Current Pain and Headache Reports

, Volume 16, Issue 5, pp 407–412

Trigger Point Needling: Techniques and Outcome

  • Simon Vulfsons
  • Motti Ratmansky
  • Leonid Kalichman
Myofascial Pain (RD Gerwin, Section editor)

DOI: 10.1007/s11916-012-0279-6

Cite this article as:
Vulfsons, S., Ratmansky, M. & Kalichman, L. Curr Pain Headache Rep (2012) 16: 407. doi:10.1007/s11916-012-0279-6


In this review we provide the updates on last years’ advancements in basic science, imaging methods, efficacy, and safety of dry needling of myofascial trigger points (MTrPs). The latest studies confirmed that dry needling is an effective and safe method for the treatment of MTrPs when provided by adequately trained physicians or physical therapists. Recent basic studies have confirmed that at the site of an active MTrP there are elevated levels of inflammatory mediators, known to be associated with persistent pain states and myofascial tenderness and that this local milieu changes with the occurrence of local twitch response. Two new modalities, sonoelastography and magnetic resonance elastography, were recently introduced allowing noninvasive imaging of MTrPs. MTrP dry needling, at least partially, involves supraspinal pain control via midbrain periaqueductal gray matter activation. A recent study demonstrated that distal muscle needling reduces proximal pain by means of the diffuse noxious inhibitory control. Therefore, in a patient too sensitive to be needled in the area of the primary pain source, the treatment can be initiated with distal needling.


Myofascial pain Myofascial trigger points Dry needling Treatment Musculoskeletal pain Trigger point injections 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Simon Vulfsons
    • 1
  • Motti Ratmansky
    • 2
  • Leonid Kalichman
    • 3
  1. 1.Institute of Pain Medicine, Rambam Health Care Campus and Rappaport School of MedicineHaifaIsrael
  2. 2.Pain Rehabilitation Unit, Loewenstein Rehabilitation Hospital (affiliated with Tel Aviv University)Ra’ananaIsrael
  3. 3.Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health SciencesBen-Gurion University of the NegevBeer ShevaIsrael

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