

Conclusion

Acupuncture and dry needling offer a promising alternative or supplementary treatment for post-operative care, providing benefits such as pain relief, improved circulation, reduced inflammation, enhanced range of motion, and the release of myofascial trigger points. Integrating these therapies into the standard post-op care protocol can lead to more comprehensive and effective recovery.

For patients and healthcare providers seeking to enhance treatment outcomes and accelerate healing in a natural, effective manner, acupuncture and dry needling present compelling options. Consider incorporating these therapies into your pre- and post-surgery care to optimize recovery and overall health.

Over to you

If you liked this article, please share with friends and family who may want to learn more about acupuncture and dry needling for post-operative care.

Sources:

• Vickers, A. J., Vertosick, E. A., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Irnich, D., Witt, C. M., Linde, K., & Acupuncture Trialists' Collaboration (2018). Acupuncture for Chronic Pain: Update of an Individual Patient Data Meta-Analysis. The journal of pain, 19(5), 455–474. https://doi.org/10.1016/j.jpain.2017.11.005

• Kim SY, Min S, Lee H, Cheon S, Zhang X, Park JY, Song TJ, Park HJ. Changes of Local Blood Flow in Response to Acupuncture Stimulation: A Systematic Review. Evid Based Complement Alternat Med. 2016;2016:9874207. doi: 10.1155/2016/9874207. Epub 2016 Jun 14. PMID: 27403201; PMCID: PMC4923553.

• Zhao, Z. Q. (2008). Neural mechanism underlying acupuncture analgesia. Progress in Neurobiology, 85(4), 355-375. https://doi.org/10.1016/j.pneurobio.2008.05.004

• Shah, J. P., & Gilliams, E. A. (2008). Uncovering the biochemical milieu of myofascial trigger points using in vivo microdialysis: an application of muscle pain concepts to myofascial pain syndrome. Journal of bodywork and movement therapies, 12(4), 371–384. https://doi.org/10.1016/j.jbmt.2008.06.006

• Liu, L., Huang, Q. M., Liu, Q. G., Ye, G., Bo, C. Z., Chen, M. J., & Li, P. (2015). Effectiveness of dry needling for myofascial trigger points associated with neck and shoulder pain: a systematic review and meta-analysis. Archives of physical medicine and rehabilitation, 96(5), 944–955. https://doi.org/10.1016/j.apmr.2014.12.015

• Kietrys, D. M., Palombaro, K. M., Azzaretto, E., Hubler, R., Schaller, B., Schlussel, J. M., & Tucker, M. (2013). Effectiveness of dry needling for upper-quarter myofascial pain: a systematic review and meta-analysis. The Journal of orthopaedic and sports physical therapy, 43(9), 620–634. https://doi.org/10.2519/jospt.2013.4668

• Bae H, Bae H, Min BI, Cho S. Efficacy of acupuncture in reducing preoperative anxiety: a meta-analysis. Evid Based Complement Alternat Med. 2014;2014:850367. doi: 10.1155/2014/850367. Epub 2014 Sep 2. PMID: 25254059; PMCID: PMC4165564.

• Baldawi, M., McKelvey, G., Patel, V. R., Krish, B., Kumar, A. J., & Patel, P. (2022). Battlefield Acupuncture Use for Perioperative Anesthesia in Veterans Affairs Surgical Patients: A Single-Center Randomized Controlled Trial. Journal of integrative and complementary medicine, 28(8), 683–688. https://doi.org/10.1089/jicm.2021.0429

Disclaimer: This web site is intended for educational and informational purposes only. Reading this website does not constitute providing medical advice or any professional services. This information should not be used for diagnosing or treating any health issue or disease. Those seeking medical advice should consult with a licensed physician. Seek the advice of a medical doctor or other qualified health professional for any medical condition. If you think you have a medical emergency, call 911 or go to the emergency room. No acupuncturist-patient relationship is created by reading this website or using the information. Morningside Acupuncture PLLC and its employees and contributors do not make any express or implied representations with respect to the information on this site or its use.

Read more from our blog