The Pairing of Trigger Point Dry Needling with Rehabilitation Techniques

Trigger point dry needling is a manual treatment modality used for individuals experiencing tightness, pain, and inhibited range of motion in any region of the body. Dry needling can be described as the insertion of a blunt, microfilament non-medicated needle into the skin for the purpose of targeting specific muscles, which contain tight bands known as trigger points. When the needle is inserted into the trigger point the muscle contracts, holds tight to the needle, and elicits a neural twitch response. This ultimately causes the muscle to relax, allowing for reduction in pain and improvements in range of motion. Although the use of dry needling is rising in popularity in the United States, knowledge of its use and effects is limited. Fortunately, more research is being conducted on this form of treatment. In this thesis, the purpose and physiological effects of dry needling will be discussed in detail, along with a comparison between other alternate medical modalities of treatment which target trigger points. In addition, current research on the effectiveness of incorporating dry needling with other manual therapeutic modalities will be discussed. Dry needling has been shown to be very effective in treating trigger points by improving range of motion, decreasing pain, reducing muscle tightness, and increasing muscle oxygenation. Positive effects of dry needling are even more likely to occur when paired with other modes of therapeutic treatment, often in a physical therapy setting but may also be performed by other health professionals including chiropractors, athletic trainers, occupational therapists, and physicians

HUBUNGAN MYOFASCIAL TRIGGER POINTS (MTRPS) PAIN TERHADAP KARAKTERISTIK PASIEN NYERI PUNGGUNG BAWAH (NPB) KRONIK DI POLI SARAF RSUD DR. ZAINOEL ABISIN BANDA ACEH

ABSTRAKLatar Belakang: Nyeri punggung bawah merupakan nyeri yang dirasakan di daerah punggung bawah, lumbosakral dan dapat menjalar hingga ke tungkai bawah. Nyeri punggung bawah merupakan penyumbang terbesar kecacatan global dan penyebab utama disabilitas. Etiologi nyeri punggung bawah dapat disebabkan oleh beberapa faktor dan dapat disertai dengan timbulnya nyeri akibat adanya stimulasi pada Myofascial Trigger Points (MTrPs), yaitu spot kecil yang hiperiritasi dan terletak memusat yang timbul di dalam taut band otot skeletal yang mengalami cedera atau beban kerja yang berlebihan. Tujuan penelitian ini adalah untuk mengetahui hubungan antara Myofascial Trigger Points (MTrPs) Pain terhadap Karakteristik Pasien Nyeri Punggung Bawah Kronik.Metode: Jenis penelitian ini adalah analitik observasional dengan desain penelitian cross sectional. Pengambilan data dilakukan pada bulan September sampai dengan bulan November 2016. Pengambilan sampel dilakukan dengan teknik consecutive sampling sebanyak 76 orang. Data dikumpulkan melalui anamnesis dan pemeriksaan fisik serta wawancara dengan menggunakan Numeric Rating Scale (NRS). Data kemudian dianalisis menggunakan uji Chi-Square.Hasil: MTrPs positif pada 61 orang dengan MTrPs M. quadratus lumborum pada 47 orang, M. gluteus medius pada 42 orang, M. iliopsoas pada 16 orang, M. rektus abdominis pada 9 orang, M. gluteus maksimus pada 49 orang, M. gluteus minimus pada 43 orang dan M. piriformis pada 46 orang. Jumlah MTrPs terbanyak adalah 5 MTrPs aktif yaitu sebanyak 20 orang, nyeri alih terdapat pada 59 orang pasien.Kesimpulan: Terdapat hubungan antara Myofascial Trigger Points (MTrPs) pain dengan karakteristik pasien yaitu pekerjaan, intensitas nyeri, dan nyeri alih yang dialami oleh pasien.Kata Kunci: Nyeri punggung bawah, Trigger Point, Myofascial Trigger Points, Myofascial Trigger Points (MTrPs) pain, MTrPs.ABSTRACTBackground: Low Back Pain is pain that is felt in the lower region, lumbosacral and can spread to the lower limbs. Low Back Pain is the disease which contribut to the major impact on public health and causes global disability. Low back pain can be caused by different etiology, in some cases, low back pain may be associated with the onset of pain as a result of the stimulation on Myofascial Trigger Points (MTrPs). MTrPs defined as hypersensitive small spots within taut band of skeletal muscle which suffer from injury or excessive workloads. The purpose of this study is to determine the association between Myofascial Trigger Points (MTrPs) Pain with patients characteristics.Methods: This study was observational analytic study with cross sectional study design. Data were collected from September until November 2016. The sampling using consecutive sampling technique as much as 76 people. Data were collected through anamnesis and physical examination as well as interview with Numeric Rating Scale (NRS) and then data were analyzed with Chi square test.Results: Active Myofascial Trigger Points (MTrPs) were found in 61 patients, quadratus lumborum muscle in 47 people, gluteus medius in 42 people,. Iliopsoas muscle in 16 people, rectus abdominis muscle in 9 people ,gluteus maximus in 49 people, gluteus minimus in 43 people and piriformis muscle in 46 people. Highest number of active MTrPs was 5 actives MTrPs in 20 people, referred pain from MTrPs in 59 people.Conclusion: There was association between Myofascial Trigger Points (MTrPs) Pain with patients characteristics, epidemiology characteristic is patients jobs, and clinical characteristics are pain score and referred pain from MTrPs.Keywords: Low Back Pain, Trigger Point, Myofascial Trigger Points, Myofascial Trigger Points (MTrPs) pain, MTrPs

