Episode Transcript
[00:00:00] Speaker A: I'm here to tell the chiropractic profession guys we could totally dominate the pain management space in conservative care. It's not just about the needle. It's about how the needle makes you a completely different chiropractor.
[00:00:13] Speaker B: Hi, everyone. Welcome to Chirocast, the show where chiropractic insight meets everyday impact. I'm Dr. Stephanie Brown and today we're diving into a topic that's becoming increasingly popular among chiropractors, and that would be dry needling.
So whether you're certified or just curious if it might be a right fit for your office, you are in for a real treat. Today we are being joined by Dr. Erin Wiegand, President of Chiro Needle and a leading voice in the dry needling space.
We will explore what dry needling is. I'm gonna be honest, I don't even know what it is. So we're gonna find out and what it isn't.
Clinical and business benefits and how technology like ChiroTouch helps streamline your workflow when offering new services like this.
So let's hop in. Dr. Erin W. And welcome.
[00:01:05] Speaker A: Hi. Dr. Stephanie.
[00:01:06] Speaker B: Yeah. So glad you could join us today. I really appreciate it. So could you just start telling us a little bit about yourself and how you got into dry needling?
[00:01:16] Speaker A: Yes. So I'm Dr. Aaron Wiegand. I practice in Phoenix, Arizona.
I went to Palmer west and and graduated there about 18 years ago. Been in practice since then and just do a lot of PI work now in my practice, but got into dry needling. You know, the same way a lot of chiropractors find therapies for themselves is that I was injured. I had a 13 millimeter disc extrusion in my low back at the time. Didn't know what it was, but knew I was in pain and knew I had to see patients, had to figure it out. Went to a physical therapist office. I was in my building and they used dry needling, pulled out this 100 millimeter needle. I mean, it was literally about that big. And said, well, we're going to stick this in your glute meadow and then we're going to stim it. And I'm like, whatever, I just need to get to work. I got rent. It's like most chiropractors. We got bills to pay. We can't take a day off.
And I felt 70% better. And I was super relieved and then kind of upset. I didn't even know what this was. And yet this pt who's fresh out of school, was doing this amazing Thing that helped me a lot and I was like, well, how come I can't do this for my patients? So I took the next four years or so and started studying with pts, learning everything I could about dry needling and integrating it into my office and then eventually bringing it into my personal injury practice.
And during COVID just like everybody else trying to find something to keep busy, developed chiro needle to share this with the rest of the profession and hopefully use it as a conduit to then help their patients find relief as well.
[00:02:46] Speaker B: Okay, cool.
So we have two directions we can go here, but first thing I want to ask is, what is chiro needle?
[00:02:55] Speaker A: Chiro needle, right. So chironeedle is the company I created and really started off as just creating a class for dry needling. I wanted to create the class for chiropractors. I had been spending hours and hours over 100 hours of dry needling classes in physical therapy settings. And while there are many, many, many similarities, and I learned a lot from them, the pace of patient care is simply different in a chiropractic setting. And the population and the types of cases that we see and also the abilities chiropractors have to integrate dry needling in a combination there with, we call a multimodal care plan is just different. And so I decided to create a curriculum the way I would have liked to have seen it as from a chiropractic perspective, integrating also the what do you do after dry needling? How do you integrate it with the adjustments? What kind of rehab and therapy do the conditions that dry needling treatment, you know, demand and what works best? So I put that together as a class, just almost as a personal pet project.
And then people started signing up for the class and we started doing that and it just grew from there. We started in Phoenix, Arizona, and then we started going to Austin and Houston and Dallas and Flagstaff and Tucson and just, you know, getting chiropractors together and having a good old fashioned technique class where we get together.
And unlike other seminars where you mostly just sit and just either learn more about how what you're doing is already working or learning why some, you know, some machine that you're buying is working. You know, this is something you're going to get in with your friends, with your chiropractic colleagues and use your hands and learn a new skill set. So it just became so much fun. And now, four or five years later, we're teaching almost every month.
[00:04:43] Speaker B: Okay, awesome. I like it. So that brings us back to probably something more important. And that would be in general, just what is dry needling. So kind of have to have an understanding of that first, I think, to decide if you want to do that.
[00:04:55] Speaker A: Right.
[00:04:56] Speaker B: And I will share with you personally, I have, I see an acupuncturist every. It varies, but maybe four to eight weeks on or off and, you know, what have you. But so what is dry needling and how might it be different from other modalities that use needles?
[00:05:12] Speaker A: Sure, that's a great question. I'm so glad you brought that up. Dr. Stephanie let's just start with the origins of dry needling. So Travell and Simmons doing trigger point injections, well, they're injecting these things in trigger point, seeing what works, what doesn't work. And then they want to see what the placebo effect or what the other effects of the needle. And just injecting saline, you know, what effects did those have? And first they started with saline. They found, well, that was, those work that worked pretty effective. And then they said, okay, what if we don't inject anything? They found that was effective.
Obviously that led to us using trigger point injections now. But people kind of went back. Some physical therapists went back and looked at the literature and said, well, you know, the needle worked pretty good just by itself. On top of that, we had pain management specialists doing the same thing with their, with injections, using trigger point injections as well as epidurals, and using just the needle to see, you know, what was the placebo effect. And what they found is the needle in and of itself was highly therapeutic. And physical therapists kind of like found this, put it to use. And lo and behold, we have the advent of dry needling. However, you know, this happened in my practice. I started with dry needling and my, my patients started asking for acupuncture.
I didn't know I had, to be honest. I said, I, I don't know really, you know, much about acupuncture.
And they thought, well, you have these needles. Why can't you just do this thing?
[00:06:29] Speaker B: And I said, yeah, right, that's what I'm wondering.
[00:06:32] Speaker A: I feel, I felt so out of my own. I said, I don't know. So I said, you know what, I'm going to go get some acupuncture, learn a little bit more. It was wildly difficult to get acupuncture. Setting an appointment when they're available and all they can do is acupuncture. I said, well, I went and got acupuncture and I felt better. I really Enjoyed it. I said, but what if that acupuncturist was able to adjust and do rehab and do all these other things that the patient would need after their acupuncture section? So immediately I went and got my acupuncture certification as well. And now I integrate traditional chiropractic rehab, dry needling, and acupuncture in my practice. But there are two completely distinct things. They just happen to use the same tool.
[00:07:08] Speaker B: Okay, interesting. So is the approach to how you would place the needle different than how an acupuncturist may decide where they're placing their needles?
