MYOFASCIAL TRIGGER POINTS and DRY NEEDLING
Anytime our body has been injured, the muscular tissue around the injury is almost always contributing towards the pain we feel, and in many cases is indeed the injured structure. The work of Janet G. Travell, M.D. (Cardiologist, personal physician of former President John F. Kennedy) and David G. Simmons, M.D. contributed to the understanding of how our muscles form tight knots, called myofascial trigger points, and how these trigger points relate to chronic and acute pain. Through their research, the medical field has learned how these trigger points are formed, how to identify trigger points clinically, and most importantly treatment strategies for trigger points.
Karl Lewitt, M.D. was the first medical practitioner to publish the “dry needling” technique in 1979. Dry needling is a term used because there is no injection of medicine involved, which would be considered “wet needling”. Dry needling is the practice of deactivating the myofacial trigger point by inserting a small solid filament needle directly, and specifically, into the contracted muscular tissue to elicit a localized twitch response(LTR). A LTR is an uncontrollable, short-arc spinal cord reflex that resets the muscle back to a normal relaxed state. Multiple LTR’s are typically required to completely deactivate the trigger point and recent research suggests eliciting a LTR is required for the desired effects.
Myofascial trigger points are usually treated conservatively at first, targeting the involved structure with appropriate stretching and strengthening exercises as well as hands-on manual therapy techniques to improve muscle tissue quality.