Marsha Haller, MD, Medical Acupuncture

Myofascial Acupuncture Treatment of Chronic Pelvic Pain

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Myofascial Acupuncture for Pelvic Pain

Chronic pelvic pain is a challenging disorder, with various combinations of urological, gynecological, musculoskeletal, neurological, inflammatory and emotional factors all contributing to pain and dysfunction that can be truly disabling.  Regardless of the etiology, a myofascial component is generally involved in maintaining the problem through compression of nerves and blood flow through chronically tight, restricted muscles and fascia in the pelvic floor and surrounding areas.   Physical therapy is a mainstay of treatment for myofascial pelvic pain. Nevertheless,  when manual techniques are unable to unlock trigger points or other restrictions in the pelvic floor and related areas of hip, back and abdomen, dry needling of trigger points in the involved muscles has become important addition to the treatment.  Dry needling forms a foundation for Dr Haller’s myofascial acupuncture treatment. 

“Dry needling” vs “fine needle trigger point deactivation”

Myofascial acupuncture is an integrated medical procedure that utilizes a delicate but effective form of trigger point treatment called acupuncture or fine needle trigger point deactivation, a variant of dry needling. In fine needle trigger point deactivation, delicate acupuncture needles are repeatedly placed into the trigger points, tight bands, and overlying connective tissue in order to release, soften and lengthen the underlying muscles and fascia, restoring normal tissue texture and mobility.

Dry needling, as generally performed by physicians (and in many areas physical therapists), mainly targets the classic myofascial trigger points described by Travell and Simon. Fine needle trigger point deactivation differs from “dry needling” in several ways.  One is the emphasis on loosening individual tight bands in the muscles, and connective tissue of the skin and fascia. This helps normalize tissue texture, blood flow and function, and relieves pain in previously restricted areas of the pelvis and related areas of the hips, abdomen and back. Another difference  is that after the needling, cupping or gua sha, two traditional (and well researched) modalities that target fascia and improve circulation can help to maintain the gains achieved.

 What other “acupuncture related techniques” are used?

Because chronic myofascial pelvic pain is a complex condition involving the nervous system as well as dysfunction of the pelvic floor, it is vital to approach it from more than one angle.  Several medical acupuncture procedures may be useful additions to the treatment plan because they target different components of the nervous system that play a role in maintaining chronic pelvic pain. Segmental deactivation and percutaneous electrical nerve stimulation focus on the abnormal pain messages carried by sacral and lumbar nerves supplying the pelvic structures. Chinese scalp acupuncture and ear acupuncture are powerful tools that stimulate specific brain areas related to the involved body parts. The addition of traditional acupuncture points and electrical stimulation to the treatment encourages flow in the channels that course through the pelvis, flushing out blockages that cause pain.  Though multiple sessions are generally required, a noticeable difference is commonly experienced with each visit.

Pelvic Pain Resources

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