[00:07:20] Speaker A: Well, just like in chiropractic, it does. It does. Just like in chiropractic, in acupuncture, they do it a lot of different ways. Traditionally, the needles are only going so far, you know, usually about 15 millimeters, maybe 25 millimeters.
And they're trying to stimulate meridians or neuro points to help the general health of the body. You know, it's not just musculoskeletal conditions there. You know, in acupuncture, you're trying to balance this kind of energy and. Or the autonomic nervous system in order for better health of everything, Dry needling is pretty confined to the musculoskeletal system. And it goes much, much deeper. Traditionally, there are acupuncturists doing something called deep acupuncture, where they do go deeper. This has been as of late, and they're even publishing on it. But dry needling often goes down to the bone level. I mean, you're pecking the periosteum, you're in tendons, you're in ligaments. It's much more soft tissue.
[00:08:11] Speaker B: Wow. So it really goes that deep?
[00:08:13] Speaker A: It does. It does sometimes.
[00:08:15] Speaker B: Got it.
[00:08:16] Speaker A: Yeah, it can.
There's some techniques called periosteal pecking, where you're actually going to kind of poke holes in the periosteum so you create a bleeding effect and therefore get more fibrinogen. So you can create a scar tissue or heal certain things, like tendons, especially lateral epicondylitis, supraspinatus, tears, things like that. So I always call it like kind of a poor man's prp.
There's lots of research on this. It's highly effective, and it's competitive with those oftentimes higher risk and higher cost modalities, such as trigger point injections, prp, Botox. There's literature out there comparing dry needling, and it is considerably, much safer and much less expensive. And you're getting it done by a chiropractor who can also then immediately adjust and give you rehab. I always say this, you know, when you're as you get as a chiropractor, you start young and you don't know what real pain is. And then you get older and you realize you really appreciate what you're doing for your patients. Am I right?
[00:09:13] Speaker B: Yeah, I'm going through that this week, actually.
[00:09:17] Speaker A: You see your patients and you're like, you get, you get your first bout of real back pain. You're like, is this what I've been helping the whole time? I really need to charge more because I am a miracle worker. You really don't appreciate yourself until you have the pain.
And, you know, with 13 millimeter disc extrusion, you know, even though I had to have a microdiscectomy, you know, these things flare up and I, you know, and sometimes I need an epidural. But the sad part is I go to get an epidural and that's it. There's no one there to immediately put me on decompression therapy or do dry needling and some stem on the, on the glute muscles to help or do any kind of rehab or, God forbid, adjust. I would have to go to a pain management specialist, then make an appointment to a chiropractor, get the adjustment and decompression. And oftentimes, because many chiropractors don't do rehab, then go find a physical therapist that's going to put me through rehab. It would take me four appointments. I'm here to tell the chiropractic profession, guys, we could totally dominate the pain management space and conservative care by being able to place the needle in a strategic way that's competitive with a lot of what pain management does. And then do your chiropractic thing of adjustments, especially in the low back and neck decompression. And then if you have a basic understanding of functional rehab, man, you are competitive. You know, you're basically taking the place of five doctors at once. Much more convenient, much lower cost, much lower risk, much more effective than what anything else anybody has out there. So that's what I'm out here to tell you. It's not just about the needle. It's about how the needle makes you a completely different chiropractor.
[00:10:45] Speaker B: Got it? Okay, that's cool.
Can you think of any, like, myths or misconceptions that you've heard that people might have about dry needling and, or how it might apply within the chiropractic profession?
[00:10:59] Speaker A: Ooh, that is a lengthy one. All right, well, let's try to summarize it here pretty quickly. So let's dispel some myths. The one myth is that it's just rebranded acupuncture. It isn't. I've done both, I've gone through both. Eastern medicine is an elegant, elegant philosophy and technique. It is completely different than dry needling as far as is it extremely painful? Believe it or not. Here's the thing about needles.
The length doesn't really dictate the pain. It's the gauge. Right. The gauge of the needle. A bit, you know, I, if, if the needle is as thick as a nail, but it's only 15 millimeters, I would rather have 100 millimeter long needle that's as thin as hair.
That's where the pain comes. The length. People go, oh, it's too long. The length doesn't matter. Now the other thing is that people say it's extremely painful. Well, just like going to different chiropractic schools, there's different schools of dry needling. And I have been to myriad of practitioners and just like when you get, you look as chiropractors, we go get sample adjustments from each other all the time and you know, we're not all the same. And some there's different strokes for different folks. And you're going to find people who needle away that you like and needle in other ways that you don't. Some people are just trigger point, joint, er, they go in there and they just try to aerate the meat. I call it meat tenderization technique. That's okay. Others are more subtle and try to work more with the nervous system. And that's a lot what I teach.
So is it really painful? No. Is it rebranded acupuncture? Absolutely not.
Is it within the philosophy of chiropractic? Absolutely. And I'd like to take just a minute to explain why.
[00:12:28] Speaker B: Yes, that was going to be where I wanted to go next. Let's do it.
[00:12:31] Speaker A: I'm a second generation chiropractor and while, you know, it's easy to label me as a heretic for mixing my father and I, you know, if you, if you're in a chiropractic family, Christmas is always fun. But so here's what we know.
If you're a chiropractor and you are all about the mind, body, connection, you're a holistic chiropractor, then it means you believe that the mind and the body, they work together and they are integral in overall health. Well, if that's true. Then we also know that pain is bad for your health. We know it's bad for your mental health. It makes you antisocial, makes you lose empathy, it makes you more prone to anxiety and depression. And we also know pain is bad for your general health. I've taken many, many hours of class with Dan Murphy. And if you've ever spent any time with Dan Murphy, if you take away anything, you should know that nociception leads to increased sympathetic tone. Increased sympathetic tone means increased stress response. And your immune system and every other system goes in the dumper if you're going to sum up, you know what, what you know that on World Health. So what I'm here to say is pain management is health management.
Being in pain is bad for your health. And we are going to have a whole lot of people, especially with the boomer population, who are going to be in chronic joint pain. And let me tell you folks, there are not a lot of good options out there. I work in pain management right now. I work in a multidisciplinary pain management clinic where we do epidurals, we do radio frequency ablations, we do botox, we do prp, we do spinal implants, we do everything on a sudden and we're grabbing at straws, especially since we can't use opiates like we used to, thank God. Yeah, bad, you know, the options aren't great. So if you can find a way to provide drug free pain relief and neurological calming, especially to people who have chronic pain, that neurogenic, centrally mediated pain, man, you. No one else is doing that and we could be a big asset to the population and their health by being that pain doctor that they need.
