DermoNeuroModulation (DNM) is a structured, interactive approach to manual therapy that targets the central nervous system, peripheral nerves and skin. “Dermo” refers to the skin, “neuro” refers to “nervous system”; the term “modulation” means a change in input and/or output, e.g., sound levels in music. DNM techniques are slow, light, kind, intelligent, responsive and effective. Positioning of limbs and trunk affects deeper nerve trunks (by shortening and widening their container), and is combined with skin stretch directed toward cutaneous fields of nerves that branch outward into skin (which may draw neural structure further through its container). It is prudent to remember that manual handling of a patient’s physicality is only a small part of developing a complete therapeutic context for change - while optional, it can also be optimal. Nothing in the body can or will change until the central nervous system concludes it is safe to allow change to happen. A good case could be made that all forms of manual therapy are therefore largely neuromodulatory in their effects; since no one can treat a patient manually except through skin, all manual therapies are therefore dermo as well. DNM addresses complaints of emergent or persisting regional pain, correlated with tension patterns (whether visible to the therapist or felt by the patient), palpable tightness or non-homogeneity in tissue, and tenderness within superficial tissue as felt and reported by the patient.
DNM is based on Melzack’s Neuromatrix model of pain, the most clinically useful pain model in existence from an interactive manual therapy standpoint. DNM is a fully interactive treatment model: unlike a strictly operative model, in which, for example, biomechanical “faults” must be found, then “corrected”, DNM considers biomechanical expression as defence, not defect. By putting “pain” first; i.e., we put the nervous system of the patient (not their anatomy) front and centre in the treatment encounter. Subsequent improvement in motor output is assessed and regarded as a sign that the nervous system now works with less intrinsic stress.