What is it? Myofascial Trigger Points are very tender, hyperirritable muscle fibers (often described as “muscle knots”) that cause a wide variety of symptoms.
How do they occur? Trigger Points can develop “out of nowhere” in three basic ways:
Sudden onset, no injury (“acute”): During a routine activity such as walking, gardening, housekeeping you develop sudden pain (tightness, stiffness)in a body part (hip, thigh, shoulder…)
Delayed onset (“subacute”): After a routine activity (you may have overdone it a bit) or a new activity (yardwork, hiking, exercising, playing a sport).
Post-injury: in the weeks or months after an injury, you develop persistent pain, stiffness, instability, weakness and/or a number of other symptoms that may be “hard to describe”. You may have been told you have “scar tissue” or made to feel it is all “in your head” because all your diagnostic tests and “unremarkable” or normal. Myofascial trigger points can develop for any number of reasons. Common causes include: overuse or repetitive strain, acute injury or trauma, poor posture, suboptimal body mechanics / malalignment, stress or muscle tension, prolonged immobilization, inactivity, underlying structural abnormalities (osteoarthritis, tendon disorder, nerve entrapments etc).
What are the symptoms? Pain, stiffness, and tightness are perhaps the most common symptoms. Other symptoms include weakness, stiffness, heaviness, numbness, tingling, burning, itching, instability, the subjective sense that your affected body part is swollen (even though it may not look swollen). Patients often say “the pain moves around” or “it’s hard to describe” – which suggests that a trigger point is a factor.
How is it diagnosed? A detailed history and physical exam, with an emphasis on palpation – touching and applying pressure with fingers to detect areas of tenderness, tightness, and restriction). Imaging studies such as radiographs (X-rays), ultrasound, and MRI may be obtained to rule out other causes… Importantly, Trigger Points often mimic traditional orthopedic diagnoses such as “tendinitis”, “bursitis”, and “arthritis”. As a result, they are often overlooked – even by specialist physicians.
What standard treatments are available? Manual therapies (deep tissue massage, cupping), Dry Needling, and shockwave (none of which are covered by insurance); Trigger Point Injections (typically covered by insurance)
What advanced, non-surgical treatments are available? Therapeutic Needling is the term Dr. Mahooti coined to describe a minimally invasive procedural technique he developed that is like Dry Needling, but better. Therapeutic Needling is a low risk procedural technique that integrates principles from Trigger Point Injections, Dry Needling, and acupuncture. He has performed upwards of 20,000 procedures, teaches the technique to physicians at numerous regional and national medical conferences, and is founder of the Therapeutic Needling Institute.
When should I schedule a consultation with Dr. Mahooti? If you have any of the above symptoms that are persistent, have not responded to stretching, massage and other traditional orthopedic treatments (anti-inflammatories, physical therapy, cortisone injections, and activity modification)
