Q I am afraid of Needle Knife Therapy. What kind of procedure is it, and how painful is it?
A Dochim is a blade-shaped needle that is thicker than a standard needle and has a flat tip. It is used to dissect adhesions within thickened tendon sheaths. Pain is minimized by using local anesthesia or a cooling spray before the procedure, and the treatment is performed only on the precise site under ultrasound guidance. Although there may be some soreness for 1 to 2 days after the procedure, daily activities can be resumed immediately.
Detailed Answer
Needle Knife Therapy (Dochim) uses a blade-shaped needle with a diameter of 0.5 to 1.0 mm and a flat tip to directly dissect the tissue between the thickened inner membrane of the tendon sheath and the adhered tendon. The principle is to release internal adhesions and lower tunnel pressure without incising the roof of the first dorsal compartment tendon sheath. It offers high safety because it acts only on the precise location, avoiding tendons, nerves, and blood vessels through real-time ultrasound guidance. The procedure takes approximately 5 to 10 minutes. Afterward, a compression dressing is applied, and a wrist brace is worn on the same day.
Korean Medicine Clinic Perspective
Dochim can be viewed as a procedure that physically opens blocked meridian pathways by acting directly on blood-stasis tissues where Qi and blood have stagnated. Once adhesions within the tendon sheath are released, the flow of Qi and blood in the thumb and lateral wrist meridians is restored, resuming the natural regeneration process. At Dongjedang, we apply a complex sequence in which pharmacopuncture is used to soften the tissue before Dochim, followed by fire acupuncture and thread embedding to accelerate regeneration. The recovery period is shortened by using herbal medicine tailored to the patient's constitution to expel blood stasis and replenish liver blood after Dochim.
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