Institute of Manual & Integrative Therapy

DIN-3a Adv. DIN for Chronic Pain Presentations

2-Days with Jon Hobbs

Coming to Columbia, SC Oct. 19-20, ’24

DIN-3a is a 2-day  live course, designed with the intermediate to advanced needling professional in mind, and is grounded in the the Hobbs Needling Paradigm.  Take your clinical reasoning game to a new level.

Open to any professional with previous needling experience and instruction. Appropriate for physical therapists, athletic trainers, chiropractors, RNs, PAs, DOs and MDs.

DIN-3a Chronic Pain Focuses:

Saturday & Sunday

  • 8 am to 5 pm

DIN-3a is a two-day course designed for clinicians who have previously undertaken training in dry needling and wish to improve their practical skills in the clinical reasoning and treatment of complex and chronic pain presentations. Participants should have already successfully undertaken a recognized dry-needling foundation-level course. 

Course Design:

DIN-3a is designed to be a mentoring case study presentation-style course that emphasizes clinical reasoning, technique selection, treatment progression, needle handling, and patient positioning. Participants are challenged through case presentations to recognize the primary pain state driving the patient presentation (Walton, et al 2018), contributing biopsychosocial factors, and lifestyle contributors, as well as which phase of rehabilitation the patient is in and to apply and progress their needling strategy appropriately. Participants are given feedback on technique selection based on pain state and phase of rehab, progressions, patient positioning, needle handling, and technique refinement.


Case presentations include a combination of:

  1. Chronic regional pain syndrome.
  2. Acute on chronic lumbar radiculopathy.
  3. Fibromyalgia.
  4. Acute on chronic cervical radiculopathy.
  5. Chronic osteoarthritic presentations.
  6. Sleep, anxiety, and depression presentations.

Techniques explored:

  1. Superficial and deep dry needling.
  2. Systemic needling strategies.
  3. Trigger point needling.
  4. Periosteal pecking and tendinopathic needling strategies.
  5. Perineural, periarterial, and periarticular needling.
  6. Segmental and peripheral needling.
  7. Homo-segmental vs. hetero-segmental needling.
  8. Parasympathetic vs. sympathetic needling strategies for autonomic regulation.
  9. Needling strategies for insomnia, anxiety, depression.
  10. Electrical needling strategies for chronic pain. 
  1. Linear progressions.
  2. Dynamic progressions.
  3. Pendular progressions.
  1. To introduce the concepts of pain states as they relate to complex and chronic pain presentations and the use of needling as a treatment modality.
  2. To receive mentoring and feedback on the participant’s clinical reasoning, technique selection, treatment progression, needle handling, and patient positioning.
  3. To refresh the participant’s knowledge of the health and safety aspects and anatomy related to the clinical application of needling.
  4. Explain the mechanisms of the five main physiological reasons to needle.
  5. Safely and effectively needle a variety of anatomical structures for the purpose of the treatment of complex and chronic pain presentations.
  6. Clinically reason the application of local muscle, segmental and systemic needling in the treatment of complex and chronic pain presentations.
  7. Integrate needling into the complete management of complex and chronic pain presentations in a clinical setting.
  8. To be able to progress and adapt treatments in a given patient presentation through the three phases of rehab.

At the conclusion of the course, students must demonstrate a minimum of 80% proficiency in the following course assessments to achieve a passing grade. The assessments will demonstrate that the student has met the listed objectives:

    1. .In-class technique safety demonstration and sign-off sheet.
    2. Required post-class survey.

The Hobbs Needling Paradigm: Up your needling game today!!

1. Identify Primary Pain State

  • Nociceptive
  • Peripheral Neuropathic
  • Nociplastic
    • +Consider BPS influencers.

2. Consider The Rehab Phase

  • Phase 1: Symptom Modulation
  • Phase 2: Loading Capacity Optimization
  • Phase 3: Function & Performance Improvement

3. Choose Desired Response

  • Reason 1: Local healing/inflammatory.
  • Reason 2: Local analgesic.
  • Reason 3: MSK & trigger points.
  • Reason 4: Segmental.
  • Reason 5: Supraspinal & systemic.

1 + 2 + 3 =

Appropriate technique selection.

Explore our other course offerrings: