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Acupuncture for Treatment of Myo-Fascial / Facial Pain
What is Acupuncture?

Acupuncture is the stimulation of special points on the body, usually by the insertion of fine needles.  Acupuncture
points are seen to correspond to physiological and anatomical features such as peripheral nerve junctions and
diagnosis is made in purely conventional terms (as opposed to using
Traditional Chinese Medicine terms).

An important concept used in Western Acupuncture is that of the "
trigger point".

The
Trigger Point (TrP / Myo-fascial TrP / MTrP) is an exquisitely tender spot in a discrete taut band of hardened
muscle that produce a local pain and characteristic pattern of referred pain, among other symptoms.  The
TrP is
composed of numerous, so-called,
contraction knots.  An individual contraction knot appears as a segment of a
muscle fibre with extremely contracted sarcomeres and an increased diameter.

TrP's prevents full lengthening of the muscle, weakens the muscle and mediates a local twitch response of muscle
fibres when adequately stimulated.  When compressed, the
TrP produces referred motor and often autonomic
phenomena (such as vasoconstriction, vasodilatation, goose bumps & the raising of hairs), generally in its
pain
reference zone
.

There is general agreement that any kind of muscle overuse or direct trauma to the muscle can lead to the
development of
TrP's.  The taut band limits stretch of a muscle and produces weakness that is rapidly reversed as
the TrP is inactivated.

A typical example of
myo-fascial trigger points might be tender areas in the muscles of the neck and shoulder which
relate to various patterns of headache.
Diagrams Showing Head & Neck Trigger Points
What happens during a treatment?

Typically, between 5 – 15 trigger points are needled during an acupuncture session.
Photo of Acupuncture Needles
The needles are usually left in place for 10 - 20 minutes, although some practitioners needle for only a few seconds
or a small electrical current (
electro-acupuncture).
Some acupuncturists attempt to produce a sensation called "de Qi" - a sense of heaviness, soreness or numbness,
at the point of needling. This is said to be a sign that an
acupuncture point has been correctly stimulated.  Many
patients say that they find
acupuncture a relaxing or sedating experience.

A typical course of acupuncture treatment for a chronic condition would be 4 – 6 sessions over a three month
period.  This might be followed by "top up" treatments every 2 - 6 months.


Is acupuncture safe?

The needles used are individually sterilised and disposable.  They are used on one patient only before being
discarded.

Side effects are rare.  The most common are listed here:

Bleeding and Bruising.  A little bleeding can occur when the needles are removed. Occasionally, a bruise may form.

Sickness.  This may be mild either during or after any of the sessions.

Dizziness and fainting.  This is a very rare and usually happens during the treatment.  Stopping the treatment and
removing the needles reverses the feeling.  Future treatment may be given with fewer needles or over a reduced
period of time.

Drowsiness.  Patients report they have felt sleepy or tired during or after treatment.  This is normal and may affect
the ability to drive or operate machinery.  If this is a problem, please ensure you are escorted to the clinic for your
treatment.

Increase in pain.  Many patients have reported an increase in the level of their pain following a treatment.  This can
be a positive sign but if the level of pain continues to increase treatment may be stopped.

Infection.  Every effort is made to prevent infection occurring.  The needles are disposed of immediately after a
single use.

Air in the Lung (Pneumothorax).  When acupuncture needles are placed in the chest or the top of the shoulders,
there is an extremely small chance that lungs underneath may be punctured.  All the practitioners have been trained
to avoid this happening.  However, any new shortage of breath following
acupuncture to this area should always be
reported to the A&E at the hospital.  Please tell them that you have had
acupuncture and, if possible, take this
information leaflet with you.  A chest X-ray may be taken.

The rarer side effects include:

  • Mild pain at the needle site
  • Stuck or bent needle
  • Headache
  • Allergy or infection
  • Pain not at needle site



What can I expect to feel?

Reaction to the insertion of the needle can be divided into two groups: Local and General.


Local effects:

As the needles are so fine there is only the slightest prick as the needle pierces the skin.  Afterwards, it is possible
to have a variety of sensations from nothing at all to a sensation of heaviness; a tingling sensation like pins and
needles or the sensation approaching that of a local anaesthetic.

If the needle is advanced further then there may be a duller pain or heaviness of a limb which may last for some
time afterwards.  It is possible that odd sensations may be experienced in areas distant to the spot being needled.

General effects:

These are variable and tend to happen in more sensitive individuals.  Some patients experience a lightness of mind
and body, a relaxation which approaches effects gained by 1 - 2 drinks of alcohol and is usually pleasant.  Others
may simply feel that their general well-being is improved.  Still others may feel no difference in their general state.  
It is possible for a few susceptible individuals to feel faint but this is usually short-lived and subsides when the
needle is removed.


Will acupuncture treatment help me?

75% of all people will get some benefit from acupuncture treatment.  The facial pain may totally resolve or be much
improved.

Unfortunately, about 25% of patients do not seem to respond to acupuncture and we can never guarantee results.


Useful Websites:

British Medical Acupuncture Society

British Acupuncture Council


Useful Articles:

BDJ 2000.  Acupuncture - Introduction to Acupuncture in Dentistry

Effective Healthcare 2001.  Acupuncture

BDJ 2001.  Acupuncture - The Role of Acupuncture in Controlling the Gagging Reflex using a Review of 10 Cases

Anaesthesiol Clin 2007.  Myofascial Trigger Points

BDJ 2009.  Immediate Effects of Microsystem Acupuncture in Patients with Oro-Myofacial Pain & Cranio-
Mandibular Disorders (CMD) - A Double-Blind, Placebo-Controlled Trial

BDJ 2010.  Burning Mouth Syndrome - Is Acupuncture A Therapeutic Possibility

J Dent 2011.  Limited evidence that acupuncture is effective for treating temporomandibular disorders

British Acupuncture Council 2012.  Acupuncture & Facial Pain

Curr Pain Headache Rep 2012.  Etiology of Myofascial Trigger Points

Phys Med Rehabil Clin N Am 2014.  Diagnosis of Myofascial Pain Syndrome

J Adv Clin Res Insights 2016.  Dry needling technique in myogenous temporomandibular disorders - A clinical
commentary

BDJ 2017.  Interactive Group Therapy for the Management of Myofascial Temporomandibular Pain
Last Updated 19th November 2019
Photo of Electro-Acupuncture
Trigger points and their characteristic patterns of referred pain can be treated by direct needling at the trigger
point
.  This concept is also used in musculo-skeletal medicine with trigger points being treated by manipulative
techniques.

Trigger points in the muscles of the head and neck produce certain patterns of head and neck pain.