[00:14:31] Speaker B: Yeah, I think it's important too that then they can be doing that in the setting of a chiropractic office which is going to come along with that approach to health versus maybe, you know, outside in approach to health, perhaps.
So I do think that there's a benefit for the patient if they have options like this with practitioners like us who kind of have a different approach than western medicine does to most, most healthcare for sure.
[00:15:00] Speaker A: For sure. Physical medicine is indeed in a lot of need. It's going to be in more and more need and pain. Again, it makes your psychology bad. It makes your digestion go to pot, your immune system. And you know what, you know, it's hard to exercise if your joints hurt. I mean, if we knew if you were to pick something just to tell someone to be healthier, according to literature, it would be Eat more plants and move more than you did before.
So you can't move a lot if you're in pain.
So you know, learning how to exercise, it's hard to do with your pain. It's hard to meditate when you're in pain. We know meditation is good for your health and mental health. And also if you're stressed out all the time, it makes you crave different foods. How many of us have been stressed out? Do you crave a salad?
[00:15:43] Speaker B: No, not usually, no.
[00:15:44] Speaker A: You want a big fat greasy burger when you're stressed out. So it's real hard to be healthy and in pain if you can and if you can help people with their aging joints get through some, get some relief and get back to an active lifestyle, you are a health and wellness practitioner.
[00:15:58] Speaker B: Yep. All right, cool.
Okay, so give us an idea here. In your experience, what kind of conditions can dry needling either treat, resolve, help improve quality of life, all those things.
[00:16:13] Speaker A: Well, let's start with the literature. You know, there's over 1,000 dry needling articles in PubMed.
There's another, I believe, over 10,000 PubMed articles on acupuncture. So, you know, I always say the human body doesn't know what letters are after your name. Needles are therapeutic. So on what conditions? Well, most basic, we know shoulder, shoulder pain, shoulder tears, impingement syndrome, really effective plantar fasciitis, Very effective osteoarthritis of the knee, effective headaches. Tmj. Guys, TMJ is a horrible condition. No one knows how to treat it. If you can do that, you're moving mountains.
Lateral medial epicondylitis.
Research recently on the carpal tunnel where they actually can show the needle going into the flexor retinaculum and changing the thickness of the retinaculum by manipulating the soft tissue inside.
Perineural needling, it's where you put needles close to the nerves and stim them so that they can heal. And with things like neuropraxis or you've all had those brachial plexus kind of conditions after car accidents.
Lots. Look, everything that walks in your office and more.
[00:17:22] Speaker B: Got it.
[00:17:23] Speaker A: Back pain, neck pain, shoulder pain, it's going to expedite the process. It's going to get that healing process happening faster.
[00:17:29] Speaker B: Got it. This is going to be a two part question too because I love to do that.
Do you know why it's called dry needling?
[00:17:36] Speaker A: Oh, excellent.
[00:17:37] Speaker B: I don't know what wet needling is like. What's dry? Why is it called dry needling?
[00:17:41] Speaker A: It's called dry needling because they. At the beginning when Trail and Simmons were doing this, they. They. It was just sticking a hypodermic needle in with nothing in it. So it was a quote unquote, dry needle.
[00:17:53] Speaker B: Understood. Okay, that makes sense. Got it. I'm happy that there's an answer to that too, though.
[00:17:58] Speaker A: Me too. And I'm glad that I know it. Otherwise, I'd be really awkward right now.
[00:18:01] Speaker B: Yeah.
Okay, good. We don't need to go there. Perfect. Okay, so then part two to that, though, is you've mentioned, though, like, attaching stem and doing stem to it. So.
[00:18:09] Speaker A: So.
[00:18:11] Speaker B: Obviously it's still like dry needling, but how. How does that add to it when you add stim?
[00:18:17] Speaker A: Sure. Look, everything we do in our practice is pain gating, right? We're. We're trying to. We're fighting the battle. There's mechanoreception versus nociception. And at the spinal cord, there's a fight to see who gets to make it to the brain. And so when you move more, that's more mechanoreception and less nociception. If you have more inflammation, that's gonna be more nociception against the mechanoreception.
So, for example, when we adjust somebody their joint moves more, that's more mechanoreception. That's a win. If you put a needle into a muscle or a tendon or a ligament, there's a lot of mechanoreceptors in there. There's a ton of them. And if you put them, especially like suboccipital muscles or these muscles that are high, highly innervated, and then you add stim to the situation, it's like the difference between if you just put a little needle in 15 millimeters, that's like a flashlight. If you put a long 100 millimeter needle in, touching all those mechanoreceptors, and then you add some stimulation to that, man, it's like. It's like a lighthouse just.
I always tell people, if you're my generation, you remember something called the Care Bear stare. It's like the Care Bear stare of mechanoreception. You put a needle, you put needles into muscles all along the nerves, and you turn on some electricity, man, it's just like of that mechanoreception going up against that nociception. And for our patients suffering from chronic pain, where there isn't that pain generator that we can actually heal, that their nervous system's kind of misinterpreting the sensation, man. To be able to kind of hack the nervous system and send that mechanical reception in to fight that nociception without having to move them all that much. These are patients that they don't do very well with manual adjusting, and they maybe can't even handle exercises. Their body's just so keyed up on pain with some gentle needles, with some stem. I mean, acupuncture is great for this, but we can use those same principles and dry needling to really crank it up another level.
[00:20:05] Speaker B: Would you recommend someone do dry needling and then also get adjusted in the same visit? Would they get adjusted before or after or like, what does the intersection with the actual chiropractic adjustment look like when you've got dry needling?
[00:20:18] Speaker A: You know, one of my mentors was Burl Pettibon. You know, Burl Pettibon used to had this saying. He had a lot of sayings. One of them was never adjust a cold spine.
It was like, look, before they go get adjustment, do whatever you need to do to get it kind of primed and ready for the adjustments. You get an even better one. And I really took that to heart all through my career. Adjustments are always after some preparation.
And doing dry needling increases circulation to the muscles, reduces the spasm. And even in your patients with osteoarthritis of the cervical spine, if you do periosteo pecking on the articular pillars, which I know sounds very invasive, but it works amazingly, it lubricates those joints, and you're going to get motions out of those patients. Those are the patients where you go to adjust them, and they get one little click and they're like, thank you so much. Well, this after doing dry needling, I've had the same patient, big releases, big mobilizations. It's a great preparatory to the adjustment.
[00:21:13] Speaker B: Okay, cool.
