DAKOTA DUNES, S.D. -- Doyle Turner had sought relief of his thoracic outlet syndrome for years before he turned to a physical therapist and her needles.
Turner, 49, had a clavicle bone that wasn't in its designated place. This misalignment caused problems with the nerves and muscles in his chest, including his heart.
"It was causing my heart to go into tachycardia, it'd just race," Turner said. "It would go really fast, but it has a tendency to not pump blood very good when it goes that fast."
In addition to the wayward clavicle, Turner also suffered internal shingles, in which the body doesn't show outward signs of the disease. His ticker was not at all pleased with this state of affairs.
"Drove the heart absolutely nuts," he said. "At one point, I was taking six nitroglycerin a day."
In tremendous pain -- for which he made several emergency room visits -- Turner doctored around for his condition. His heart was healthy, the doctors said: but somewhere in his chest, there was a very unhappy nerve. At one point he spent three days in a cardiac intensive care unit, where doctors were perplexed by his stubborn tachycardia.
Doctors were able to treat Turner's internal shingles (he suffered recurring bouts), which provided some relief, but he was still in pain and had to retire early from farming. He spent time on Google trying to divine the nature of his problem, and eventually concluded he suffered from thoracic outlet syndrome, in which nerves or blood vessels in the chest are compressed.
A doctor agreed with this assessment and sent him to a vascular surgeon, where he got a formal diagnosis and confirmation that a chest nerve was indeed at the root of the whole thing. He was then sent to Megan Snoozy, a physical therapist at Physical Therapy Specialists in Dakota Dunes.
Though she had seldom (if ever) seen a case like Turner's, Snoozy performed a technique called dry needling on him. They did dry needling twice a week for six months.
After one dry needling session several months in, Turner was in an immense amount of pain. That misaligned clavicle and its associated muscles, which had been bound up for decades, were in for a reckoning.
"I was not feeling good at all, I was in a considerable amount of pain," Turner said of his chest muscle realignment.
Now his clavicle is back in its normal position, and after a few more weeks of regular treatment, today he only goes back for more dry needling as needed.
He was even able to emerge from his early retirement and go back to work.
Dry needling is a physical therapy technique in which a therapist takes a solid needle -- one without an opening like a syringe, thus the "dry" part -- and pushes it into a patient's muscle where a knot is found. They move the needle up and down, like a piston.
The needle causes a contraction in the muscle, which eventually goes back to the way it's supposed to be.
"There are trigger points in the muscles -- the muscle fibers kind of knot up or spasm, get overused," Snoozy said. "That 'knot' that people feel that's tender -- there's a little backlog of blood and potassium and sodium and stuff that can't get through, and that's what makes it tender."
Knotted muscles can be inefficient, weak, sometimes painful -- and the pain caused by a knotted muscle can be felt far away from the muscle itself.
The technique, depending on the patient, can be painful -- not so much the needle itself, but stimulating an unwell muscle can be uncomfortable for some.
"I would say that it's intense, as that twitch response happens," she said.
Snoozy cautions that Turner's case is far from ordinary. She says she more often uses dry needling to treat headaches (some of which can be caused by neck muscle problems), as well as neck, shoulder, back and arm pains, hip muscle tightness, tendinitis, bursitis, posture dysfunctions, knee pains, iliotibial band syndrome, piriformis syndrome and other conditions of the muscles and connective tissues.
South Dakota only approved dry needling for physical therapists in the state last year. Before that, Snoozy traveled to Sioux City (dry needling was allowed in Iowa years earlier) to for dry needling sessions.
Dry needling wasn't taught in physical therapy classes when Snoozy was in school. She had to take separate training for the technique, which she has performed for about 2 1/2 years.
While on its face it may appear similar to acupuncture, Snoozy said dry needling is not really closely related to acupuncture.
"They're different theories, I don't know acupuncture -- my understanding is it's more of an Eastern medicine," she said. "Technique-wise, I don't know exactly what they do."