Myofascial Trigger Point

A hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is painful on compression and can give rise to characteristic referred pain, referred tenderness, motor dysfunction, and autonomic phenomena.

Any myofascial trigger point is to be distinguished from a cutaneous, ligamentous, periosteal, or any other non-muscular trigger point.

A cluster of electrically active loci each of which is associated with a contraction knot and a dysfunctional motor endplate in skeletal muscle.

~ Travell & Simons’, Myofascial Pain and Dysfunction, The Trigger Point Manual. Second Edition, Lippincott Williams & Wilkins

Myofascial Pain Syndrome

The sensory, motor, and autonomic symptoms caused by a myofascial trigger point. The specific muscle or muscle group that causes the symptoms should be identified. A regional pain syndrome of any soft tissue origin.

~ Travell & Simons’, Myofascial Pain and Dysfunction, The Trigger Point Manual. Second Edition, Lippincott Williams & Wilkins

Factors that Can Cause a Trigger Point

  • Sudden trauma to musculoskeletal tissues (muscles, ligaments, tendons, bursae)
  • Injury to intervertebral discs
  • General fatigue
  • Repetitive motions; Muscle strain due to over activity; Excessive exercise
  • Lack of activity (e.g., a broken arm in a sling)
  • Chilling of areas of the body (e.g., sitting under an AC duct)

What is Dry Needling?

Dry Needling is a broad term used to define “non-injection” needling from the practice of “injection needling” which utilizes a hypodermic syringe and usually involves the injection of an agent such as saline, local anesthetic or corticosteroids into the tissue. In contrast, Dry Needling uses a solid, filament needle without a razor-blade point, which is utilized to stimulate specific reactions in target tissues for its therapeutic effects.

How Does Needling Stop the Cycle?

A spasm muscle is essentially a damaged muscle. Because the spasm reduces the blood flow to the muscle it does not get the proper amounts of oxygen and nutrients needed. Thus, fibrous scar tissue replaces the muscle fibers, which keeps the muscle tight causing continued spasm and prevents the release of metabolites.

What Does Dry Needling Feel Like?

Needles are usually only inserted for a few seconds or can be left in a little longer depending on the desired effect. The sensation of the needle is usually described as a tingling or dull ache. In some instances electrical stimulation may be use to aid the release of the tissue and trigger point. The most common side effect of Dry Needling is muscle soreness.

Is Trigger Point Dry Needling (TDN) Acupuncture?

NO. Acupuncture is based on the ancient Chinese philosophy of the balance of Yin and Yang. It usually treats local dysfunctions distally, and uses specific energy meridians to approach the dysfunctions. TDN is the direct release of the specific structure involved.

How does it Works?

Many painful conditions are developed as tissues try to adapt to a trigger point or muscle spasm in the muscles and connective tissues within the body. This will affect optimum functioning of the joins and spine. This can result in localized and referred pain.

After an identification of these points, TDN techniques are capable of restoring normal muscle function by deactivating the irritated foci,thus decreasing pain associated with it and dysfunction.

By allowing the body to decrease the level of pain and muscle tension, further treatments could be carried out, such as stabilization and strengthening exercises. As an example, “tennis elbow” develops as a result of chronic irritation of the tendons of the forearm that attaches the muscle to the bone in the elbow. Inflammation develops and pain results in the area with any activity. The muscles respond by tightening and shortening. This causes further strain and a self-perpetuating condition develops. For the treatment of this condition, TDN can release the affected tissues, stimulating the natural body’s healing process, as well as releasing the trigger point and restoring normal muscle length. Skill Level and Training

Dry Needling approach demands an advanced education before practicing. Prior to being accepted into a TDN class the Physical Therapist must have 2+ years manual therapy experience. Then they must complete a total of 46 hours of training face-to-face with the instructor as required by the Colorado Department of Regulatory Agencies (DORA), and demonstrates they are qualified to perform TDN. Rodrigo Gil Moreno de Mora, PT, DPT, MA is a Doctor of Physical Therapy and has meet these requirements after taking Dry Needling I and Advanced Dry Needling II.

Dr. Gil Moreno de Mora graduated from Regis University in 1996 with a Masters in Physical Therapy and then completed his doctorate, also at Regis, in 2005.

**If you are interested in more information, we’d be happy to talk with you! We can also share with you research articles regarding TDN and it’s effectiveness.