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Travell and Simons describe 255 trigger points in their seminal work, while the most commonly accepted acupoints are 747, and so it has been possible to conduct comparison sudies and it is possible to deepen such study further in the daily practice of the massage therapist, chiropractor, osteopath or acupuncturist who has built a backgroud in both acupressure and trigger point therapy. Incidentally, the validity of acupunture appears undeniably confirmed from the above comparison.
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Dry needling is one of the most effective treatment options to inactivate myofascial trigger points. The 1999 edition of Travell and Simons Myofascial Pain and Dys- function: The Trigger Point Manual5 proposes an integrated hypothesis regarding the etiology.
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But then, the undeniable correspondence of these subsets of points is very interesting because the theoretical postulates of the two medical systems are fundamentally different. Simons, he published a quarterly myofascial literature review column for over 10 years. My own conclusion is that trigger points are a subset of the acupoints of Traditional Chinese Medicine both as far as number and as far as scope or therapeutic reach. 1981 Mar 62(3):114-7.), as well as according to subsequent studies, there is good correspondence with known acupoints in about 70% of the examined cases (see the excellent research ). Melzak titled Myofascial trigger points: relation to acupuncture and mechanisms of pain ( Arch Phys Med Rehabil. The scope of acupuncture is also broader that the scope of trigger point therapy and acupuncture aims at obtaining improvement and cure for conditions of any nature, not only for myofascial syndromes.īut in spite of these profound differences, the fact remains that according to several experts, many acupoints have a quite accurate correspondence to many classic trigger points. For this very reason, in Traditional Chinese Medicine those acupoints that generate pain constitute a particular subclass of acupoints that are overall called ah-shi points or tender points, where the Chinese word ah-shi literally means "oh yes", which is to say, "this is the right point."įinally, from a theoretical point of view, acupuncture is based on concepts such as Qi or Chi and Meridians, concepts, that is, which are foreign to the Western medical understanding within which the Trigger Point discipline has, after all, evolved. Moreover, while all trigger points produce pain when stimulated, not all acupoints cause pain following a stimulus. However, we can immediately state that there is no perfect correspondence.įirst of all, while myofascial trigger points are always contained in muscular tissue, acupoints can be localized also in different types of tissue. Williams & Wilkins, Baltimore, 1983).Since there is without doubt an analogy between trigger points and acupoints, and Janet Travell's preferred treatment method itself was that of transfixing the trigger points with the needle of a syringe of proper dimensions, the question naturally arises as to whether there is connection or identity between acupoints and trigger points. Now all the upper and lower extremity pain patterns and their corresponding trigger points are clearly illustrated on convenient flip charts, ideal for patient education. Travell & Simons myofascial pain and dysfunction : the trigger point manual.
#TRAVELL AND SIMONS TRIGGER POINTS MANUAL#
The physical findings for diagnosis of a myofascial trigger point are (1) palpation of a tender nodule in a taut band, (2) a referred pain pattern specific for the muscle, (3) a local twitch response (LTR) with snapping palpation or triggering with needle, and (4) restricted ROM (Travell J, Simons DG, Myofascial pain and dysfunction: the trigger point manual, vol 1. Travell and Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual have been hailed as the definitive references on myofascial pain and locating trigger points. Active TrP produce a referred pain pattern specific to that muscle spontaneously and when the TrP is palpated. Latent TrP are associated with stiffness and restricted ROM but no pain unless palpated. Trigger points (TrP) can be latent or active (Simons DG, Travell JG, Postgrad Med 73:66–108, 1983). The diagnosis of MPS is based on the presence of 1 or more trigger points. Myofascial pain syndrome (MPS) as defined by Travell and Simons is characterized by trigger points (TrP), limited ROM of the affected muscle(s), and neurologic symptoms (autonomic, proprioceptive) (Simons DG, Travell JG, Postgrad Med 73:66–108, 1983).