Review article


, 4:13

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Needling therapy for myofascial pain: recommended technique with multiple rapid needle insertion

  • Li-Wei ChouAffiliated withDepartment of Physical Medicine and Rehabilitation, China Medical University HospitalSchool of Chinese Medicine, College of Chinese Medicine, China Medical UniversityResearch Center for Chinese Medicine & Acupuncture, China Medical University Hospital
  • , Yueh-Ling HsiehAffiliated withDepartment of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University
  • , Ta-Shen KuanAffiliated withDepartment of Physical Medicine and Rehabilitation, National Cheng Kung University HospitalCollege of Medicine, National Cheng Kung University
  • , Chang-Zern HongAffiliated withDepartment of Physical Therapy, Hung Kuang University Email author 


Myofascial trigger point (MTrP) is a major cause of muscle pain, characterized with a hyperirritable spot due to accumulation of sensitized nociceptors in skeletal muscle fibers. Many needling therapy techniques for MTrP inactivation exist. Based on prior human and animal studies, multiple insertions can almost completely eliminate the MTrP pain forthwith. It is an attempt to stimulate many sensitive loci (nociceptors) in the MTrP region to induce sharp pain, referred pain or local twitch response. Suggested mechanisms of needling analgesia include effects related to immune, hormonal or nervous system. Compared to slow-acting biochemical effects involving immune or hormonal system, neurological effects can act faster to provide immediate and complete pain relief. Most likely mechanism of multiple needle insertion therapy for MTrP inactivation is to encounter sensitive nociceptors with the high-pressure stimulation of a sharp needle tip to activate a descending pain inhibitory system. This technique is strongly recommended for myofascial pain therapy in order to resume patient’s normal life rapidly, thus saving medical and social resources.


Acupuncture Analgesia Mechanism Myofascial trigger point Needling