Fallacies & Hype of Trigger Points & Dry Needling: Jewels Hidden in Trashes

“Trigger points cause myofascial pain” is a tenet in today's musculoskeletal medicine world, despite the never-ending controversies over its clinical value or even its legitimate existence (Quintner, JL, 2015).

Fallacies

In the past 80 years since the term "trigger point" (TrP) was coined in 1983 (Travell JG et al, 1983), perhaps millions & millions of human muscles have been palpated, rubbed, kneaded, stretched, relaxed, strengthened, and /or mobilized ... we have not reached any consensus yet on what constitutes a trigger point (Shah JP, 2015).

At the same time, numerous trials in the last half century demonstrated that precisely locating TrPs is utterly unnecessary when using dry needling for pain relief, because pricking with a needle anywhere on the body produces the same level of effect (Qaintner JL, 2015).

Hype & B.S.

Paul Ingraham is a skeptic science writer from Canada, a former Registered Massage Therapist and the assistant editor of ScienceBasedMedicine.org. Based on extensive scientific evidences, he talked about the fallacies surrounding trigger point therapy:

• There’s a lot of hype and B.S. about trigger points, and way too many professionals now believe in them like religion, and sell treatments with the delusional overconfidence of psychics and astrologers.

• Intense trigger point therapy—painfully strong massage and dry needling—is overprescribed and risky. Evidence for the efficacy of dry needling is too weak to justify the risks in most cases.

Jewels

Outside the TrP echo chamber, there are jewels. For example, the “off-switches” on the body identified by Ryan Whelton, an American physical therapist, who can quickly and reliably relieve pain by his hand: you just need to flip on the switch. I watched a few videos on his website. The outcomes of his "off-switches" for pain is amazing.

Whelton found that “Every millimeter of the body has direct connections to other areas of the body. ...When these connections are acheived in an effort to affect an injury or painful area on another part of the body the results are often remarkable".

According to Whelton, performing his manual technique, most clinicians “report 80%-90% of their patients they can instantly relieve pain and achieve full range of motion or close to it”.

Wheltons' finding of off-switch for pain flatly nullified the 80 years old TrP theory.

A Magic Bullet Medicine Buried in The Dust

While both patients and clinicians today are suffering from or struggling with a meagerly effective musculoskeletel medicine, few clinicians or patients, if any, are aware that pain treatment was just a piece of cake for ancient Chinese doctors 2000 years ago. For example, they could shut down a 10 years old neck pain just in 5 seconds with 90% of certainty.

For patients in modern times today, this is an unbelievable magic. Wait a moment. Actually such magic occurred 2000 years ago not just with neck issues, but actually with almost any health conditions (not limited to pain) at any body parts.

The magic intervention ancient Chinese doctors used to treat diseases was needle therapy (not the acupuncture or the dry needling used today). I call it Neijing acupuncture.

Unfortunately, Neijing acupuncture, the most brilliant jewels of wisdom that ever existed in the history of medicine, all of a sudden became a “forgotten item” at a turning point in history.

Fortunately, the jewels did not disappear. They are still there today at this moment just being deeply buried in the dust from the last 2000 years.

Searching Needles from Haystacks

The purpose of my Newsletter – Truth of acupuncture science, is to dig out the jewels from the dust, particularly to clarify their value which is beyond our imagination, and why they ended up being ignored, forgotten and discarded.

This is not an easy job. It is like to search the needles from numerous haystacks (literature) piled up in the last 2000 years. Even the jewels are dug out, few people today would be ready to understand why those unearthed tiny antiques could have the power like a magic bullet.

This is largely because we all have been deeply hardened to the meager effectiveness of the modern medicine. Any thing obviously superior to meagerness can be a big surprise. For example, in modern exercise therapy, after weeks even months of treatment, a patient with low back pain could not get 5% better than placebo effect. How come a poking of a few needles or a few toothpicks could induce at least 40% pain relief in 5 seconds?

Plus, in this digital information flooded era, we all know what snake oil means in the medicine world. We do not want to be too gullible. But some times we may become blindly or stupidly skeptical. So those unearthed antiques can even be viewed by some as snake oil.

Nevertheless, I am just continuing to dig as much as I could. Curiosity and knowing I know too little are 2 propellers are pushing me from behind.

Identify “Hidden” Jewels from “Hype & B.S.”

In the last few years, I have made some findings which may be helpful to the readers who are curious to know the truths “hidden” in the “Hype & B.S.” surrounding TrPs and Dry Needling.

Knowing these truths can assist us to turn the “Hype & B.S.” into a genuine medical magic bullet. I listed some findings as below.

• The Birth & Growth of Dry Needling: The Development of An Apple on An Apple Tree. Read
• Trigger Point Stupidity in Dry Needling for Neck Pain. Read.
• “Off Switches” for Pain Discovered by A Physical Therapist. Read.
• A Chiropractor's Magic Off-Switches for Pain: When Trigger Point Echo Chamber Smashed Open. Read.
• Dry Needling For Pain: A Blindfold Game. How to Turn It into A Magic Bullet? Read.
• The Clinical Value of Trigger Points: Every Clinician Has A Chance to Hit A Lottery. Read.
• Fooled Myself with Bibles: Trigger Point Massage & A Therapist's Confession. Read
• Dry Needling for Headache: Transform It into A Magic Bullet. Read.
• 80 Years in Search of Trigger Points: 19 Opinions for Diagnosis, Which Is Right? Read.
• Rhomboid Pain: Are Trigger Points Necessary for A Cure? Read.
• Acid Reflux Pain: Are Trigger Points Necessary for Treatment? Read
• Pelvic Floor Dry Needling & Therapists' No. 1 Headache. Read.
• A Pet Theory in TrP Dry Needling: Local Twitch Response (LTR) under Scientific Tests. Read.
• Headache & Trigger Points: Chicken or Egg, Which Comes First? Read.

Final Words

• “A hallmark of wisdom is knowing when it’s time to abandon some of your most treasured tools – and some of the most cherished parts of your identity.” – Adam Grant, organisational psychologist at Wharton
• “Science is the belief in the ignorance of experts…The experts who are leading you may be wrong…” – Richard Feynman, Quantum Physicist

References

Quintner, JL et al, A critical evaluation of the trigger point phenomenon. Rheumatology 2015, 54, 392–399.

Paul Ingraham, Sep 2, 2023 , Trigger Point Doubts. https://www.painscience.com/articles/trigger-point-doubts.php

Shah JP et al. Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM R. 2015 Jul;7(7):746-761.

Travell, JG et al, Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, MD: Williams & Wilkins, 1983.

Whelton Ryan, Whelton Myofascial Referral Technique. https://wheltonmethods.com/

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