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Needling therapy for myofascial pain: recommended technique with multiple rapid needle insertion.

Chou LW, Hsieh YL, Kuan TS, Hong CZ - Biomedicine (Taipei) (2014)

Bottom Line: Suggested mechanisms of needling analgesia include effects related to immune, hormonal or nervous system.Compared to slow-acting biochemical effects involving immune or hormonal system, neurological effects can act faster to provide immediate and complete pain relief.This technique is strongly recommended for myofasical pain therapy in order to resume patient's normal life rapidly, thus saving medical and social resources.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan ; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.

ABSTRACT

Myofascial trigger point (MTrP) is a major cause of muscle pain, characterized with a hyperirritable spot due to accumulation of sensitized nociceptors in skeletal muscle fibers. Many needling therapy techniques for MTrP inactivation exist. Based on prior human and animal studies, multiple insertions can almost completely eliminate the MTrP pain forthwith. It is an attempt to stimulate many sensitive loci (nociceptors) in the MTrP region to induce sharp pain, referred pain or local twitch response. Suggested mechanisms of needling analgesia include effects related to immune, hormonal or nervous system. Compared to slow-acting biochemical effects involving immune or hormonal system, neurological effects can act faster to provide immediate and complete pain relief. Most likely mechanism of multiple needle insertion therapy for MTrP inactivation is to encounter sensitive nociceptors with the high-pressure stimulation of a sharp needle tip to activate a descending pain inhibitory system. This technique is strongly recommended for myofasical pain therapy in order to resume patient's normal life rapidly, thus saving medical and social resources.

No MeSH data available.


Related in: MedlinePlus

Stimulation of a sensitive locus with needle tip during MTrP injection to elicit pain, referred pain or local twitch response.
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Fig3: Stimulation of a sensitive locus with needle tip during MTrP injection to elicit pain, referred pain or local twitch response.

Mentions: Recent studies on both human subjects and animals suggest multiple MTrP loci in an MTrP region [7, 10] and an MTrP locus containing a sensory (sensitive or LTR locus) and a motor component (active, spontaneous electrical activity, or SEA locus). (Figure 1) [7, 8, 10, 11]. Stimulation of a sensitive locus elicits local pain, referred pain, and local twitch response [7, 8, 11, 12]. Hong suggested that an MTrP is integrated in the spinal cord via a “myofascial trigger point circuit (MTrP circuit)” (Figure 2) [6, 8, 11]. Nociceptors in an MTrP region connect to a group of dorsal horn cells (sensory neurons) in the spinal cord, “MTrP related sensory neurons” responsible for central sensitization and transmission of pain information to the brain. The neural network with connections among them is defined as an “MTrP circuit” [6, 13]. Such a circuit corresponding to a certain MTrP can send nerve branches to connect with another MTrP circuit corresponding to other MTrPs. Latent MTrP may activate if stimuli from peripheral sites are strong enough to trigger its MTrP circuit. Mechanical stimulation to a sensitive locus may elicit local pain if strong enough. Stronger stimulation may elicit referred pain to a remote region. Very strong (such as a tiny needle tip) stimulation may elicit local twitch response (Figure 3). Histological study suggests sensitive locus as actually a free nerve ending, a sensitized nociceptor [7, 8, 11]: i.e. MTrP as a region accumulating multiple sensitized nociceptors [8, 11] whose irritation or sensitization of nociceptors causes spontaneous pain. Yet pain from stimulation of sensitized nociceptors differs from pain elicited by stimulation of normal (non-sensitized) nociceptors. In clinical practice (especially during MTrP injection), many patients distinguish these types of pain with different nature; they usually describe pain due to MTrP as a “sore pain” that occurs spontaneously (active MTrP) or is elicited by stimulation of sensitized nociceptors.


Needling therapy for myofascial pain: recommended technique with multiple rapid needle insertion.

Chou LW, Hsieh YL, Kuan TS, Hong CZ - Biomedicine (Taipei) (2014)

Stimulation of a sensitive locus with needle tip during MTrP injection to elicit pain, referred pain or local twitch response.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4264979&req=5

Fig3: Stimulation of a sensitive locus with needle tip during MTrP injection to elicit pain, referred pain or local twitch response.
Mentions: Recent studies on both human subjects and animals suggest multiple MTrP loci in an MTrP region [7, 10] and an MTrP locus containing a sensory (sensitive or LTR locus) and a motor component (active, spontaneous electrical activity, or SEA locus). (Figure 1) [7, 8, 10, 11]. Stimulation of a sensitive locus elicits local pain, referred pain, and local twitch response [7, 8, 11, 12]. Hong suggested that an MTrP is integrated in the spinal cord via a “myofascial trigger point circuit (MTrP circuit)” (Figure 2) [6, 8, 11]. Nociceptors in an MTrP region connect to a group of dorsal horn cells (sensory neurons) in the spinal cord, “MTrP related sensory neurons” responsible for central sensitization and transmission of pain information to the brain. The neural network with connections among them is defined as an “MTrP circuit” [6, 13]. Such a circuit corresponding to a certain MTrP can send nerve branches to connect with another MTrP circuit corresponding to other MTrPs. Latent MTrP may activate if stimuli from peripheral sites are strong enough to trigger its MTrP circuit. Mechanical stimulation to a sensitive locus may elicit local pain if strong enough. Stronger stimulation may elicit referred pain to a remote region. Very strong (such as a tiny needle tip) stimulation may elicit local twitch response (Figure 3). Histological study suggests sensitive locus as actually a free nerve ending, a sensitized nociceptor [7, 8, 11]: i.e. MTrP as a region accumulating multiple sensitized nociceptors [8, 11] whose irritation or sensitization of nociceptors causes spontaneous pain. Yet pain from stimulation of sensitized nociceptors differs from pain elicited by stimulation of normal (non-sensitized) nociceptors. In clinical practice (especially during MTrP injection), many patients distinguish these types of pain with different nature; they usually describe pain due to MTrP as a “sore pain” that occurs spontaneously (active MTrP) or is elicited by stimulation of sensitized nociceptors.

Bottom Line: Suggested mechanisms of needling analgesia include effects related to immune, hormonal or nervous system.Compared to slow-acting biochemical effects involving immune or hormonal system, neurological effects can act faster to provide immediate and complete pain relief.This technique is strongly recommended for myofasical pain therapy in order to resume patient's normal life rapidly, thus saving medical and social resources.

View Article: PubMed Central - PubMed

Affiliation: Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan ; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.

ABSTRACT

Myofascial trigger point (MTrP) is a major cause of muscle pain, characterized with a hyperirritable spot due to accumulation of sensitized nociceptors in skeletal muscle fibers. Many needling therapy techniques for MTrP inactivation exist. Based on prior human and animal studies, multiple insertions can almost completely eliminate the MTrP pain forthwith. It is an attempt to stimulate many sensitive loci (nociceptors) in the MTrP region to induce sharp pain, referred pain or local twitch response. Suggested mechanisms of needling analgesia include effects related to immune, hormonal or nervous system. Compared to slow-acting biochemical effects involving immune or hormonal system, neurological effects can act faster to provide immediate and complete pain relief. Most likely mechanism of multiple needle insertion therapy for MTrP inactivation is to encounter sensitive nociceptors with the high-pressure stimulation of a sharp needle tip to activate a descending pain inhibitory system. This technique is strongly recommended for myofasical pain therapy in order to resume patient's normal life rapidly, thus saving medical and social resources.

No MeSH data available.


Related in: MedlinePlus