So I don't expect you to be a walking dictionary of every state, but do you have a overview of, you know, our chiropractors allowed to do dry needling in every state and like it?
I don't know. Can you speak to that a little bit? Because I'm sitting here wondering, like, you know, can I even do this where I live, for example?
[00:21:36] Speaker A: Where do you live, Dr. Stephanie?
[00:21:38] Speaker B: I'm in New York State.
[00:21:39] Speaker A: Okay. I don't believe you can do it in our state. And here's the general rule of thumb. If you're on the coasts, probably not.
[00:21:47] Speaker B: Okay.
[00:21:48] Speaker A: Okay.
There are states like Florida recently passed legislation to include dry needling in their practice Act. Texas has it, I believe Louisiana has it, Arizona has it, Nevada has it. And then in the Midwest, they kind of have this. We don't say no and we don't say yes.
[00:22:06] Speaker B: Perfect.
[00:22:07] Speaker A: Yeah. So it depends on your state. Some states there's an hour requirement. Some states you just have to take a class. You know, some states it's like hundreds of hours because they want it to be the same as acupuncture.
So it just depends on where you're at. And usually physical therapists, you know, they win that battle and then we kind of tag along and get to do it as well. So it just depends on your state. Call your state board, call your association, and if you don't have dry needling in your practice act, you know, it's something worthwhile to fight for because your competition definitely is going to have it. Your pts down the street are going to have it. Your patients already know about it, they ask for it, you can Google it and see the results. It's something that people already know. And I always tell chiropractors, be wary of anything that no other health professional is willing to deal with. If you're the only health profession willing to use a technique or some sort of technology or intervention, it makes me rise an eyebrow because with dry needling, I have nurse practitioners in my class, I have physical therapists, I have, you know, everyone's doing it because the evidence is so strong and it's effective. So try to get it done in your state because it's definitely an asset.
[00:23:11] Speaker B: Okay, interesting.
So do you know, I don't know if you will know this or not then, though. Um, can physical therapists do it? Is it just part of their scope everywhere, or is that going to be state by state too?
[00:23:21] Speaker A: Probably same state by. And it pretty much. It follows chiropractic and PT again, they can't on this coast. It's really. There's just lobbying efforts by the acupuncture profession to try and, you know, maintain the, their kind of monopoly on providing the technique. Yeah, they want, they want, they want to be in charge of all, which is understandable. We do the same thing with adjustments and other in other professions. So, you know, we haven't done a very good job though. I'm just gonna say no, no and no. Yeah, we won't get into that. But yeah, no, different podcast. That's a whole other podcast. That's the edgier one. That's. That's on the weekends.
But yeah, so. So, you know, luckily, you know, because we've teamed up with physical therapists, legislatively that's what's allowed us to kind of move this forward state by state. You know, chiropractors on their own, um, probably. Probably wouldn't have made the victories we would have with in dry needling or made the end roads without the assistance of the apta.
[00:24:17] Speaker B: Okay, cool. Interesting. I like it. Okay, a little back to clinical.
I'm trying to think. When I go to acupuncture, if they, if they. I don't think they do clean the skin first before they put the needles.
[00:24:30] Speaker A: Oh, boy. Oh, man. We're getting into it. All right.
[00:24:33] Speaker B: Wait, are they supposed to. Maybe they do. I. I've never thought of it before, but. But that's where I was going to ask you. You're talking about how deep these things can go sometimes.
Cleanliness, infection, like.
[00:24:44] Speaker A: Yeah, clean needle technique. Yeah, let's talk about clean needle technique.
You know, I think it's important.
So clean needle technique. You know, part of these classes is that there are certain requisites that the states require you go over certain things, and one of those things is bloodborne pathogens. And for good reason. Chiropractors, we're not used to working with bodily fluids or hazardous waste. Well, dry needling kind of changes that. You know, it definitely increases your responsibility to your patients, your staff and yourself. And so clean needle technique, you know, best practices, you know, if you look at that for, like giving injections or using the kind of. They'll say, you don't have to wear gloves unless you anticipate bleeding. Well, you don't know if you're going to. If somebody's going to bleed or not. Yeah, the gloves don't protect you from a needle stick. They're typically less sterile than your washed hands.
But you want to wear them anyway, because I want my doctors wearing gloves no matter what. So I just assume do it anyway. Right. And you don't know if someone's going to. You pull out a needle sometimes you're like, oh, we got some blood. What are you going to run over and put on gloves? Just wear the gloves. Alcohol swabs.
Again, the recommendation is, look, most of the bacteria lives underneath the surface in the sebaceous glands, and you're driving bacteria into the bloodstream no matter what.
So. And the recommendation is that unless it's like, soiled or dirty on the outside, is alcohol necessary? You know, so the answer is, according to the OSHA documents that I've read, the answer is no. That being said, do it anyway.
You know, alcohol, swab every area, put on gloves. You know, it's comforting to the patient. It costs nothing. It shows professionalism.
And you don't know what's teeming on the surface. You don't know if that person has a history of mrsa. I mean, how many of our patients come in, give us their history, and they think they only need to tell us the things they think we need to know? Yeah, right. You don't know what's going on there. So, you know, be extra safe. It takes just, you know, again, your physical therapist counterparts are doing it. It's what doctors do. Be a professional. Use alcohol, wear gloves. Use clean needle technique and proper needle disposal.
[00:26:55] Speaker B: Okay, I got a good one. What do you do about clothes?
[00:26:58] Speaker A: Don't ever needle through clothes. I keep hearing these horror stories where it's like, oh, yeah, they did the needling through their clothes. I'm like, I'm sorry, what? Yeah, that's not. Okay. Just. Let's just go on the record right now. Not okay. Wear gloves.
[00:27:09] Speaker B: Can you tell us why? I think I have my own ideas, but I'm curious.
[00:27:13] Speaker A: Yeah, there's bacteria on clothes.
[00:27:15] Speaker B: Okay.
[00:27:16] Speaker A: Yeah. I mean, you don't know that person's dog. Lay on their lap before you went. It's just.
Don't. Nobody has anyone given an injection through clothes. Like, let's be real doctors, and let's act accordingly.
Draping and gowning. Now, this is a big part of dry needling because you have to expose some parts. It's important to make sure you have privacy. You have consent, right? You have hopefully somebody else in the room.
