Myofascial Pain Syndromes Clinical Trial
Official title:
Comparative Study, Between Dry Needling Techniques, in the Evolution of Myofascial Pain Shoulder in Athletes. Elastography as Indicator in the Repair of Myofascial Tissue, Post-dry Needling.
This study evaluates the deep dry needling technique as a percutaneous technique included in
the professional field of physiotherapy.
The project quantifies a significant limit on the number of local twitch responses necessary
for the favorable treatment of myofascial pain and analyzes the injury degree and/or the
repair of myofascial tissue, with "Elastography".
The myofascial shoulder pain caused by myofascial trigger points, is one of the main causes
of medical consultation and functional disability in the general population and particularly
in the amateur athlete.
Nowadays, many physiotherapists all over the world, study and practice the dry needling as a
therapeutic tool for the treatment of myofascial trigger points. The most used modality is
the technique described by Hong:
- This technique introduces an acupuncture needle in the skin until reaching the
dysfunctional muscle fiber. To do so, it uses maneuvers "fast in" and "fast out" of
needle, until the extinction of local twitch responses or the tolerance of the patient.
- The local twitch response is defined as a reflex and transitory contraction of a group
of muscle fibers associated with a myofascial trigger points.
- The technique eliminates muscle contractile activity by mechanical interruption of their
muscle fibers, mechanism which finishes with the sensitization of nearby nerves and with
the start of the nociceptive modulation peripheral, segmental and central.
The dry needling technique, in its eagerness to obtain local twitch responses, pierces the
muscle fibers both dysfunctional and normal, the fascial tissue that wraps the myofascial
trigger points and also neuro-vascular structures. That is, the treatment of myofascial
trigger points with dry needling, makes reference to a mechanical trauma done with a
acupuncture needle.
The myofascial tissue injured can suffer repair or regeneration, which is mainly due to the
extension of the lesion. The process of healing of a wound is strictly regulated by multiple
growth factors and cytokines, which are released into the wound. The alterations that disturb
the healing process, can lead to chronic wounds that do not heal or to an excessive fibrosis.
The pathobiological processes, in form of fibrosis, would present changes in stiffness and
elasticity of the neo-tissue. The quantitative elastography, is shown as an effective tool to
measure the amount of fibrosis, occasioned by repeated percussion of the acupuncture needle
on the myofascial tissue.
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