Hysen's Health Clinic

Myofascial Trigger Point Therapy.
Paul Hysen 1998.

What is myofascial pain?

Fascia is thin but strong, semi-transparent tissue that maintains the shape of muscles by wrapping around the outside of every muscle in the body and around the bundles of muscle fibres of which muscles are composed. It also connects muscles to bones and tendons, and is a part of other structures, including organs, nerves and blood vessels. Fascia forms a body-wide network of strong connective tissue that is essential for proper function. The term "myo" refers to muscle, myofascia therefore is the fascia associated with muscles. The myofascia can become over-stretched or torn due to damage or muscle overuse, and inflamed due to injury or infection. As a consequence myofascial pain is a common source of chronic pain.

Fascia

As stated above, myofascial pain often begins as an injury from an accident or overuse, although sometimes the cause is unknown. There may be factors that initiate the pain, like a "strain" from an abrupt movement, and then factors such as postural imbalance, muscle weakness, structural misalignment and overuse can prevent complete healing and thus allow the pain to persist. In order to deal with this, it is important that all contributing factors are identified and dealt with. The aim of myofascial treatment is to reduce and eliminate pain, both in the short and the long term. There are many methods used to treat myofascial pain; one of these is myofascial trigger point therapy.

What is myofascial trigger point therapy?

A myofascial trigger point consists of a series of tight bands or abnormal tightening of a small area of the fascia that is tender on movement or pressure. Fascia related pain can be treated by applying constant pressure, heat or electrotherapy on trigger points; and in the case of myofascial dry needling therapy, by the insertion of very fine needles into the trigger point. When a needle is inserted into a trigger point, the surrounding nerves signal the spinal cord to release the fascia and the muscle. Experts believe that there are also other processes involved in myofascial dry needling therapy that promote pain relief, but these are currently not yet completely understood.

Is myofascial dry needling therapy similar to acupuncture?

There are both similarities and differences between dry needling and acupuncture. In both acupuncture and myofascial dry needling therapy fine but solid needles are inserted in specific areas on the body, and nothing is injected during the needling therapy. The main difference between acupuncture and myofascial dry needling therapy however is that most schools of acupuncture are based on Oriental belief and philosophy, while myofascial dry needling therapy is strictly based on Western medical science and scientific research.

How does the needling work?

As stated before, the exact mechanisms behind the benefit gained from needling therapy is not completely understood. We know, based on the pioneering studies done by Dr. Jay Shah and colleagues at the U.S. National Institutes of Health, that there are biomechanical effects; we also know that inserting a needle into trigger points can cause favourable biochemical changes, which assist in the reduction of pain.

What type of problems can be treated with needling?

Dry needling can be used for a variety of musculoskeletal problems. Such conditions include, but are not limited to: neck, back and shoulder pain; arm pain, including tennis elbow, golfer's elbow and carpal tunnel syndrome; headache, including migraines and tension headaches; jaw pain; buttock and leg pain, including sciatica, hamstring strain, and calf tightness and spasms.

Myofascial dry needling therapy has the greatest effect on reducing pain mechanisms governed by the nervous system, but has also been used successfully in certain cases of abdominal pain, non-cardiac chest pain, problems with swallowing, GERD, shortness of breath, Bell's palsy, and rectal and pelvic pain.

Is the procedure painful?

Patients often feel a transient and mild sting when the needle is inserted, but in many cases this is totally painless. Sometimes a small electrical current may be applied to the needles to facilitate a twitch response. The local twitch response elicits a very brief response that feels like a slight cramping sensation. Others however experience a sensation of gentle tingling or warmth.

What side effects can I expect after the treatment?

Many patients report a sense of relaxation of the affected area directly after the treatment. This is because the spasms and tightness in the muscles and fascia have been released.

How many treatments will I need?

Typically, it takes several treatments but it is very individual and depends on how severe the problem was when treatment commenced and the number and complexity of contributing factors.

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