Symptoms: severe aching, often ‘referred’ (e.g. one of the shoulder muscles, infraspinatus, causes severe ache into the shoulder joint and down the thumb side of the arm.
Restriction of movement (above TP gives ‘frozen shoulder’ symptoms)
Treatment: needle the exact tender point in the muscle (this is far less painful than finding the point!). Other methods are to apply pressure (slower & more painful) or use a vapocoolant spray (not used in this clinic).
Possible Results:
- pain aggravates then abates to better level (1-4 days)
- pain just abates to better level (1-4 days)
- pain aggravates then returns to same level
- no change
Progress:
- dependant on how long you’ve had the problem
- general health of muscles (e.g. in fibromagia)
- activities which may recreate the problem
- usually between 1 to 5 treatments, average about 3
Myofascial pain syndrome (MPS) or ‘trigger point’ therapy has developed completely independently to classical chinese acupuncture and bears no relation to it except that the two both use needle insertion techniques. A key worker in the field has been one time Professor of clinical medicine Janet Travell. She and her co-workers found that when you put a muscle under strain it may respond by developing a very localised point of contraction.The strain could be either sudden, like putting an arm out to prevent a fall or to pick up an object at an awkward angle, or over a long period of time with activities such as typing or decorating.
Details of pathophysiology of TPs and why needling releases them can be found in Travells book ‘Myofascial pain & dysfunction; The Trigger Point manual’ and on the web, or can be explained by the practitioner (Tony Sugden). Originally they were injected with local anaesthetic which numbed the pain, but then it was found that the needle actually released the TP.
I find that needling TPs in conjunction with classical Chinese Acupuncture points can be more succesful especially when the problem’s been around a long time. Classical acupuncture actually refers to ‘ah shi’ points which are points tender to the touch, however the work done in western medicine pain clinics has refined the understanding of mechanisms of creation and release of TPs.
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