You want to make sure, and you talk your way through that. Oftentimes as chiropractors, we get into a groove, you know, we get in a groove. We're adjusting, we're doing exercise, we're doing soft tissue, we're adjusting. It's like. It's like. It's almost like a short order cook. You know, you're just, you know, whipping up fries and then meatloaf and then a burger to go. You know, it's just. I mean, you're. You're in it. And hopefully that's what your office is like. But with dry needling, stakes are too high. You got to take the moment, you got to slow down, you got to be focused, because there's increased risk with this. We're not going to pretend like there isn't. There's risk of pneumothorax, back infection, hitting a nerve, hitting a blood vessel, things like that. You want to make sure you are focused on this patient. And you are in communication with them. What are you feeling? How are you feeling? Is this okay? Right. You know, if you have to dry needle a piriformis, there's going to be stuff exposed. We don't know what that patient has been through. And it's very important to constantly get consent, talk to them through the process and make sure that they're having the experience that they want in their healing process with you.
[00:28:37] Speaker B: Okay, cool.
On that note, what about any negative side effects? I mean, you just mentioned some of the risks, I guess, like what are the risks? Or maybe negative side effects someone might experience.
[00:28:48] Speaker A: So the most common at what we call adverse event is bleeding. Right. Obviously now most of the times you can avoid blood vessels. It's not the end of the world. They, they seal up relatively quickly unless they have some sort of bleeding disorder or they're on some medications which can result in kind of more bruising. So you can have bruising.
Infection is a risk. Right. So you want to make sure that we're using clean needle technique. We're not reusing needles. God forbid.
What else? Some people faint.
It can. If people have a history of. Yeah, some people just. I've had two students now, I've been doing this a long time. I've had two students pass out my class. And when we have a part in the class to get over the needle phobia, which a lot of chiropractors have to get over it, we self needle for a minute to kind of get used to it. And I've had. And it's not even just, it's not from pain, it's just the idea of a needle to me. And they just, you know.
[00:29:44] Speaker B: And that they get their money back or.
[00:29:46] Speaker A: No, actually. So funny. The only. No, no, because they, they honestly, after they go through it, it's like they.
[00:29:52] Speaker B: Wake back up, then they're fine.
[00:29:53] Speaker A: That's it for the rest of it. They're over.
Happens so fast.
And so. Yeah, so there's those kinds of risk. If you have a history of epilepsy, you know, it could induce a seizure. So these are all things we go over in the class.
[00:30:06] Speaker B: Interesting.
[00:30:06] Speaker A: You know, what, what kind of risk benefit also informed consent. Let them know what the risks are relative to the benefits so they can make that choice themselves as patients.
And also what to do if and when things happen. You know, what if a needle gets stuck? Sometimes the needle doesn't want to come out.
[00:30:24] Speaker B: Really? Yikes.
[00:30:25] Speaker A: Yes. It winds around the fascia and it'll get stuck.
[00:30:28] Speaker B: Now what do you Do.
[00:30:29] Speaker A: What do you do? You gotta come to the class. I'm just kidding. No, I'm just kidding.
[00:30:33] Speaker B: I feel like I would start spinning it a little bit and, like, the opposite direction.
[00:30:37] Speaker A: So it winds tight. They get tighter. So as you wind it, it actually gets tighter, and it won't come out. And it's great for internal manipulation of the fascia. It's. It works really good. But then sometimes you'll. Staff will. Because in some states, your staff can remove them and they'll go, doctor, I can't get this out. You just have to spin it in the opposite direction. Or you can put a needle next to it, and the connective tissue will kind of grab to both, and you can take them both out. You can contract the antagonist. So there's all sorts of things to do. So we cover all those contingencies in the class, which you just got up for that part for free. Yeah.
[00:31:10] Speaker B: Crazy. That had never occurred to me that, like, they might not come out at least as. Not as easy as they went in. That's wild.
[00:31:16] Speaker A: We do it on every class.
I'll wind one up so it gets stuck, and then I'll let everybody try, and they're like, I really couldn't get this out. Like, I can't get this out. And you have to show them how to do it.
[00:31:25] Speaker B: Interesting. That's crazy. All right, cool.
Okay, let's move on to some more boring component of this. Actually, yeah, this is pretty boring. What about, like, malpractice? Obviously, you would need to disclose your malpractice insurance company. You've added this as a service in your practice.
I mean, you've been doing it a long time, so maybe you don't have a good comparison. But is it expensive? Like, does that really increase your premium? Do you have any thoughts on that?
[00:31:52] Speaker A: Yeah, you know, I can only speak to my own experience.
Every time I've called a malpractice company on this, they've said if it's already included in your practice act, you're already paying for it.
I haven't had one yet. That said, it's an increase, but I would. No matter. Anytime you add anything new in your office, check with your association, check with your board, and check with your malpractice carrier, you know, just to make absolutely sure. Yeah, but that's usually the case. If your state already includes it, it's part of your party already paying for it.
[00:32:20] Speaker B: Got it. That's an interesting way to look at it. Okay, knee.
All right. What about documentation? Like, in terms of charting like, you obviously need to write that you did something. And like, what do you have to keep track of? Like, where they went, what gauge? Like, what do you have to, what do you have to write?
[00:32:36] Speaker A: Right. Yeah. Okay. So, you know what's funny is dry needling is relatively new in the physical medicine space. And if you know anything about chiropractors and physical therapists, we are the worst documentarians on the planet.
[00:32:49] Speaker B: Oh, what do you mean?
[00:32:51] Speaker A: And that's not my opinion. That's just Medicare's opinion.
So we're kissing cousins when it comes to that stuff. So what I did is I, I, you know, I'm lucky. I got to work in a multidisciplinary setting with other practitioners, so I get to learn a lot from what they're doing. And one of the things I did was I took their notes from doing a trigger point injection, and then I took the medication part out of it. But the rest of it, it lists, you know, what did you do for the clean needle technique? You know, what, what, what percent alcohol did you use?
What was the length of the needle, what was the gauge, what was any needling tech, all that stuff. So the nice thing is, working with chirotouch is I've developed an, a whole macro set.
[00:33:35] Speaker B: Macro.
[00:33:36] Speaker A: So that. Yep. I created map the body map with the bubbles on it. And you can click on the muscle that you needled and then it just asks you, what was the length, was the gauge? You know, what, how long did you leave it in? Did you take it out? Did you do pistoning, winding?
[00:33:49] Speaker B: You know, did you set them home with it in?
I'm just kidding.
[00:33:53] Speaker A: Don't do that. Don't, don't do that. We have a count them in, count them out policy.
There's a way to do that. We talk about all those things in our class. And that's one thing I wanted to add, because chiropractors own their own business, unlike physical therapists. You know, you go to that class, most of them are employees. They have compliance people in their office doing all this for them. But what's your liability if your staff gets stuck with a needle? You know, what things do you have to have in place? And what do you do? What happens if your staff says, I just was taking needles out and I walked around the corner and so. And so stabbed me or whatever.
