Understanding Trigger Points and Their Treatment
A trigger point, defined by Doctors Travell and Simons, is a hyperirritable spot in a skeletal muscle that is usually painful on compression. These points can cause referred pain, tenderness, motor dysfunction, and autonomic phenomena. Myofascial trigger points are commonly found in acute and chronic pain conditions, making them a crucial area of study in pain management.
Causes of Trigger Points
Researchers suggest that shortening in muscles acting across a joint increases joint pressure, leading to joint pain (arthralgia) and alignment issues. Additionally, a theory suggests that abnormal, permanent muscle contractions can cause ischaemic muscle pain due to restricted blood flow in the affected muscles.
Treatment of Trigger Points
Treatment methods may deactivate trigger points, including acupressure, dry needling, muscle stretching, trigger point massage devices, or injections with different substances, including saline (saltwater) and placebo.
Releasing Trigger Points with Trigger Point Therapy
Trigger Point Therapy, a remedial massage therapy technique, involves applying direct pressure to specified points on tender muscle tissue to reduce muscle tension and relieve pain. This therapy is suitable for almost everyone, as muscles with active trigger points are weaker and cannot move through their full range of motion. Neglecting to treat the original hypertonic muscle can lead to the development of trigger points in alternative muscles recruited to compensate for the compromised muscle activity.
Dry Needling and its Mechanism of Action
Dry needling is an effective method for decreasing local muscular pain and improving muscle function. By inserting a fine filament needle into the centre of a myofascial trigger point, fresh oxygen and nutrients are delivered to the contracted muscle fibres, relaxing them and flushing away acidic chemicals. This process decompresses the local blood and nerve supply, promoting immediate, palpable relaxation and increased range of motion. The muscle spindle, a stretch receptor within the muscle, is stimulated, leading to reflex relaxation or a lengthening response.
Dry Needling vs. Trigger Point Injections
Research on trigger point injections using both placebo saline and drug therapy suggests that the pain relief from the needle’s stimulation is the consistent factor, rather than the drug or saline solution used. Dry needling, without using a drug, positively affects hyperstimulated trigger points.
Several PhysioWorks physiotherapists are trained in dry needling, offering an alternative to traditional trigger point injections.
Conditions Acupuncture or Dry Needling Could Help
After a thorough assessment, healthcare professionals may consider acupuncture or dry needling for the following conditions:
Understanding trigger points and their impact on muscle function and pain is essential for effective pain management. Various methods, including dry needling, can release trigger points and relieve a wide range of musculoskeletal conditions. If you are experiencing any of the mentioned conditions, consult with a healthcare professional to explore the potential benefits of acupuncture or dry needling for your specific case.