What follows is an attempt to further rationalise the use of an integrated mechanisms based needling approach in the treatment of myofascial pain related to the presence of trigger points.
I have provided a list of references which have influenced my understanding of the proposed neurophysiological mechanisms which may occur at the various levels. However some of the effects listed are based on clinical observation and discussion with colleagues.
The following mechanisms may apply when a myofascial trigger point is accurately located using the diagnostic criteria and then needled using:
- A local needling approach using electrostimulation
- A segmental approach in addition to or as an alternative to a local approach
- Enhanced central regulatory effects