Well, now you have an incident.
What is your responsibility? And so all that stuff we talk about in our class, about, look, yeah, there's, there's a whole way to deal with that, to minimize Your exposure.
And so we talk about things like that.
[00:34:37] Speaker B: For sure, this goes back to the notes a little bit and also clinically. But how many? I mean, again, it might depend on the patient and what they're seeing you for, but say they're seeing you for like one condition. How many needles might be involved in a one session?
[00:34:53] Speaker A: You know, I always say be, do the least amount that you need to do to be effective, especially in that first. First visit.
Needling may not even happen on the first visit. That's pretty. You know, it's like when you're getting to know someone, it's like you can't just, you know, it's like you take. Give it time. You know, you're with your patients, you have a relationship, and that is built on trust, you know, so, you know, I'll start with normally, maybe one needle, you know, just to show them this is how it feels. And also I want to see how their body responds. People have very odd reactions to needles. Sometimes even in acupuncture, they'll have emotional, just catharsis for no reason. Not no reason, but like, you know, it's just unexpected. And you'll ask them, are you okay? They're like, I feel fine. I just can't stop crying.
Or, you know, or they'll start laughing. They'll get giddy, something. You know, lots of things can happen. You want to. Kind of want to see how. Or they just get really sore. Or they're a bruiser. They bruise like a peach. And you didn't know it well, do one, but you could do as many as, like, for example, I'll do for a piriformis kind of sciatic protocol. That could be, you know, six to eight needles with stem on all of them.
Sub occipitals, could be four.
Or a contusion to the leg. I deal with a lot of really bad car accidents. So a contusion to the leg might be 30 needles in the bruise with a cup between that and the heart. So you increase circulation. That could be 30 little 15 millimeter needles. So it really just depends on what you're. I always tell my docs, what are you trying to combat here? Is it neurological pain, inflammation, increased circulation, range of motion? Once you answer the question of what you want, then you can use the needle to do it.
[00:36:29] Speaker B: Got it.
[00:36:29] Speaker A: It's like a chef's knife. Are you baking a cake or are you making a steak?
[00:36:32] Speaker B: Yeah.
[00:36:33] Speaker A: Figure, you know, then decide what you're. What you're. What tool you're going to use.
[00:36:36] Speaker B: Got It. So then the location of all those needles would have to be documented in. In your chart note for that day.
[00:36:43] Speaker A: Yes. In fact, the coding for dry needling is kind of like adjustments. It's not based on time, which is a huge asset, but it's. The first code is one to two muscles, and the other one is three to four muscles, or three. I'm sorry, three plus three plus muscles. So you have two different levels. And off the top of my head, because I am terrible at remembering codes. I don't remember what those CPT codes are off the top of my head, but you can obviously Google them. But we got those passed through the AMA with the help of the pts. I forget what year that was, but yeah, so we have coding for this. It's not time based. You could literally do one needle in and out.
It could take 10 seconds, you know, and you've satisfied the code, which is great for personal injury. And we talk about some of the strategies in the class.
[00:37:25] Speaker B: Got it. Cool. Um, so you've got those macros that you created. Have you shared them with anybody? Is that. I don't know if that's anything that you've done yet.
[00:37:34] Speaker A: No, they're my precious. No, of course. I say share them. As many people as possible.
[00:37:37] Speaker B: About mine, people are like, I want your macros. I'm like, no, I have $500. No, I'm just.
[00:37:43] Speaker A: Exactly, exactly. No, I share. No, my whole thing is I want to, you know, because I teach a lot. I do.
I'm a med legal liaison for personal injury. I do a lot of things that aren't seeing patients as much as I used to. So my hope is that my experience and knowledge can then go to other practitioners who then can use it to help their patients. So I'm very big on. If you know something, share something. Especially with chiropractors, guys, you know, we practice in a bubble where typically we're the smartest person in the room, which as the saying goes, you're in the wrong room.
And so his chiropractors are pretty isolated. By working in multidisciplinary offices, I learned, man, these guys get smarter and smarter so fast because they're hanging out with a pain management specialist that's double board certified in anesthesiology with a nurse practitioner who's.
She did family practice, now she's doing pain management, PAs and MA, medical assistants, and we're all hanging out together. I learned so, so much so fast compared to when I was in private practice that, man, chiropractors have got to get together and they got to start sharing their knowledge and experience with each other rather than being more, I think they like to kind of keep it a secret or they're just antisocial with each other or competitive and they should be working because really in the end, our goal is to see and help as many people as we can. Man. We can do that much better as a team than we can individually.
[00:39:05] Speaker B: Yeah, absolutely.
[00:39:06] Speaker A: So, yes, I share my macros.
[00:39:07] Speaker B: Absolutely.
[00:39:09] Speaker A: Long answer.
[00:39:10] Speaker B: Yeah, so.
And they've helped other people. Like, they're easy to understand and they've been able to obviously just utilize. Have you gotten any feedback?
[00:39:19] Speaker A: Yes. Yeah, I mean, it saves them hours. I mean, any of you who sat and built out your own macros, man, Hours.
[00:39:25] Speaker B: Many hours.
[00:39:26] Speaker A: You know, I always say it's like, it's like the Constitution. It's a living document. I'm always doing mine. And then I'll find a blip. I'm like, this could be more efficient. I'll just go in real quick into the editor. It takes no time. I'm like, this would be a little better if I added this or made this one thing instead of three things.
That's the beauty of Kyra touches on the flyers. Like, I have a, and then I have a basic sheet that I use that, that then my staff can use to populate the note and I can review it. So it's, it's, I want it to be so easy. You know, a high school student could create it based on, you know, what I communicate to them. And now with AI Scribe man, I, you, you know, you just, you can talk to the patient. It's dict. It creates a synopsis of the visit based on, you know, what you said. That is so cool. If I was, you know, seeing in full time practice, man, that is something I utilize all the time.
[00:40:13] Speaker B: Yeah, it's wild. It's, it's almost not creepy, but it's impressive. It's really impressive.
[00:40:19] Speaker A: Right?
[00:40:20] Speaker B: How well the AI scribe picks things up for sure. I had a funny, totally unrelated but funny story.
