What is Trigger Point Needling (TPN)?
What is TPN?
Trigger Point Needling or TPN, is a
scientifically proven form of treatment for chronic pain.
Very thin needles are inserted into painful muscle
spasms. This breaks the spasm and allows the muscle to heal
naturally.
These painful spasms are also known as trigger points.
How does TPN work?
Pain has 3 ingredients, nerves, muscles and bones. They are
all connected like 3 links in a chain. Nerves are the most
delicate and are damaged easily. When the nerve is damaged, it
irritates the muscle attached to it. The irritated muscle will
spasm and pull on the attached bone. This pulls the bone out
of alignment and pain will result. When a needle is placed in the tight painful
spasm, the muscle will relax and take the pressure off the attached nerves and
bones. Pain will reduce or disappear. The nerves, muscles and bones can heal
naturally. Since muscles also attach to discs, ligaments and tendons, once the
spasm is released, these structures can heal.
What is involved in a treatment?
Following a thorough medical examination of the patient, the
problem areas are identified and treatment is directed towards
releasing muscle spasms which constitute the source of the
pain. Typically, weekly sessions progressively lead to both
signs of objective physical improvement as well as decreased symptoms. Treatment
is provided on an outpatient basis and is often complimented with a home
stretching program and lifestyle modification. The
number of sessions is dictated by the severity of the problem as identified by
the history and physical examination. The response to treatment depends upon
multiple factors including the overall health of the patient and any
post-surgical scarring present. Generally, patients will need weekly treatment
for 1-2 months, then can be weaned off to an “as needed” basis.
How did TPN devlelop?
Dr. Chan Gunn of Vancouver, Canada developed Gunn IMS over 30 years ago. Dr.
Gunn has been recognized by numerous prestigious international scientific and
medical organizations for his significant contributions to the understanding and
treatment of chronic pain. Click on his website
to find out more information. Dr. Kim has studied extensively
with Dr. Gunn and has been recognized as an honorary fellow of Dr.
Gunn’s institution. He is only one of a handful of doctors in
the U.S. that practices this
technique.
Dr. Kim adapted Dr. Gunn’s IMS technique to suit his patient population and now
calls it Trigger Point Needling (TPN).
Are there medical articles that explain TPN?
Yes. Dr. Gunn has published many
articles. In addition, Dr. Kim
also published an extensive article titled The Evolution of Acupuncture
in the medical journal “Seminars of Integrative Medicine”.
Why does Dr. Kim use Trigger Point Needling instead of other treatments?
Dr. Kim suffered from severe chronic pain for years. He tried a number of traditional treatments, but nothing helped. He became aware of Dr. Gunn's work and went to Canada for treatment. The treatment worked, and Dr. Kim decided to learn the treatment to help his patients. Over the years, had recurrences of his chronic pain, and TPN was the best method to resolve his pain.
How long will it take to get relief?
This can vary from patient to patient. In general, if the treatment is effective, patients will feel significant relief after 1-4 treatments. Patients with spine or joint surgery may need 1-6 treatments before feeling relief.
How long will I need to continue treatment?
Once the pain decreases to a reasonable level, treatments are weaned over weeks and months. It will usually take 4-8 sessions for the pain to decrease to a reasonable level. It generally takes longer for this to occur in patients with many areas of pain vs. patients who only have a few areas. Once a patient "graduates" from treatment, they may require additional treatment on an "as needed" basis if their pain recurs, or if they develop new problems.
Does Dr. Kim prescribe pain medication?
No. Dr. Kim found that pain medication did not work for him, so he felt it would be inappropriate to suggest it to his patients. His general philosophy is that if it didn't work for him, it probably won't work for his patients. In his experience, pain medication is not effective for his patient population. Patients who are on pain medication and are motivated to stop them will usually do so on their own. Experience shows that when patients feel better, they stop their medications on their own. This includes even strong narcotic medications such as Percocet and Oxycontin. If a patient is motivated but has become addicted because of long term use of these medications, they may need to undergo drug rehab to completely stop. This has been very successful.
Does Dr. Kim do anything else in a treatment session?
Yes. Dr. Kim does Compression Massage and Manual Therapy with each session. TPN is used to treat the deepest layers of spasm. Compression massage uses a specially designed handheld massage unit over the treated areas to loosen the intermediate layers of spasm and to reduce needle soreness. Manual Therapy involves gentle manipulation or myofascial release to treat the superficial layers of spasm. Dr. Kim finds that using all 3 methods in a treatment session yields the best pain relief.
Dr. Kim also educates patients about their condition. He feels this is extremely important and finds that many of his patients simply don't know what is wrong with them. He also coaches patients on methods to reduce stress and promote muscle relaxation which helps to maintain loose muscles.
Does Dr. Kim prescribe exercise?
Yes. Many patients develop chronic pain due to year of poor posture. Poor posture can cause muscle imbalance and dysfunction. If this it not corrected, pain can and usually does result. Dr. Kim is an affiliate of the Egoscue Method which focuses on correcting poor posture, and can offer patients this type of exercise program. He practices the method himself and finds it to be very beneficial.
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