New studies are bolstering this care pairing by examining chiropractic and acupuncture for chronic pain in an integrated health plan
While you may have a solid business working solely with chiropractic patients, are there benefits to being certified in acupuncture as well? And if you’re not, should you hire a staff member who is? What are the advantages of being certified in both chiropractic and acupuncture?
Lev Kalika, DC, owner of Inc. 5000 company New York Dynamic Neuromuscular Rehabilitation & Physical Therapy (NYDN Rehab) in New York City, says the benefits are many. While he isn’t certified in acupuncture, he works with a licensed acupuncturist. Together, they perform dry needling, and Kalika provides the guidance for deep ultrasound during the procedure.
“Clinical advantages are very obvious here,” Kalika says. “You can simply achieve more profound treatment results by integrating acupuncture or dry needling into your chiropractic practice. The economic effects are also very positive. Many patients have had therapists that were not able to achieve quick pain relief and furthermore, the root cause of the patient’s problem.
“At my clinic, patients keep coming back — in large part because of the quick pain relief acupuncture and dry needling achieve. And because of the quick pain relief, patients are determined to stick around longer and spend more money to remove the root of the problem.”
Kalika also answered other questions about chiropractic and acupuncture. What follows is the interview edited for length and clarity.
Are there specific issues or illnesses that can be helped by a combination of chiropractic and acupuncture?
Back and neck pain are the greatest examples here. Despite your greatest ability to produce profound soft tissue manual releases, you are never able to remove deep, chronic trigger points in the deep spinal musculature, especially something that’s been around for a long time.
Certain fibrotic tissue is very hard, if not impossible, to illuminate manually; however, it is something that’s easy to do with the needle. Especially if you use ultrasound for guidance where you can easily visualize fibrotic adhesions in these muscles. It is no secret that many of our chiropractic manipulation trusts are not achieving audibles because the facet joint is so locked by hardened myofascia, regardless of the type of manipulation we use. Neither trust can relax splinting muscles or trigger points with a reflex after fascial densification and muscle hardening.
What about stress reduction?
We live in a very fast world and our patients are under a lot of stress. Oftentimes, they don’t realize how much stress they are under. Using acupuncture meridian therapy, we provide our patients with dramatic stress reduction.
The stress reduction and immediate rebalancing of the sympathetic system creates a sensation of well-being that patients know they’ll get.
During a patient evaluation, how do you determine if the patient needs chiropractic or acupuncture? Or both?
I don’t usually put patients in the categories of one versus the other. I simply look at which of the two will achieve faster and more sound results. To do this, I examine muscles and joints under ultrasound and look for deep lying trigger points. I motion-palpate the joints and mark the areas where I think dry needling or acupuncture would allow me to achieve faster reduction of the subluxed joints with manipulation.
When I see a blocked segment that doesn’t move in a bigger motion range, I always retest on motion palpation to realize if and how much the segment moves under a targeted vector specific mobilization using different planes and positions. When I see that no motion can be accomplished, I always dry needle that segment before the manipulation or rehabilitation.
During my examination, I also look for facilitated segments (according to Korr) using acupuncture in the area of the nerve distribution of that segment. It is the quickest way to inhibit an overstimulated nerve.
How has adding acupuncture enhanced your business?
Some patients are solely looking for acupuncture, but once we help them with acupuncture, they are willing to fix additional issues they have with chiropractic and rehabilitation. Dry needling and ultrasound-guided dry needling have also continued to bring us more patients. Our detailed communication with patients about every treatment and tool that we use also attracts more patients to our practice.
Is there any recent research that you think is important for chiropractors to know about regarding the use of acupuncture along with chiropractic?
Yes, this study examining chiropractic and acupuncture for chronic pain in an integrated health plan.
And this research article on meta-analysis of the therapeutic effect of acupuncture and chiropractic on cervical spondylosis radiculopathy is important as well.
I would strongly recommend chiropractors to undertake studying muscles, fascia, and nerves under diagnostic ultrasonography in order to be able to perform ultrasound guided dry needling and nerve treatment.
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