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Acupuncture can effectively treat tender or painful muscles!!!

As the diagram shows, acupuncture can essentially reverse myofascial trigger points. As a review of the previous blog, the current understanding is that persistently tight muscle fibers, known as taut bands, come about from stress, injury or damage. The taut bands are perpetuated by the sympathetic “fight or flight” response from ongoing stressors in the environment. Because of the tightness, blood flow is compromised in the muscle causing accumulation of the waste products. Along with the release of potent inflammatory mediators, there is a vicious cycle of poor local circulation and accumulation of waste products causing what is called an energy crisis in the muscle. This crisis leads to deterioration of muscle membrane integrity and even abnormalities in the mitochondria itself!! (1) At the level of the neuromuscular junction, there is perpetuation of the Acetylcholine at the junction that can contribute to persistent tightening of the muscle fibers.

Acupuncture Reverses these phenomena by simply first releasing the taut band from its tight configuration. Needling allows for depletion of available acetylcholine stores. Simultaneously, local inflammatory mediators increase blood flow to the areas or ischemia and leading to myofascial trigger “release” or “fasciculations” in the muscle. Further needling can cause localized bleeding which further nourishes the areas of ischemia and hence kickstart the repair process.

Recent meta-analysis of the trigger point needling shows excellent treatment for the condition (2). We will review the article at length at future blog posts so stay tuned!!

References:

1. Dommerholt, J. Bron, C. Franssen, J. Myofascial trigger points: An Evidence –Informed Review The Journal of Manual & Manipulative Therapy Vol. 14 No. 4 (2006), 203 – 221

2. Kietrys, D. Palombaro, K. et. al. Effectiveness of Dry Needling for upper – quarter Myofascial Pain: A Systematic Review and Meta-analysis. J of Orthopaedic & Sports Physical Therapy 2013 September 43:9: 620 – 635

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Myofascial Trigger Points are Explained!

As the diagram shows, trigger points, tender points or myofascial trigger points are synonymous. The picture shows the current models of why some patients have muscle tender points that seem to worsen with stress or other “triggers”. The clinical scenario is usually depicted as follows: when the clinician palpates known muscles along its origin to its insertion, the patient subjectively feels pain that seems to shoot, refer or “trigger” down a nonspecific, nondermatomal, nonmyotomal pattern. Often times, the pain is purely localized but the clinician can palpate these points readily, and under experienced hands, the clinician can feel the taut band or area of very tight soft tissue or muscle in relation to the surrounding “nontender” muscles or structures. Many times, mere palpation leads to a localized histamine release and cause immediate redness at the site of direct pressure. I tell my students to palpate with the thumb and press firmly enough to cause the nail beds of the thumb to turn white to apply enough baseline pressure.

Common sources of trigger points correlate to many known acupuncture points and it is for this reason, understanding myofascial points can give us a glimpse of what is happening at the known acupuncture points when they do correlate.

Our next blog article will show How Acupuncture May Help Cure trigger points or at least treat it. We will also present some new insights into trigger points that can pave the way for adjunctive treatments such as supplements, herbs and nutrition

References:

Bron, C. Etiology of myofascial trigger points. Current Pain Headache Rep. 2012. 16:439-444

Dommerholt, J. Bron, C. Franssen, J. Myofascial trigger points: An Evidence –Informed Review The Journal of Manual & Manipulative Therapy Vol. 14 No. 4 (2006), 203 – 221

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