Consent Form

Manual therapy refers collectively to the many, varied joint and soft tissue techniques used at the clinic. These many involve the use of hands or specifically designed metal tools to influence your range of motion, motor performance and neural irritability where applied.

Dry needling is a broad term referring to the use fine needles to stimulate the tissue and nervous system to address musculoskeletal conditions.A common form of dry needling is trigger point dry needling which involves the elicitation of an uncomfortable muscle twitch. This approach is not used at Integrated Physiotherapy. We use a non twitch approach and finer needles. This approach, Integrated Dry Needling, was pioneered at the clinic and has been taught around the world since the early 1990's. The majority of the insertions involve no sensation at all. Occasionally a sharp insertion sensation occurs due to skin stretch at the insertion site. This is similar to what occurs when pulling a hair and occurs in 1 out of every 30 insertions. We recommend this modality in the majority of treatments to address tissue and nervous system sensitivity (often perceived as tightness), inflammation, neurological muscle inhibition(often perceived as weakness) and to stimulate remodelling of maladapted connective tissue structure.

Acupuncture is a traditional oriental system of using fine needles to stimulate the tissue and nervous system to address pain and systemic conditions. There are many different approaches within acupuncture. At Integrated Physiotherapy we use a Japanese variation broadly known as meridian therapy. It is characterised higher numbers of smaller, finer needles than used in other approaches resulting in increased comfort levels during treatment. We may recommend this this modality be incorporated into your treatment when significant autonomic nervous system imbalance, immune system compromise or raised general levels of neural irritation are present on examination and compliments the Integrated Dry Needling and other techniques used in the treatment.

Some physical therapy techniques such as soft tissue mobilisation techniques, joint manipulations or mobilisations have a very slight risk of causing injury. A remote possibility of injury to structures such as but not limited to; nerves, bones, muscles, ligaments, discs or arteries exists. Exercise therapy, postural retraining, dry needling, acupuncture and previously listed techniques can occasionally cause temporary local swelling, bruising or transitory increases in the levels or distribution of pain or other symptoms.

Some physical therapy techniques such as soft tissue mobilisation techniques, joint manipulations or mobilisations have a very slight risk of causing injury. A remote possibility of injury to structures such as but not limited to; nerves, bones, muscles, ligaments, discs or arteries exists. Exercise therapy, postural retraining, dry needling, acupuncture and previously listed techniques can occasionally cause temporary local swelling, bruising or transitory increases in the levels or distribution of pain or other symptoms. High velocity cervical manipulation (commonly known as cracking or adjusting) is very rarely recommended at Integrated Physiotherapy and would be extensively discussed with you before seeking your consent . Specific risk factor testing would also be performed to determine any higher risk being present, prior to the technique being considered in your treatment. Research evidence indicates that skilled cervical/neck manipulation is safer than taking anti-inflammatory medication. In very rare circumstances (less than 1 in 163,000 to 5.8 million), damage may occur to the vertebral arteries in the neck and the patient may suffer a stroke and possibly death.

Allergic skin reactions to massage oils, strapping tapes, the metals used in some acupuncture needles or topical applications are a possibility. Skin deformation that occurs when sports taping is applied may also irritate the skin in some individuals. If any discomfort, redness or itching is experienced remove the tape immediately.

Sports taping should be removed carefully by soaking the tape in nail polish remover, baby oil or a commercial tape removal product. The skin should be supported by one hand and gentle counter traction provided against the direction the tape is being pulled. The skin should be thoroughly washed and moisturised following removal. Stretchy "K" style tapes or dynamic tapes are best removed by soaking or showering or soaking in warm water until tape and all residue have been removed.

Pneumothorax (Puncture/collapsed lung): This is extremely unlikely with appropriate needle technique from an appropriately trained practitioner. The occurrence of this is less than 1 in 70,000 - 1.27 million treatments and most of these instances are preventable with correct risk factor screening and technique application. All of the practitioners at Integrated Physiotherapy have extensive training in the dry needling and acupuncture techniques they use and the identification of any risk factors and prevention measures to further minimise this occurring. If you experience increasing shortness of breath, that may or may not be accompanied by pain, following acupuncture/ dry needling over the posterior shoulders or upper trunk, please contact Integrated Physiotherapy by text and email or attend to the nearest hospital emergency department for an assessment.

Infections are a possibility but are extremely rare when single use disposable needles are used. Integrated Physiotherapy uses only single use, disposable needles. Some people have been reported to experience minor skin irritation in response to the metals used in the needles. These rare adverse effects combined occur in less than 1 in 10,000 treatments.

Following treatment and before driving or cycling, ensure you are not feeling drowsy or fatigued. If you do experience this, consult your practitioner for advice and possibly assistance with alternative travel arrangements. Have a snack or drink and rest until you feel that you have recovered. If you have previously experienced extreme fatigue or drowsiness after acupuncture or dry needling, please inform your practitioner prior to treatment and arrange for someone else to drive you to and from the appointment.

It is very rare for people to experience any discomfort as a result of the acupuncture or dry needling techniques used at Integrated Physiotherapy. Some new soreness may be experienced as a result of changes in the mechanical and neurological loading of nerve and tissue structures as a result of altered ranges of motion following treatment. This will usually resolve within hours and a few days.

Approximately one in thirty needle sites will expel 1-2 drops of blood following needle removal. A further one in thirty will result in a small bump (subdermal haematoma) under the skin that may then resolve leaving what appears to be a bruise. These are not associated with impact or tissue damage and will be absorbed within 1-3 days in a healthy individual