samedi 17 décembre 2016

.. DRY NEEDLING N°1 Trigger Point-BMN

.. DRY NEEDLING N°1 Trigger Point-BMN                  
Dolor osteomuscular crónico -N°1- síndrome de dolor miofascial. PUNCIÓN SECA y la BMN.
Trigger point Dry Needling (or Intramuscular Manual Therapy. Trigger point needling Functional dry needling. Intramuscular stimulation). 

TP, TPs: Trigger Point, Trigger Points.
DN: Dry Needling
WN: Wet Needling
AP, APs: Acupuncture Point, Acupuncture Points.
Ac: Acupuncture.

The Trigger point_ TP, TRAVELL and SIMONS, is defined as a tender nodule, a knot inserted in a palpable taut band of a skeletal muscle. 
DN involves palpating the taut band within the affected muscle, isolating the tender nodule, and inserting an acupuncture needle directly into the TP to cause a muscle twitch, a reflexive relaxation and lengthening of the muscle.
This set of manipulations, deactivates the TP responsible for the musculoskeletal pain and impaired movement caused by trauma or disease but ignores the root cause as it is not a holistic treatment but this approach is evolving …

TPs, Acupuncture Points and Ashi Points 
Many TPs are confused with APs.
Dorsher & al., determined that of the 255 TPs, listed by Travell and Simons, 234 (92 percent) had anatomic correspondence with classical, miscellaneous, or new APs listed in Deadman & al.
·                     For Acupuncture
Outside the listed APs there are APs commonly termed ‘Ashi point’ that do not necessarily correspond with traditional point locations. 
Ashi points are specific tender spots, palpated in a pain area and painful when pressed, without name, randomly located and only selected in accordance with the syndromes or diseases.
Ashi points are often not technically APs or on specific meridians but have a clinical effect nonetheless.
They are treated and needled in Acupuncture according to a classically and globally approach.
·                     For Dry Needling 
In front of the same components, for the Therapist using TPs, this falls within his jurisdiction with exquisitely tender and hyperirritable spots, included in a taut band of a skeletal muscle, painful on deep palpation and originated of a referred pain and motor dysfunction in deep palpation. Inserting an acupuncture needle into the area, in concordance with the TPs treatment or DN, pain or sufferings are relieved after having reproduced the pain spontaneously felt.
‘ Either Acupuncture or DN, deepen palpation allows finding musculoskeletal tender points interpreted for millennia as Ashi points by the Acupuncturist and since 50 years as TPs by Professionals in DN’. 
Both are treated by insertion of acupuncture needles either compact or hollow with the possibility for the latter (the BMN) to associate Acupuncture and DN respectively with Mesopuncture and Wet Needling _WN.

The Distal Trigger Points 
Evolution of the DN treatment, as including distal TPs in DN, brings DN nearer to Acupuncture
Some authors recommend to research and treat the distal TPs, away from the primary TPs.  This recommendation involving, in the TPs treatment, the distal TPs is similar to the conventional diagnostic and therapeutic approach, performed in Acupuncture, since a lot of years, for research and treatment of local and remote APs.
·                     The facts 
About 75% of pain is caused by TPs. Over 74% of common TPs are located remote to the area where the patient feels pain.
·                     Therefore, in a Patient too sensitive to be needled in the area of the primary pain source, the treatment can be initiated with distal needling. A recent study demonstrated that distal points needling reduce proximal pain by means of the diffuse noxious inhibitory control.
·                     Distal TPs are listed in Pain guides available on the internet. Then they will be adapted to the particularism of each patient.

In summary
Insertion of a needle into a TP, confused with an AP, could be likened to Acupuncture. 
Injection of a liquid drug into a TP could be equated with Mesopuncture.
Research and involvement of remote TPs in the DN treatment is a classical approach in Acupuncture.   

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