Trigger point needling: techniques and outcome

Simon Vulfsons, Motti Ratmansky, Leonid Kalichman

Research output: Contribution to journalReview articlepeer-review

43 Scopus citations

Abstract

In this review we provide the updates on last years' advancements in basic science, imaging methods, efficacy, and safety of dry needling of myofascial trigger points (MTrPs). The latest studies confirmed that dry needling is an effective and safe method for the treatment of MTrPs when provided by adequately trained physicians or physical therapists. Recent basic studies have confirmed that at the site of an active MTrP there are elevated levels of inflammatory mediators, known to be associated with persistent pain states and myofascial tenderness and that this local milieu changes with the occurrence of local twitch response. Two new modalities, sonoelastography and magnetic resonance elastography, were recently introduced allowing noninvasive imaging of MTrPs. MTrP dry needling, at least partially, involves supraspinal pain control via midbrain periaqueductal gray matter activation. A recent study demonstrated that distal muscle needling reduces proximal pain by means of the diffuse noxious inhibitory control. Therefore, in a patient too sensitive to be needled in the area of the primary pain source, the treatment can be initiated with distal needling.

Original languageEnglish
Pages (from-to)407-12
Number of pages6
JournalCurrent Pain and Headache Reports
Volume16
Issue number5
DOIs
StatePublished - Oct 2012

Keywords

  • Acupuncture Therapy/instrumentation
  • Animals
  • Humans
  • Myofascial Pain Syndromes/physiopathology
  • Needles
  • Pain Management/instrumentation
  • Pain Measurement/methods
  • Treatment Outcome
  • Trigger Points/physiology

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