Patient was here and she was telling me all about how like she, her back was bothering her and her husband had brought up her fall decorations with all her pumpkins and stuff that she wanted to put around the house. But she was just in so much discomfort. She's like the, the Rubbermaid container is just sitting on the kitchen table with the lid on it still. She's like, I haven't even opened it. And so, you know, we've been working with her, but so I Went down to set edit my note later and I could not believe how it had summarized this long drawn out conversation about her pumpkins that she hasn't put your house yet. But like what am I gonna, I'm not gonna sit here and type about the pumpkins. Right. But like the AI scribe was able to capture like the essence of that story and just like in one sentence very clearly explain like I don't, I forget what it said, something about our seasonal decorations or something. But I, I mean I laugh, I literally laugh and it's made charting kind of fun and like I can't wait to see what it writes. Usually like be with a patient and I'm like, oh, I can't wait to see what it's going to say about this. So no, definitely a game changer.
I don't know how much you've really used it, but do you feel like you're using the scribe as well as.
[00:41:37] Speaker A: The macros or you know, I, I, I, I use pretty much the macros. I keep my stuff so simple.
[00:41:46] Speaker B: Yeah.
[00:41:47] Speaker A: And also what I do a lot of telehealth with personal injuries. So like I'll, I'll just interview people over, over chat and then decide where they need to go and help manage their cases. I practice in a totally different and unique way but I'm also a one man show meaning when I, I don't have staff. So you know, I see we had over a thousand referrals in the last year and a half into my company and you know, I have to do everything on my own. So some of these I, I end up having to do the intakes and everything like that. So, and I, I do not like redundancy. So I'm a big fan of get that that intake is so, so good at getting the information that you need.
And then if you wanted to create a narrative out of it, that's a click of a button and, and then from there it's super easy. So but I could see how on especially let's say you're, you know, somebody just pops in man and you're like I don't have time to get their paperwork, I don't have time.
I would see how I, I would just love to click on that subscribe like all right, let's talk about your health history. Let's talk about this. And you're not worried about trying to type simultaneously while also trying to be present with the patient. There's nothing worse than a doctor typing and dealing with their computer while you're trying to Explain to them your situation.
[00:42:55] Speaker B: Yeah, right.
[00:42:56] Speaker A: So it's such a. I mean, it allows you to be present, which I think is, you know, and that's the rewarding part of being a doctor, being present in the moment with your patient. We didn't get into this to be typing notes all day. We got into it because we love people, which is probably why we don't like doing notes and why I love chirotouch, because it allows you to do more of the doctor stuff that makes you happy and less of the admin stuff that, you know, we became chiropractors to avoid.
[00:43:17] Speaker B: Yeah, exactly. Yeah. I had actually went to see my medical doctor this past week, and it was hilarious because I know that they had migrated over to, like, a new charting system in their office a year or two ago, and it was actually one of my patients was, like, their liaison for the company to, like, do this or whatever. But so I'm in there Friday and I'm just looking at her because she, like, comes in with her laptop and it rolls in. She's got this little table and then. And she's listening. And I felt like she was present for the most part, but, like, she was typing the entire time. And I was just thinking to myself, like, you guys don't have a. Like, there's no AI scribe listening to us right now. So it's amazing. I mean, I've only had it in my practice for a few months, but it's amazing to me how, like, I almost have this expectation now that, like, all of my healthcare providers should be using it because I have it right.
But I also was kind of like, wow, how do you not have this technology helping us in our visit today? Like, I was surprised.
[00:44:13] Speaker A: You know, it's. I was going to say, in pain management, they have a scribe, it's called a person. They walk around with a cart, you know, and they're sitting there clicking away while the doctor's talking and doing their thing, and it's horribly inefficient.
And so, I mean, having this technology and, you know, the plus side of being a chiropractic office is that you can change things on the fly like that. You know, healthcare in general, when you're working in medical practice, it's too big of a ship to make quick turns. And so when those kinds of integrations are harder to do. And the nice thing about being a chiropractor and having chirotouch, it's the click of a few buttons, you know, getting in touch with somebody to help that you could, you could change a policy or procedure using chirotouch over lunch, you know, and make your practice better. You see something wrong, you immediately can change it with chirotouch and your practice is better immediately after lunch.
[00:45:00] Speaker B: Yeah, it really can be that fast. So we're definitely fortunate in that regard. For sure.
[00:45:05] Speaker A: Yeah.
[00:45:06] Speaker B: All right. We touched on this a little bit before, but certainly like, you guys have your own courses and classes, but like, what's typical training that might be involved for somebody that wanted to maybe get certified in dry needling or what does that look like?
[00:45:20] Speaker A: Okay, so every state is different.
My classes, because, you know, first I did it kind of like my, when I went to the physical therapy classes, who I want to give huge credit to, Sue Felson and Structure and Function, dry needling. You know, she, I was one of the few chiropractors in her class and she put me, took me under her wing and man, I, I, she was the first trainer in female trainer in MLB history for the Dodgers. I learned she was so generous with her time and experience to, to do this for me or to bring me under her wing and educate me in dry needling. I TA'd for her and that's kind of how I learned how to do all this so fast and.
But the classes were split, split up into like, you know, advanced or upper extremity, lower extremity. Well, that makes sense for a physical therapist. Right? Because it's a lot of extremities and the spine is also there. You know, it's, ours is more focused spine and then extremities.
And so I've split my classes up into spine and extremities. So there's a whole weekend of spine and there's a whole weekend of extremity. And I address it based on condition specific meaning when they come in. This is what I have as far as the literature on how to use dry needling. Integrate it with what you already know and then on how to treat specific things like plantar fasciitis protocol, migraine protocol, TMJ sciatica.
So it's organized more for chiropractors. Whereas if you go to a lot of these other classes, you're going to get upper extremity and maybe cervical and thoracic. And that's going to be a two to three day class over the course of 24 hours or so.
And mine, we do it in two days and we also integrate a lot of the rehab. Meaning, okay, what kind of exercises should we do with this? You've adjusted Someone you've needled, someone you now produce this motion.
What are you going to do with it? How we make this stick? And that's. And that's. I think we keep dropping the ball as chiropractors is we got to get into active, you know, care. What the patient's part of the responsibility of the care. We get them moving, but it's their job to keep it moving. So increase mobilization mobility, increase stability and strength. And then how do we move someone along that program?
