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Trigger Point Needling: Techniques and Outcome

  • Myofascial Pain (RD Gerwin, Section editor)
  • Published:
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Abstract

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.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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No potential conflicts of interest relevant to this article were reported.

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Authors and Affiliations

  1. Institute of Pain Medicine, Rambam Health Care Campus and Rappaport School of Medicine, Technion, Spencer Building, 6 Ephron Street, Haifa, 31096, Israel

    Simon Vulfsons

  2. Pain Rehabilitation Unit, Loewenstein Rehabilitation Hospital (affiliated with Tel Aviv University), Ra’anana, Israel

    Motti Ratmansky

  3. Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Leonid Kalichman

Authors
  1. Simon Vulfsons
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  2. Motti Ratmansky
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  3. Leonid Kalichman
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Correspondence to Simon Vulfsons.

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Vulfsons, S., Ratmansky, M. & Kalichman, L. Trigger Point Needling: Techniques and Outcome. Curr Pain Headache Rep 16, 407–412 (2012). https://doi.org/10.1007/s11916-012-0279-6

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  • DOI: https://doi.org/10.1007/s11916-012-0279-6

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