What is it? How is it Treated?
Myofascia is the connective tissue covering all of the muscles of the body. Myofascial pain is caused by the body’s response to injury or excessive strain. The injury or strain may be at a distant location and the overuse of the affected area is a compensatory mechanism.
Just as in our own bodies, an injury to a knee may elicit overuse of the muscles used to take weight off of the leg. This in turn may cause pain in the lower back and the muscles that are used to raise the leg. In our pets, this movement is called flexion.
We have muscles that will extend joints and opposing muscles that will flex the joint. When we have a pain in one of these muscles, the opposing muscle is often inhibited. This inhibition and weakness may be alleviated by treating the opposing muscles. Once the trigger points are treated, the inhibition and weakness is eliminated.
There are techniques to alleviate myofascial pain. These techniques are utilized along with eliminating the inciting cause of pain. Dr. Jan Dommerholt pioneered the dry needling technique building upon his training with Dr. Janet G. Travell, the White House physician to President John F. Kennedy. An acupuncture needle is inserted into the trigger point. This causes a mechanical release as well as a biochemical change to the trigger point. The muscle twitches alleviating the contraction and allowing blood and oxygen into the area to flush away the chemical mediators.
Dry needling is the process of treating these painful trigger points. The process involves inserting a very fine acupuncture needle into the contracted band of the muscle. This needle insertion is not painful but will elicit a local twitch response of the muscle. The elicitation of the twitch response gives immediate relief to the painful trigger point. In pets that are in a lot of pain, the physical exam and handling of the patient may be too painful. These patients are sometimes administered a mild sedative to allow treatment.
Although this procedure is often used by physicians and physical therapists to treat their patients, it is just taking hold in veterinary physical rehabilitation circles. Very few veterinarians in the country have had myofascial trigger point training. Dr. Zinderman has trained with Dr. Dommerholt and has assisted him in training other veterinarians.