It's commun to find chronic-myofascial-pain patients with actives but also latents trigger points. Only actives TrPs induce pain (known by the patient) but we also know that latents TrPs may become active.
So, do you only treat actives TrPs (Dry needling for example)?
Is it a good idea to also treat latents TrPs?
Have a Nice Day - Phill
Hi Phill, if you have not already read it, I recommend this article:
http://www.ncbi.nlm.nih.gov/pubmed/23801006
Kind regards,
Samuele
http://www.ncbi.nlm.nih.gov/pubmed/23801006
If the primary aim of the treatment is pain relief, one should eliminate active trigger points. But if the aim of the treatment is to restore muscle flexibility, full range of motion, muscle strength, muscle endurance, or muscle coordination elimination of latent trigger points can be of help. For further reading: Latent myofascial trigger points. Ge HY, Arendt-Nielsen L. Curr Pain Headache Rep. 2011 Oct; 15(5):386-92.
Article Latent Myofascial Trigger Points
Bonjour Phill:
Good question. We have to treat always all kind of TrPs in order to diminish the impact the myofascial pain syndromes in the muscle function. When somebody is suffering this condition is forever, because of that we must treat all TrPs to get long periods without symptoms as possible.
Why leave a latent trigger point? Aim of healthcare is prevention, surely. Dry needling preferred intervention owing to rarity of side-effects. HOWEVER, treating myofascial trigger points, whether active or latent, is largely a waste of time unless you identify the reason for their formation and correct the aberrant neurology +/- biomechanics… otherwise, they'll be back by the end of the week!
Hi Martin,
You mean we have to work on prevention!
What are the tracks that you suggest?
If a patient has musculoskeletal weakness or a tendency to muscle tension and MfTps, either idiopathically or because of environmental/emotional factors, the rate at which problems re-develop are often predictable and the occasional preventative treatment can be scheduled to address latent points/dysfunction before it becomes active.
Aggravating factors can also be addressed with exercise; posture; ergonomic assessment and advice; nutrition; psychotherapy; massage; orthodontics etc – are clinics are all multidisciplinary which helps in this regard.
In my opinion we have to treat always all TrPs: actives and latents trigger points and its important to think is prevention of future problems.
Only treat the active trigger points. Leave the others. Patient can do home stretching exercises (if motivated!). Treating latent trigger points is probably not a good use of your time, in my opinion...
dry needling and schock waves together with black roll and neuro muscle Training are well in the dally praxis
When you treat active trigger point you are treating latent trigger point too. Why?E.g.: Nowadays, Dry Needling is one of the treatment more used. If you don't find the active point in the moment of puncture you could be finding latent points that you can treat too. The patient could improve with puncture in latent trigger point.
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