What is Myofascial Therapy?
When muscles are stressed or injured trigger points may form, causing pain and dysfunction. Myofascial therapy alleviates this pain and dysfunction.
Symptoms can include:
- Pain in the neck, shoulder, back, pelvis, hip or jaw (TMJ)
- Radicular like pain
- "Sciatic" pain
- Joint ache
The technique referred to as dry needling has gained popularity as an effective pain management technique over the last 5-10 years. The term dry needling refers to the use of a fine solid needle used without medication to deactivate trigger points and treat muscle pain and dysfunction.
History of Myofascial Pain
References to Myofascial pain can be found in the medical literature going back to the early 1500’s, although the terminology used focused on the concepts of “nodules” or “tumours” and hardening of muscle.
Work by Kellgren in the 1930’s identified the specific pain referral patterns that arise from skeletal muscles. His work mirrored the Clinical observations of Dr Janet Travell who, along with her co-worker Dr Rinzler, coined the term “Myofascial Trigger Point” in 1943.
Over the next 50 years a variety of workers developed treatment protocols that included injection with local anaesthetic, deep massage and stretching to treat Myofascial pain. In 1979 Dr Karl Lewit published a paper entitled “The needling effect – Treatment of Myofascial pain”, where he effectively described “dry needling”.
Needling technique proves critical
It is well accepted now that it is the needling effect rather than the injection of any substrate that provides the therapeutic benefit in injection techniques. This realization has lead to the popularisation of dry needling technique amongst therapists treating Myofascial pain and dysfunction because of its straight forward application and inherent safety as compared to injection techniques.
Myofascial dry needling treats the underlying pathophysiology, aiming to normalise the distinct biochemistry of the Myofascial Trigger Point through achieving multiple twitch responses.
Current evidence-based research identifies this process as fundamental to the effectiveness of dry needling. This biochemical change mirrors the clinical change, which is the relief of pain.
Pain reduction and active rehabilitation
Apart from the immediate benefit of pain reduction, the relief of Myofascial pain enhances active rehabilitation measures such as therapeutic exercise and postural re-education. These in turn assist in the restoration of normal movement enabling a speedier return to sporting, occupational and domestic activities. As such the Myofascial approach to pain management utilising dry needling is congruent with the current literature and its emphasis on the role of exercise in achieving and maintaining pain free normal movement.