One of the best things about physical therapy is the high volume of variety and classically unique cases that present themselves to me on any given day.  Today’s blog post is about just such a day.

Several weeks ago, my wife met this cool, spunky lady at a networking event.  They hit it off and, as I am told, became BFF’s over hors d’ oeuvores. While they were chatting, it came up that this lady, we’ll call her Kim, had a sister that she thought would benefit from dry needling.  BUT, the sister was kinda scared so she wanted Kim to try it first.

A few weeks later, Kim showed up in my clinic to scout me out on behalf of her sister.  I asked if she was dealing with any pain presently.  “No pain to speak of,” came the response, “but I have numbness in my left toe that has been there for years.  I can’t wear close-toed shoes without it hurting which is why I always wear flip flops.”

My interest was peaked.  She didn’t have the typical symptoms of someone that might be dealing with toe numbness due to a pinched nerve in the back, nor did she have any metabolic diseases that would cause this specific type of toe numbness.  It was highly unusual and very perplexing.  BUT my job wasn’t necessarily to fix or even diagnose the toe numbness, just introduce her to what trigger point dry needling felt like so she could report back to her sister.

Because of her symptoms, I thought there might be some tightness in her calf that might be causing some digression of Plantar Fasciitis.  Nope.  Then I started checking the rest of her leg and low back to see if that caused any symptoms. Double nope.  Finally, I started pushing around in her left hip.  “That hurts!” she exclaimed.


That was interesting to hear since she didn’t mention it the first time I asked about any discomfort she might be having.  That hip was essentially an after thought for her.  It would bother her at times and she went to yoga a lot to work it out.  She was also training for a marathon so that hip would also cause occasional problems when she ramped up her mileage.

The hip pain I understood, the toe not so much.  I had her roll onto her stomach while I pushed around in that left hip some more.  There was some mild tenderness and spasm on the side.  We decided that if nothing else, that would be the most ideal place to treat for that day’s session.

Out came the needles and in they went into the side of her left hip.  She took it in stride like most patients do and remarked how it wasn’t, “nearly as bad as I thought it would be.”

It never is.

We treated some other spots in the left hip, chatted for a few minutes about an upcoming health fair and called it a day.  She promised to let me know how the hip felt next time she went running.  I smiled, thanked her for her time and waved good bye as she left the office.

That visit was unique but also fairly benign.  Kim had some toe numbness that she had come to accept as permanent along with some left hip pain that was a bit of a bother but didn’t really keep her from doing the things she enjoyed.  I didn’t think too much of it, but I will confess I was curious how the hip would respond next time she ran.  I always want to know how someone responds to my needles.  The toe, on the other hand, didn’t even register with my speculative mind.

A few days later I finally got the text I had been waiting for.  It read, “Ran 3 miles today pain free and no numbness.

The first part was what I had hoped for but the last part completely shocked me.  No numbness?  That was totally unexpected.  Without going into a huge anatomy lesson, let me just tell you that there is no reason that I can think of anatomically that would rationally justify that type of result with the intervention I provided.  Those results were the Hail Mary of physical therapy.  And it was just from a casual introduction to my practice.

Both Kim and I were pleased from that first session.  She is running with less/no pain and not dealing with the toe numbness.  I am happy about the hip feeling better and TOTALLY enthralled with the outcome in her left toe.  There are a number of reasons why that could of worked but I have no clue which one that might be.  Either way it was cool!

There are a couple of take home lessons to be learned here.  First, start with conservative treatment when some type of new ache or pain pops up, not last.  I have heard COUNTLESS stories of people who walked into their primary care physician’s office with an acute bout of low back pain and ended up on the the operating table a few days or weeks later.  Kim’s mom had a similar situation in the same toe and had bones removed to fix the problem!  That is WAY too extreme.  That’s like getting married after the first date – no thank you.  Second, if you have a question about an ache or pain, see a physical therapist.  We are the musculoskeletal experts.  Third, I’m not saying that dry needling fixes everything, because it doesn’t, but it is hands down the best intervention I have come across when it comes to treating most soft tissue injuries bar none.  If you have an ache or pain, dry needling might be the solution you are looking for.

If you have any questions about this article or something else that you are dealing with, please don’t hesitate to contact me directly at 479-402-9400 or at [email protected].

Dr. Christian Robertozzi

Author Dr. Christian Robertozzi

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