Raising the Bar for Pain Relief

Intramuscular Trigger Point Release for Pain Management and Relief

What is intramuscular trigger point release?

Intramuscular trigger point release is an invasive procedure in which a solid filament  needle is inserted into the skin and muscle directly 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.

Is intramuscular trigger point release similar to acupuncture?

There are many similarities and differences between intramuscular trigger point release and acupuncture, but intramuscular trigger point release is NOT acupuncture. Licensed physical therapists in a growing number of states can use trigger point release under the scope of their practice to alleviate musculoskeletal pain. Practitioners at WFR are not licensed acupuncturists and do not practice acupuncture. In contrast to most schools of acupuncture, intramuscular trigger point release Is strictly based on Western medicine principles and research.


How does intramuscular trigger point release work?

The exact mechanisms of intramuscular trigger point release are not known. There are 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 so-called local twitch responses,  which are spinal cord reflexes.  Getting local twitch responses with intramuscular trigger point release is the first step in breaking the pain cycle.

What type of problems can be treated with intramuscular trigger point release?

Intramuscular trigger point release can be used for a variety of musculoskeletal problems.  Muscles are thought to be a primary contributing factor to symptoms.  Such conditions include, but are not limited to neck, shoulder, back, pelvis, pelvic floor, buttocks and leg pain, as well as headaches (migraines and tension-type headaches) and fibromyalgia.  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 disposable needles.

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 a few hours up to 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.  Recommendations may include applying heat or ice over the area, gentle stretches and modification of activities.


How long does it take for the procedure to work?

Typically, it takes 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 intramuscular trigger point release?

In the US, intramuscular trigger point release 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 upon all of us to educate others about new and innovative ways to treat pain.

How does intramuscular trigger point release fit into MY rehabilitation program?

Generally speaking, intramuscular trigger point release is the modality of choice when it comes to treating patients in the clinic.  More frequently, intramuscular trigger point release is needed in the beginning in order to break the pain cycle.  Once that is achieved, other treatment options are introduced.

Once I am feeling better, how often do I need to come back to maintain my progress?

The musculoskeletal system is under constant pressure from gravity, stress, work, etc.  A regular exercise program combined with good posture can prevent many problems.  If the pain comes back, “tune-ups” are recommended to treat and prevent injuries.