DCs may benefit from using instruments when administering trigger point therapy

Trigger point therapy has long been used by acupuncturists, massage therapists, and physical therapists, as well as doctors of chiropractic. Trigger points are hard knots of muscle usually located in the upper trapezius and often in deep tissue. Some professionals have noted a pattern of referred pain due to trigger points.

Trigger point therapy can be administered in a number of ways. Physicians may perform dry needling, which is what conventional healthcare providers call acupuncture. Physical therapists may perform myofascial release techniques to treat trigger points, and massage therapists and chiropractors most often use manual pressure to relieve trigger point pain.

As with several other types of treatments, using instruments to help treat patients with trigger points can be physically easier for DCs than using manual techniques. Applying ischemic pressure can be physically demanding and actually cause pain for the clinician. Using instruments to provide the treatment means that DCs are less likely to need such therapy themselves.

A DC may use instruments to treat trigger point pain in a couple of different ways. An instrument may be used to actually administer the therapy. Instruments are precise and often better for reaching the deep tissue where trigger points are generally located. Since the instrument does the work of applying pressure, the DC avoids the possible pain and stress that can come with performing manual trigger point therapy.

A second way of using instruments in the treatment of trigger point pain is to use them to measure range of motion. Before and after measurements can reveal how effectively the treatments are working. Patients may appreciate the data; and practitioners can make changes to the treatment plan as necessary.

In 2011, a group of researchers investigated whether there was any difference in patient outcome when three different methods of trigger point therapy were used.
Participants were divided into four groups: a control group, a group that received manual ischemic compression, one that was treated with the pin and stretch technique, and one that received therapy using a spring loaded instrument.

The researchers used elastography, an ultrasound technology that measures tissue density, along with doppler blood flow and patients’ subjective reporting to measure the results. They concluded that there was no measurable difference in the outcomes of the four types of treatment but that due to a small sample size, more study is warranted.

References

National Association of Myofascial Trigger Point Therapists. “Myofascial Trigger Point Therapy.” myofascialtherapy.org. http://www.myofascialtherapy.org/myofascialtherapy/ index.html. Updated 2014. Accessed November 2014.

Dischler D, Glazer D, Hansmeier L, Morris J, Rahden L. “A Diagnostic Approach to Asses the Effects of Several Soft Tissue Treatments on Myofascial Trigger Points in the Upper Trapezius Using Diagnostic Ultrasound.” Logan University. http://www.logan.edu/mm/files/lrc/seniorresearch/ 2011dec16. pdf. Published November 2011. Accessed November 2014.