Myofascial Trigger Point Therapy IMTT

 
  Gautschi R. Manual Trigger Point Therapy. Recognizing, Understanding and Treating Myofascial Pain and Dysfunction.
712 pp. / 1178 illus. / Forewords by Prof. S. Mense and Dr. J. Dommerholt
Thieme 2019
ISBN: 978-3-13-220291-7 

This book includes complimentary access to a digital copy on https://medone.thieme.com .
 
 
      Myofascial Pain and Dysfunction
 
Much of the acute and chronic pain in the musculoskeletal system originates in the muscles, where it is caused by myofascial trigger points (mTrPs) and associated fascia disorders (Travell and Simons 1999; Dejung 2009)

MTrPs develop from overload or traumatic overstretching of themuscles, often leading to the formation of oxygen-poor zones in the muscle (hypoxia). Hypoxia results in a lack of adenosine triphosphate, and because of this themyosin and actin filaments in these areas are unable to separate from each other (rigor complexes), causing local reactive soft-tissue changes (contractions, adhesions). These small sites of affected muscle tissue can be palpated as mTrPs. Provocation by pressure triggers pain, which often irradiates to other regions of the body (referred pain).
MTrPs can cause not only pain but also paresthesias, muscle weakness without primary atrophy, restricted range of motion, proprioceptive disturbances with impairment of coordination, and vegetative reactions.

“Myofascial syndrome” is a term used to describe the sum of all symptoms caused by active mTrPs and associated fascia disorders

From experience, targeted trigger point therapy can usually eliminate these problems, even in the case of long-standing symptoms.

Myofascial Pain
a new paradigm
in the field of pain medicine


     Myofascial Trigger Point Therapy

Manual trigger point therapy is a systematic,manualtherapeutic interventional strategy with the goal of deactivating the potential of the mTrPs to cause disturbances, treating the accompanying connective tissue changes and preventing recurrences.

The form of trigger point therapy IMTT involves a systematic six-step program (Swiss approach). This program utilizes
four manual therapy techniques (techniques I–IV) to selectively deactivate the trigger points, and, especially in chronic pain patients, to stretch the reactively modified and shortened connective tissue. Home exercises for stretching/relaxing (technique V) break up the monotony ofworking postures and encourage the muscles to regenerate. Functional training (technique VI)
supports the healing process through appropriate weight-bearing exercises and movements, which make the muscles more resilient while better ergonomics reduce failure load.

In addition to local therapy of the mTrPs and the fascia disturbances, one must also identify the perpetuating factors and include them in the therapy in order to attain sustainable success in the treatment of chronic myofascial pain.
Manual trigger point therapy in the form described here is a differentiated method and is performed by specially trained
physical therapists and physicians.

Manual trigger point therapy combines mechanical, reflex, biochemical, energetic, functional, cognitive–emotional, and behaviorally effective phenomena (Gautschi 2008). Manual trigger point therapy thus influences not only the peripheral nociceptive pain but also, at the same time, intervenes in the body’s pain processing and output mechanisms.

The effectiveness of the treatment is complemented by the use of acupuncture needles to treat the trigger points ("dry needling").

 
      Dry Needling
 
"Dry Needling" is the treatment of myofascial trigger points using acupunctur needles.
 

Trigger points and fascia disorders
a (too) often unrecognized cause of
acute and chronic pain


 

 

 


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