Chikungunya Pain Relief: How Ultrasound-Guided Dry Needling Helps

Chikungunya Pain: Understanding Causes and Effective Treatment

Chikungunya is a viral infection which is commonly associated with incapacitating, severe joint pains after the infection has subsided .

At Ashirvad Institute for Pain Management and Research, we consider that these joint pains are because of enthesopathies. Enthesopathy is when shortened muscles pull on their ends in the joint capsule to produce inflammation which then manifests with its 4 cardinal symptoms – dolor (pain) tumour (swelling) calor (warmth) rubor (redness). The muscles get shortened because of viral myositis (inflammation in the muscle) which is a hallmark of many viral infections.

All viral infections are usually self-limiting, and the myositis also disappears once the viral infection is over. However, the muscle knots that are formed during the active phase of myositis persist in Chikungunya even after the virus has disappeared to cause these debilitating joint pains.

Currently these pains are treated by temporary fixes like pain killers, icing, physiotherapy etc. As such these patients continue to suffer significant disability for months, even years.

Fortunately, a treatment called ultrasound guided dry needling (USGDN) produces consistently good and reliable results in relieving not just the pain but also the disability after chickengunia. USGDN relaxes the muscle knots formed by the muscle inflammation, thereby reducing the pull of the tendons on the joints. 3 to 4 sessions of USGDN will completely relieve the chikungunya pains allowing the patients to return to their normal routine with active life work without pain. We have reversed these pains in innumerable patients after chikungunya at Ashirvad in the last 2 decades.

Recently, there have been reports of a new strain of chikungunya virus, which is causing paralysis-like symptoms. Based on our previous experience with chikungunya. It is quite possible that this might be an highly exaggerated response of muscles to myositic inflammation of Chikungunya.

The muscle knots developing because of the inflammation with this strain of virus, cause such intense simultaneous muscle spasm of both the agonist and antagonist muscles of joints (the muscles that move the joints) of the limb that they actually splint the joints of the limb. (hip, knee and ankles in lower limb and the shoulder elbow and wrist in upper limbs).

I have described this phenomenon of agonist antagonist contraction causing paralysis like clinical picture in other neuropathic/neuromyopathic diseases in my book “ Chronic pain: Out-of-box treatments that cure” available on Amazon (chapter 8, pages 135-152 case studies- the paralyzed shall walk)

The seemingly paralyzed limbs can be made to regain movements by doing USGDN of extremity muscles to relax them and also relieve the concurrent severe pain that makes movements impossible. This surmise can be proved by consistently reversing the paralysis-like symptoms by USGDN. Here I would like to specify that simple dry needling (the type done by physiotherapists) performed blindly without ultrasound visualization is usually inadequate to reverse the severe and multifocal pains of chikengunya and is unlikely to achieve the kind of results routinely achieved by USGDN. The use of ultrasonography for dry needling makes USGDN very target specific and effective and more relevantly, visualizing the needle in the muscle helps us to reach the depths of many muscles with impunity, without injuring vital structures like pleura, peritoneum, blood vessels or nerves. I am mentioning this here to inform people that the paralysis caused by the present wave of chickengunya might well be reversible with USGDN and there is no need to despair.

They are welcome to seek help at Ashirvad or with any pain specialist trained by me in USGDN at Ashirvad. Please call Ashirvad 9869029391 or 9820135430 to know the number of pain specialist near you who would be able to help. I am particularly mentioning the names of following specialists who have done Ashirvad fellowship for 1 year. There are also several others spread all over India who have been trained in our USGDN workshops: