Today musculoskeletal disorders are one of the main causes of consultation with our physiotherapists. There are many soft tissue problems: trauma or blows, inflammation, loss of strength… and Myofascial Pain and Dysfunction Syndrome, which mainly affects the muscles and is caused by the Myofascial Trigger Point.
What is a myofascial trigger point?
A Myofascial Trigger Point is a palpable nodule within a taut band of skeletal muscle, the most significant feature of which is pain.
It is called the trigger point (or in Anglo-Saxon terminology Trigger Point), alluding to the trigger of a firearm, since when we press the trigger, the impact of the bullet occurs at a distance. Thus, in a trigger point the pain produced is radiated.
This phenomenon explains why in many patients a muscular problem, such as hypertonia or contraction of the sternocleidomastoid, causes referred or distant pain in the area of the head in the occiput or in the orbicular area (around the eye). We would speak in this case of a tension-type headache.
The presence of trigger points is quite common in the posterior muscles of the neck and back. This is due to the fact that, due to their morphology, biomechanics and function, they are muscle groups that are very prone to fatigue and hypertonia.
What symptoms do trigger points cause?
To find out if it is a trigger point that is causing your injury, in addition to intense pain, you will be able to perceive:
- Muscle weakness.
- Muscular fatigue.
- Chronic headaches.
- and many other symptoms depending on each individual.
When a patient has trigger points, the band where the trigger point is lodged feels tense. Sometimes a nodule will be visible and sometimes not.
Myofascial Pain caused by Trigger Points is different in each muscle. The severity and extent of the pain pattern will depend on the degree of trigger point irritability and not on the size of the muscle. On the other hand, their irritability can vary according to the time or day and the stress threshold.
What causes or factors cause the appearance of a trigger point?
Muscles are made up of many muscle fibers and these fibers in turn are filled with sarcomeres which are what allow contraction. When a muscle is in permanent contraction due to muscular overload, a trigger point is activated in the area.
Trigger points thus reflect points where sarcomeres become overactive.
- Physical factors:
-Postural fatigue due to maintained postures (the muscles of the back are usually fatigued).
-Direct or repetitive trauma.
-Fatigue due to overexertion in muscles subject to excessively sustained or repeated contractions.
-By action of other trigger points of muscles that are in the area of referred pain.
- Emotional factors: stress, anxiety…
- Visceral factors: Stomach or liver problems from poor diet or stress can activate upper back trigger points.
Treatment of myofascial trigger points
The treatment of myofascial trigger points can be done using different methods, since they can be conservative or invasive.
Among conservatives, physiotherapy techniques based on manual therapy can be performed, such as digital pressure on trigger points, decontracting massage therapy, stretching and cryotherapy (application of ice). Regarding its invasive treatment, dry needling is postulated as one of the most effective techniques in the approach of myofascial pain syndrome.
There are also other invasive physiotherapy techniques such as intratissue percutaneous electrolysis, neuromodulation, which help the physiotherapist in Dwarka in dealing with pain.
The benefits of invasive techniques is that, although they are more aggressive, they help speed up recovery periods.
It consists of the percutaneous application of acupuncture needles to the myofascial trigger point area with the aim of breaking the adhesions of the nodule.
It is a very effective technique since after 24-48 hours the pain has disappeared and the muscle has managed to relax, recovering its normal state.
Is dry needling the same as acupuncture?
Due to their similarities in the therapeutic approach, many patients confuse acupuncture with dry needling, since both are performed with needles.
The main difference between the two is the mechanism of action: As we have mentioned before, dry needling seeks to break the muscle contraction mechanism that is generating the pain. However, acupuncture is based on the principles of traditional Chinese medicine and seeks to release and normalize the energy flow of the body through the energy meridians.
If you report muscle pain, it is best to see a qualified physiotherapist in Delhi for evaluation. In order for a physiotherapist in Dwarka to perform the dry needling technique, they must be trained and accredited to perform this invasive technique.