title: Needling therapy for myofascial pain: recommended technique with multiple rapid needle insertion.
abstract: Myofascial trigger point (MTrP) is a major cause of muscle pain, characterized with a hyperirritable spot due to accumulation of sensitized nociceptors in skeletal muscle fibers. Many needling therapy techniques for MTrP inactivation exist. Based on prior human and animal studies, multiple insertions can almost completely eliminate the MTrP pain forthwith. It is an attempt to stimulate many sensitive loci (nociceptors) in the MTrP region to induce sharp pain, referred pain or local twitch response. Suggested mechanisms of needling analgesia include effects related to immune, hormonal or nervous system. Compared to slow-acting biochemical effects involving immune or hormonal system, neurological effects can act faster to provide immediate and complete pain relief. Most likely mechanism of multiple needle insertion therapy for MTrP inactivation is to encounter sensitive nociceptors with the high-pressure stimulation of a sharp needle tip to activate a descending pain inhibitory system. This technique is strongly recommended for myofasical pain therapy in order to resume patient's normal life rapidly, thus saving medical and social resources.
authors.affiliation: Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan ; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Chou
authors.affiliation: Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan.
authors.forename: Yueh-Ling
authors.initials: YL
authors.lastname: Hsieh
authors.affiliation: Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Taichung, Taiwan.
authors.forename: Ta-Shen
authors.initials: TS
authors.lastname: Kuan
authors.affiliation: Department of Physical Therapy, Hung Kuang University, 34, Chung-Chie Road, Sha Lu, Taichung, Taiwan.
authors.forename: Chang-Zern
authors.initials: CZ
authors.lastname: Hong
keywords: Acupuncture; Analgesia; Mechanism; Myofascial trigger point; Needling