So, I had a patient come in on Xarelto (rivaroxaban) requesting acupuncture. And my gut instinct said, "Hell no", but I thought I'd check the literature first.
And it turns out, anticoagulants aren't an absolute contraindication to dry needling. There are a couple of clinical guidelines for physiotherapists using acupuncture that talk about avoiding joints and using finer gauge needles (e.g. Australian Society of Acupuncture Physiotherapists - www.acupuncturephysio.org)
But there's an interesting paper where they compared patients on warfarin, patients on antiplatelet therapy and patients on nothing interesting and they didn't seem to have many more complications:
Young-Jee Kim, Soo-Kyung Kim, Seung-Yeon Cho, Seong-Uk Park, Woo-Sang Jung, Sang-Kwan Moon, Chang-Nam Ko, Ki-Ho Cho, Sang-Beom Kim, Won-Chul Shin, Jung-Mi Park. Safety of acupuncture treatments for patients taking warfarin or antiplatelet medications: Retrospective chart review study. Eur J Integr Med 2014;6:492–496.
Here's a commentary:
http://www.sciencedirect.com/science/article/pii/S2213422015000256
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