Pengaruh Penambahan Core Stability Exercise Pada Muscle Energy Technique Terhadap Penurunan Nyeri Myofacial Trigger Point Upper Trapezius Pada Pembatik PT Danar Hadi

Background: Myofascial Trigger Point Syndrome (MTPS) is one of the conditions causing pain originated from nerves, bones and joints. MTPS itself is a syndrome arises due to the affectivity of one or more trigger points in the muscle fibers. Provision of therapeutic modalities for myofacial trigger points in the upper trapezius is muscle energy technique combined with core stability exercise and single application of muscle energy technique. Objective: This study aimed to determine the effectiveness of the administration of muscle energy technique combined with core stability exercise and single application of muscle energy technique. Methods: Quasi eksprimental with two grop pre and pst test design. The population in this study is written in PT Batik batik Dana Hadi, the total respondents 30 people, with details of the first group 15 and the second group of 15 people. Measurements carried out with VAS pain score, the results were analyzed using Paired Sample T-test and test independent sample t-test. Result: Paired Sample T-test in both groups showed p = 0.000 <0.05, which means there is the influence of muscle energy technique therapy with the addition of core stability exercise and only using muscle energy technique to decrease pain myofacial upper trapezius trigger point. Based on the average value group of muscle energy technique with the addition of core stability have an average exercise greater influence than just using muscle energy technique (7.4800> 5.7933) test results Independet Sample T-test on clogs I shows the results of p > 0.05 (63.390> 2.145 and 0.000> 0.05) and in group II, p> 0.05 (59.226> 2.048 and 0.000 <0.05), which means there is a significant difference between the two groups .. conclusion: the use of muscle energy technique with the addition of core stability exercise is better than just using muscle enegy myiofacial technique in reducing pain upper trapezius trigger point. Keywords: muscle energy technique, core stability exercise, myofacial upper trapezius trigger point

Perbedaan Contract Relax Streching Dan Myofacial Release Technique Pada Nyeri Trigger Point Syndrome Otot Upper Trapezius

Introduction: Myofascial Trigger Point Syndrome (MTPS) is one of the conditions that can bring in addition to causing pain originating from nerves, bones and joints. MTPS itself is a syndrome that arise due to teraktifasinya one or more trigger points in the muscle fibers. Provision of therapeutic modalities for myofacial upper trapezius trigger point in select that contract relax stretching and myofascial release technique. Purposes: This study aimed to determine differences in contract relax stretching and myofascial release technique, trigger point pain syndrome in the upper trapezius muscle. Methods: This study used a quasi exsperimental design, with the approach of pre-test and post-test two design groups. The population in this study are employees of sub-district Puskesmas Panjalu Ciamis who have diagnosed with myofacial upper trapezius trigger point, the total respondents as many as 10 people, with as many details of group I and group II 5 by 5 people. Testing is done by using the value of the pain VAS. Results were analyzed using the Wilcoxon test and Mann Whitney test. Results: Statistical test using the Wilcoxon test for hypothesis 1 and 2. The Mann Whitney test for hypothesis 3. On the hypothesis 1 and 2 obtained p value: 0.043 or p <0.05 so there is the effect of Contract Relax Stretching and Myofascial Release Technique on reducing myofascial trigger point pain upper trapezius muscle. In the third hypothesis, the value of p: 0.000 or p <0.05 which means there is a significant difference Contract Award Relax Stretching and Myofascial Release Technique to myofascial trigger point pain reduction upper trapezius muscle.Conclusion: The use of Myofascial Release Technique is better than using the Contract Relax Stretching in reducing pain myiofacial upper trapezius muscle trigger points. Keywords: Contract Relax Stretching, Myofascial Release Technique, myofacial upper trapezius muscle trigger point

Análise da eficácia de duas técnicas de dry needling em trigger points miofasciais latentes do trapézio superior no padrão de ativação eletromiográfico e na dor

Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaIntrodução: Os trigger points miofasciais são caracterizados como pontos locais hipersensíveis que normalmente formam uma banda tensa palpável dentro das fibras musculares esqueléticas, podendo ser de 2 tipos: ativos ou latentes. Uma das formas descritas de tratamento é a técnica de dry needling. Objetivo: Analisar os efeitos de duas técnicas de dry needling (com e sem manipulação) no padrão de ativação eletromiográfico e na dor do trigger point latente do músculo trapézio superior, comparativamente a uma técnica de impostura ou placebo. Metodologia: Participaram no estudo 26 indivíduos, tendo sido distribuídos de forma aleatória em 3 grupos de tratamento: placebo, puntura simples e técnica de dry needling com manipulação. Todos os grupos foram submetidos a avaliação da dor e do padrão de activação electromiográfico antes e após a técnica de puntura, assim como 24 horas após dor. Resultados: Não se obteve diferenças significativas em termos de dor e padrão eletromiográfico (sEMG) antes e após cada uma das técnicas de dry needling e 24h após. Conclusão: A aplicação da técnica de dry needling, com manipulação ou sem manipulação, em trigger points latentes não induziu alterações no limiar de dor e no padrão electromiográfico da amostra em estudo.Introduction: The myofascial trigger points are characterized as hypersensitive local spots that are usually formed within a palpable taut band of skeletal muscle fibers, and they may be described as active or latent. One of the described forms of treatment is the dry needling technique. Objective: To analyze the effect of two dry needling techniques (with and without manipulation) on upper trapezius muscle latent trigger points with comparison to a sham technique. Methods: 26 subjects took part in the study, who was randomly assigned to 3 different groups: sham or placebo, dry needling technique with and without manipulation. All the groups have been assessed for pain and electromyographic pattern before and after treatment and 24 hours later. Results: The present study did not find statistical differences in terms of pain and electromyographic pattern (sEMG) before and after each technique of dry needling and 24h later (pain). Conclusion: The dry needling application, with and without manipulation, did not induce changes on electromyographic pattern and pain threshold, on latent trigger points, in the sample under study.N/

Myofascial Trigger Points in Children With Tension-Type Headache: A New Diagnostic and Therapeutic Option

The goal of this pilot study was to evaluate the effect of a trigger point–specific physiotherapy on headache frequency, intensity, and duration in children with episodic or chronic tension-type headache. Patients were recruited from the special headache outpatient clinic. A total of 9 girls (mean age 13.1 years; range, 5-15 years) with the diagnosis of tension-type headache participated in the pilot study from May to September 2006 and received trigger point–specific physiotherapy twice a week by a trained physiotherapist. After an average number of 6.5 therapeutic sessions, the headache frequency had been reduced by 67.7%, intensity by 74.3%, and duration by 77.3%. No side effects were noted during the treatment. These preliminary findings suggest a role for active trigger points in children with tension-type headache. Trigger point–specific physiotherapy seems to be an effective therapy in these children. Further prospective and controlled studies in a larger cohort are warranted

Recognizing myofascial pelvic pain in the female patient with chronic pelvic pain.

Myofascial pelvic pain (MFPP) is a major component of chronic pelvic pain (CPP) and often is not properly identified by health care providers. The hallmark diagnostic indicator of MFPP is myofascial trigger points in the pelvic floor musculature that refer pain to adjacent sites. Effective treatments are available to reduce MFPP, including myofascial trigger point release, biofeedback, and electrical stimulation. An interdisciplinary team is essential for identifying and successfully treating MFPP

An investigation into the effects of compression therapy on latent Upper Fibres Of Trapezius trigger points on peripheral sympathetic nervous system activity In the upper limb.

To establish if Compression Therapy (CT) applied to latent trigger points causes a peripheral sympathetic nervous system (SNS) response To quantify the sympatho-excitation by measuring skin conductance in the hands To investigate if a manual therapy technique which specifically targets muscle tissue can elicit a SNS respons

The occurrence and inter-rater reliability of myofascial trigger points in the quadratus lumborum and gluteus medius: A prospective study in non-specific low back pain patients and controls in general practice

The presence of a trigger point is essential to the myofascial pain syndrome. This study centres on identifying clearer criteria for the presence of trigger points in the quadratus lumborum and gluteus medius muscle by investigating the occurrence and inter-rater reliability of trigger point symptoms. Using the symptoms and signs as described by Simons' 1990 definition and two other former sets of criteria, 61 non-specific low back pain patients and 63 controls were examined in general practice by 5 observers, working in pairs. From the two major criteria of Simons' 1990 definition only ‘localized tenderness’ has good discriminative ability and inter-rater reliability (kappa > 0.5). This study does not find proof for the clinical usefulness of ‘referred pain’, which has neither of these two abilities. The criteria ‘jump sign’ and ‘recognition’, on the condition that localized tenderness is present, also have good discriminative ability and inter-rater reliability. Trigger points defined by the criteria found eligible in this study allow significant distinction between non-specific low back pain patients and controls. This is not the case with trigger points defined by Simons' 1990 criteria. Concerning reliability there is also a significant difference between the two different criteria sets. This study suggests that the clinical usefulness of trigger points is increased when localized tenderness and the presence of either jump sign or patient's recognition of his pain complaint are used as criteria for the presence of trigger points in the M. quadratus lumborum and the M. gluteus medius