(There are several types of acupuncture diagnosis and point selection methodologies including Chinese, Japanese and Five-Element acupuncture. Point selection is based on locating trigger points, as opposed to making point selections based on acupuncture diagnosis. This is a modern addition to acupuncture. However, some acupuncture schools are also teaching trigger point referral patterns. Other than searching for tender points when treating pain and sticking needles in the patient, classical acupuncture has nothing in common with trigger point needling. Most written attempts to clarify the difference between acupuncture points and trigger points have been unsuccessful. For example, if you have heel pain, your therapist or health care provider should be able to tell you that the trigger points that could be causing the pain are likely located in the soleus, quadratus plantae, abductor hallucis, or tibialis posterior muscles, and then know how to search for and confirm the presence of trigger points. Even those trained in “trigger point therapy” or “neuromuscular therapy” may still be doing somewhat random searches for trigger points. But if chiropractic medicine is outside the realm of what the patient is willing to try, I do the best I can for them, but also let them know I don’t think I’ll completely resolve it with my modalities.ĭon’t be afraid to ask any practitioner about their training in the treatment of trigger points. For example, if I believe a vertebra or other joint needs to be manipulated in order to completely resolve the problem, I know that acupuncture and massage will unlikely effect the needed adjustment, but it will relax the surrounding muscles so a chiropractor or osteopathic physician can assist in solving the problem.

I decide what I think they need, and then assess their acceptance of trying different modalities. It depends on the person’s body, their particular set of symptoms, and their willingness to try certain therapies or perform the self-help techniques. The therapies that benefit one patient may not be the best set for another. I use whatever combination of therapies and recommendations that I think will best benefit the patient.

It is unlikely that any one therapy will entirely treat your pain.

Travell and simons knee pain patterns