Muscles make up the largest component of our body, comprising 40% of our body weight. The fascia, which is the collagen encompassing them, together with the muscles themselves are capable of generating severe pain which can be exhausting and even chronic. This contradicts the general belief that if someone suffers from muscle pain it will pass in a few days. Several cases of severe, chronic low back pain, neck pain and whiplash injuries, for example, emanate largely from muscular sources. Trigger points are thought to result from local ‘energy crises’ in which a vicious circle of physiological processes perpetuate this painful condition, and this can occur in any muscle in the body. The accepted teaching in medical schools is that any pain that radiates from the spine past the knee or down the arm to the wrist must arise from pressure on a spinal nerve root. However, there are muscles capable of radiating pain down the upper and lower limbs (see figure). Some muscles are capable of referring pain to the head causing a migraine-like headache as seen in the figure at the top of this chapter.
In most cases, the treatment is very simple- dry needling, otherwise known as western acupuncture. The secret to achieving good results rests in the methodical nature of the treatment treating all muscles of the functional unit. This treatment is more effective than trigger point injections whether the injectate is cortisone, local anaesthetic or even botox, because one can be more methodical without having to be concerned with overdosing. It is also important to verify the causes of the pain, ergonomic factors that perpetuate the pain and rule out other pathologies that may trigger the development of trigger points.