And I think a lot of times we try to farm it out. I think sometimes chiropractors go, well, here's a. Here's a brochure on some exercises. You know, physical therapist office. You go to their office. It's a big open space with rubber bands and balls. It looks like Cirque du Soleil chiropractic offices. I find a lot of times when I go to them, I call it like a flop house. It's just people laying on tables, getting stuff done to them. You know, it's a roller table and then some stem over here in the heat pack. And they're just laying there going, does it feel better yet? Does it feel better yet? We're going to get. Well, if it doesn't, then we kind of go, well, you got to give it time. That's unacceptable. People need to get moving and keep moving and doing. We know the literature is just passive modalities do not work as well as active care. The quicker you get a moving and doing stuff, the better they're going to be. So we teach a lot of that in the class of, hey, you got to move in. This is the quickest, best way to get a moving is needles and adjustment. What are you going to do with that?
You know, because we. Because as we know. Look, let's just be frank. Chiropractic incomes have not gone up in over 30 years. Insurance companies are not going to wake up one day and decide to start paying us more. Okay? The median income of a chiropractor, I think right now, according to the Bureau of Labor statistics, is what, $60,000. Whereas a PT is 80,000, let's be frank. And when. As soon as they get prescribing rights, we're going to be up a creek.
So you better get real efficient at solving the PA the problems your patients want you to solve quickly because they're not coming in three times a week anymore. I don't even leave the house to go get toilet paper, okay? I'm not going. I don't like grocery Shopping, I don't. Everything is.
[00:49:07] Speaker B: I don't like going anywhere either.
[00:49:09] Speaker A: No. So you better be able to fix people in two visits a week and do it fast. And that means as incomes go down, which has always been the case for chiropractors. My father's a chiropractor. Mercedes 80s. They haven't come back. They're never coming back.
So get efficient. Get me. And that's where chirotouch is great because it makes you super efficient at managing your practice. But needles don't cost much. Adjustments work great, and exercise doesn't cost much either. You know you want. Those are the three things that are the most effective in dealing in joint pain management. And they don't cost a lot. We got to get fast, cheap and effective. And that's actually what they're saying at the physical therapist classes that I sit at now. Same thing. They're like, look, guys, reimbursements are going down. All these techs and big spaces and equipment, it's all going away. So you guys better get real consumerist real quick. So patients come in, they say, I have this pain. You better be able to fix it. And this thing where we do well, your real problem is actually this. The bait and switch. Chiropractic not gonna fly anymore. So you better get real good at fixing the problem. They walk in with, super fast and with. And super efficiently.
[00:50:11] Speaker B: Yeah, for sure.
[00:50:13] Speaker A: So.
[00:50:15] Speaker B: You have a website and you have courses and trainings. Can people host those or do you have set places where you are teaching or how do you like to organize that?
[00:50:28] Speaker A: Yes. So right now I'm teaching in Phoenix, Austin, Dallas and Houston. That being said, I'm always looking for other states to come to and especially as their practice hats. And usually it works like this is an association will call me or practitioner, say, hey, I want to host a class. So first we're going to find out, well, can we do this there? As soon as we find out that we can, then it's like, all right. And we try to bring a class there, and if it works, we'll keep coming there. So we're looking at states like North Carolina, Florida, Montana, you know, trying to see where we can go to do these courses. And so we're real open. So my website's chironeedle.com you can see what classes we have going on right now. And then if you want one to come to your area, let's say you have a group of docs already and you're like, we want to know, dry needling, will you Please come here. I'm more than happy to do that again. I just want to, I want chiropractors to have this tool. I want them to be competitive and I want them to be effective in the future coming ahead.
[00:51:25] Speaker B: Awesome. I like it. Yeah. So we're going to have a link to your site in the description of the podcast. So if you guys just pop open that description, you can find that link there to get to Dr. Wiegan's website. If there were someone on the fence, like, should I do this? Should I not? Like it's going to be too hard or too much or it's like I'm so busy in practice right now, it's just one more thing to add to everybody's plate. Like what advice or how, how would you respond to that if somebody was on the fence?
[00:51:54] Speaker A: Well, I'd say one, take the class.
Even if you don't know if you want to do it, because then you can decide whether you. The best way to know whether you want to do it or not is to go do it and see if it's for you.
And then, you know, our age ranges in our class are from people who graduated a week ago to 70 year old practitioners.
Again, my father is a second or I'm a second generation chiropractor, you know, and his 70 year old friends are in my class often. So you're never, you know, as a doctor, here's something you never want to hear as a doctor. Doctor, I, I've had doctors who say, well, I've been doing paper handwritten notes for 25 years and it's been fine.
I never want to hear any doctors say that. My dentist said, this is why I've been doing it for 25 years. And I'm not changing.
That's not what you want to hear out of doctors. There is no place for traditionalism within healthcare. There just isn't. So if you're a chiropractor, you know, you want to. If you want to expand your knowledge and actually gain a new skill, which again is super rare out there, this is the class. And if you don't want to take mine, that's fine. There are great other ones I love. Again, structure and function. Dry needling. Suefalzone. If you're a sports person and you want to do that kind of thing with, she is amazing. If you want to do more like pain management, chiropractic and rehab, that's my class. It's what I designed it for. Go out there and there's a million different ways to do it. It's like, it's almost like adjusting. There's nothing more fun than learning how to adjust and then doing it and getting better and better. But everything else we do in our practice is buying a machine. Typically it does stuff to people and we become technicians.
[00:53:25] Speaker B: Yeah.
[00:53:26] Speaker A: Good news. Dry needling is like adjusting. It's that much fun. It's like having another adjusting tool where you get to become the artist again. I always say be a chef, not a cook. Write the recipes, don't follow them.
[00:53:37] Speaker B: I like it. Nice. Well, Dr. Wiegand, thank you so much for joining us and sharing your knowledge today.
It's really clear that dry needling is probably, I don't want to say probably going to become mainstream because I already think it's super prevalent, but I do think that it is very up and coming and we're just going to start seeing more and more of it. So it's probably a good idea for chiropractors to try to help be on the forefront of that for sure.
And I do think it can complement, you know, what we're already doing with chiropractic care in our offices.
So for our listeners, if you want to check out Dr. Wiegan's pre built dry needling macros for Chirotouch or learn more about a course with chiro needling, we have added links into today's episode notes and don't forget to like, scribe and share Chirocast with a colleague who would benefit from today's conversation. Thanks for listening as always, and we'll talk soon. Thank you.
[00:54:36] Speaker A: Thank you for joining us on this episode of Chirocast Insights for Modern Chiropractors, brought to you by ChiroTouch, hosted by Dr. Stephanie Brown, produced by Debbie Brooks, editing from Matthew Dodge. Our theme song, House 5 is from Scott W. Brooks. If you enjoyed today's show, don't forget to like, link and subscribe. We appreciate your support and we'll catch you next time.
