Myofascial Pain Trigger Points
Here are some clinical characteristics of myofascial trigger points;
- A myofascial Trigger Point (TP) is a hyperirritable locus within a taut band of skeletal muscle, located in the muscular tissue and/or its associated fascia.
- An active TP causes the patient pain.
- A latent TP is clinically silent with respect to pain, but may cause restriction of movement and weakness of the affected muscle. A latent TP may persist for years after apparent recovery from injury; it predisposes to acute attacks of pain, since minor overstretching, overuse or chilling of the muscle may suffice to reactivate it. Both latent and active TPs cause dysfunction; only active TPs cause pain.
- Normal muscles do not contain TPs. Normal muscles have no taut bands of muscle fibres, are not tender to firm palpation, exhibit no local twitch responses and do not refer pain in response to applied pressure.
- Myofascial pain is referred from trigger points in specific patterns characteristic of each muscle.
- Trigger points are activated directly by acute overload, overwork fatigue, direct trauma and by chilling.
- Trigger points are activated indirectly by other trigger points, visceral disease, arthritic joints and by emotional distress.
- Injecting 0.2-1.0mL of 1% local anaesthetic into these taut bands.
- Gentle dry needling of the trigger points once anaesthetised to break up the abnormal muscle bands.
- Applying stretches to the affected muscle to release the trigger point.
- Muscle energy release is a specific style of stretching involving a contraction and relaxation technique. This is applied to normalise the affected muscle function especially while the local anaesthetic has inactivated trigger point or taut band thus allowing the release of the trigger point.
- Sometimes home stretching exercises are given to maximise the treatment.
Dr. Philip Lim
Dr. Michael Mock
Dr. Sue Leong
- diagnostic model
- trigger point injection & muscle energy release
- ligamentous & fascial release
- joint manipulation & release
- platelet rich plasma
- joint injection
- muscle scar tissue hydrodissection
- shoulder joint hydrodilation
- real-time ultrasound core training
- prescriptive exercises
- breathing dysfunction & capnotrainer