While total hip arthroplasty (THA) is one of the most common and successful orthopedic surgeries, some patients may experience persistent, recurrent, or new hip pain despite successful THA. Dry needling (DN) is a common treatment for musculoskeletal pain, yet little data has been published on the use of DN on hip pain after THA. This series highlights two patients with prior THA and current hip pain that improved with DN used alongside conventional physiotherapy exercises.Patient 1, a 70-year-old male four years post left THA, presented to a physical therapist with a three-year history of left hip pain. Patient 2, a 65-year-old female 10 years post right THA, presented with a onemonth history of right hip pain after a fall. Both patients were reported to have a stable prosthesis without clinical or radiological evidence of loosening or other major complications. Examination of both patients revealed decreased hip range of motion, decreased hip strength, and lateral hip trigger points suggestive of a muscular origin of pain. The physical therapist treated both patients with DN alongside strengthening and stretching exercises, yielding significant improvements in pain severity, function, and range of motion.These cases illustrate the successful use of DN alongside conventional physiotherapy to alleviate hip pain in patients with previous THA. Further research is needed to examine the efficacy and safety of DN for hip pain in individuals with prior THA.

A 72-year-old man with cardiovascular disease, depression, and anxiety presented to a chiropractor with a six-year history of anorgasmia, anejaculation, and erectile dysfunction as well as chronic, episodic low back pain. He previously saw a neurologist, two urologists, and had extensive and expensive testing, including brain, cervical, thoracic, lumbar, and pelvic imaging and electrodiagnostic testing. The patient had a disc bulge at L5/S1 causing moderate spinal canal stenosis while other testing was relatively normal. He had previously tried discontinuing a selective serotonin reuptake inhibitor, trialing psychological counseling, and administering penile injections, all without any improvement in sexual function. The chiropractor identified lower extremity weakness, sensory, reflex, and balance deficits and initiated a one-month trial of care, applying lumbar mobilizations and thrust manipulation at L1/2. The patient reported resolution of anorgasmia and anejaculation the first week, which was maintained over a total three months' follow-up. Low back pain also did not return. The current case report highlights the apparent success of lumbar spinal manipulation in improving anorgasmia and anejaculation in an older man. This response may be explained in that the sympathetic (T10-L2) and somatic (S2-4) innervation required for male orgasm and ejaculation is derived from the lumbosacral region. Further research is needed to determine if these findings are reproducible.