At Myofascial Pain Treatment Center, our goal is to reduce or eliminate pain in the short and long term. We have respect for each person and work create a warm and caring environment. We strive to educate each patient so that they can make healthy changes and become as self sufficient as possible in their healing process.

There are three primary techniques that are used to treat myofascial pain. Some patients have the manual therapies and some choose to add the needling as well.

Manual myofascial trigger point therapy - This very effective hands-on technique involves using deep, held pressure to the trigger points. The goal is to release the contraction of the trigger point. Myofascial release  techniques and stretching are a part of treatment. When appropriate, patients are given stretches to do at home. If interested, patients are taught how to do self treatment.

Trigger Point  Needling - TP needling is a procedure in which a very thin solid filament needle is inserted into the skin and muscle directly aimed at a myofascial trigger point.  A myofascial trigger point consists of multiple contraction "knots", which are related to the production and maintenance of the pain cycle. A physician referral is required for the trigger point needling (form).

Spray and Stretch technique - This technique uses a vapo-coolant spray to help increase the muscles ability to stretch.

More information about needling:

Is trigger point needling similar to acupuncture? - There are  similarities and differences between trigger point needling and acupuncture. In contrast to most schools of acupuncture, trigger point needling is strictly based on Western medicine principles and scientific research.  Patients who have experienced both trigger point needling and acupuncture say that the technique, sensations and results are very different from each other.

Erika Waly Bourne, RN, CMTPT is not a licensed acupuncturist and does not practice acupuncture.  Depending on the state, trigger point needling is within the scope of practice of many medical professionals including physicians, nurses, nurse practitioners, physician assistants, acupuncturists, physical therapists, dentists and chiropractors. 

How does trigger point needling work? -  There are both mechanical and biochemical effects. Based on the pioneering studies by Dr. Jay Shah and colleagues at the National Institutes of Health, we know that inserting a needle into trigger points can cause favorable biochemical changes, which assist in reducing pain. It is essential to elicit a "local twitch response". Getting local twitch responses with needling is the first step in breaking the pain cycle.

What type of problems can be treated with trigger point needling?      TP needling can be used for a variety of musculoskeletal problems. Muscles are thought to be a primary contributing factor to the symptoms. Such conditions include, but are not limited to neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache  including migraines and tension-type headaches, jaw pain, buttock pain and leg pain (sciatica, hamstrings strains, calf tightness/spasms). The treatment of muscles has the greatest effect on reducing pain mechanisms in the nervous system.

Is the procedure painful? - Most patients do not feel the insertion of the needle. The local twitch response elicits a very brief (less than a second) painful response. Some patients describe this as a little electrical shock; others feel it more like a cramping sensation. Again, the therapeutic response occurs with the elicitation of local twitch responses and that is a good and desirable reaction.

Are the needles sterile? - Yes, we only use sterile, single use, disposable needles.
Can I needle myself as part of my home program? - No, trigger point needling requires extensive training and should never be tried at home.
What side effects can I expect after the treatment? - Most patients report being sore after the procedure. The soreness is described as muscle soreness over the area treated and into the areas of referred symptoms. Typically, the soreness lasts between a few hours and two days.

What should I do after having the procedure done? - Our recommendations vary depending on the amount of soreness you have and on the individual response to the treatment. Often patients feel tired. Recommendations may include applying heat or ice over the area, gentle stretches and modifications of activities. Gentle movement reduces the recovery period.

How long does it take for the procedure to work? - Typically, it takes between one and several visits for a positive reaction to take place. Again, we are trying to cause mechanical and biochemical changes without any pharmacological means. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.

Why is my doctor not familiar with trigger point needling? - In the US,  needling is a relatively new method for treating myofascial pain and not everyone is already aware of this effective modality. Feel free to inform your doctor about this treatment option. It is important for all of us to educate others about new and innovative ways to treat pain. Some doctors may be familiar with a similar technique called trigger point injection. This technique uses larger hypodermic needles and injects an anesthetic or other "wet" substance. TP needling has the advantage of using thinner, less invasive needles thereby allowing more areas to be treated in a session.

Once I am feeling better, how often do I need to come back to maintain my relief? - The musculoskeletal system is under constant pressure from gravity, stress, work etc. A regular, healthy, exercise program combined with good posture and good ergonomics can prevent the return of pain.

At Myofascial Pain Treatment Center, we believe that it is our job to "work ourselves out of a job".  We are always here for you but hope that you are pain free and not in need of ongoing treatment.