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DNM in Vancouver February 17/18 2018: a manual therapy model for treating persistent pain

Copy of DNM-Dermoneuromodulation
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Copy of DNM-Dermoneuromodulation
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DNM in Vancouver February 17/18 2018: a manual therapy model for treating persistent pain


What Is Dermoneuromoduating?

an explanation for a new manual therapy approach 



The term DNM Stands for Dermo (skin) Neuro (nervous system) Modulation (a change from one state to another). It is a method of manual therapy/massage therapy used to change the state of the nervous system from a painful hyperactive state to a less painful and reactive one. Diane Jacobs, a Canadian PT with 40 years experience developed DNM as a way to better treat people with chronic and persistent pain. I have had the lucky pleasure to directly learn from and work with Diane over the last four years.


In the world of Manual Therapy (MT) there seems to be hundreds of techniques and methods that attempt to approach treating people in pain. One thing they all can agree on is that we push pull and twist skin directly and soft tissue indirectly. The speed, duration and force of these maneuvers may be different but the underlying mechanistic effects all follow the same rules. 

Lately, there has been a large growth in research around the mechanisms of massage and other manual therapies with a drift into the neuroscience involved in pain.

Two processes seem to be apparent when we look at the research:

  1. The effects of touch have strong psychological and physiological effects. 
  2. The nervous system controls these effects. 

If we are to use Manual Therapy as a treatment for pain resolution we should look at really understanding pain physiology within a social, biological and psychological framework. 

  • What we know from studying the non specific effects of physical medicine is that we should strive for a treatment environment that creates the least amount of threat to the person being treated; therefore, We should act, dress and keep the treatment space in a way that won’t put the patient on the defensive. 
  • We know that we touch the skin primarily in manual therapy and that the skin is intimately tied into the nervous system embryologically as both arrive from the ectoderm. 
  • We know that the Nervous System makes up around 2% of our body by weight but uses 20% of our O2 and Glucose at all times.
  • The nervous system carries impulses from the peripheral (and from within) which are processed in the spinal chord and brain to create an output response. If the impulses are deemed dangerous enough the output is pain. 
  • We know that pain is a complex process that depends on contextual, psychological and biological factors that mostly happen without our conscious perception and that pain can’t happen without a nervous system. 
  • There are 72 kilometres of nerves in the human body and is intimately connected to the the vascular system millimetre by millimetre.
  • Nerves do not respond well to sustained mechanical deformation specifically, compression more than stretch.


Dermoneuromodulating is a method that attempts to take these facts as a underlying framework for an interactive, hands on, approach to treating the experience of pain. It considers the nervous system of the patient to treat from “skin cell to sense of self”. Techniques are usually light and holds are slow. Limbs and trunk are positioned to affect deeper nerve structures in combination with skin stretch. This is done to potentially shorten and widen a nerve's container thus reducing mechanical deformation of the nerve. 

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This course will be held February 17 and 18th at WCCMT-NW
WCCMT New Westminster Campus
613 Columbia Street
New Westminster, BC, V3M 1A7
Coffee and Snacks will be provided both days