Diagnosing a trigger point requires practice. The muscle should be gently palpated with a flat hand across the muscle, or
in the case of a muscle with large accessible muscle bellies, with a pincer palpation. The key to finding trigger points is
to palpate perpendicular to the muscle fibers by using a very gentle technique.
When you encounter a taut band as you move across the muscle, it will feel like a slight thickening that's a little smaller
than the diameter of a pencil. If you're unsure if this is a trigger point, use your fingers to apply additional pressure
to see if it elicits one of the responses previously mentioned.
The most effective and least expensive treatment for trigger points in dogs is dry needling. Some patients will require sedation
and others won't, depending on the level of pain they're experiencing and their personalities.
An acupuncture needle is used to explore the taut band and find the trigger point. When contact with a trigger point is made,
an involuntary twitch occurs that involves a spinal reflex loop. This is seen even if the animal is anesthetized. When the
contraction is released, the relief experienced by the patient is almost immediate.
The recommended treatment varies depending on the patient and the muscle, but it usually lasts about 20 minutes and is administered
weekly until the dog is more comfortable. Not every trigger point is treated, just the ones causing the problem. Trigger points
are forever. Once treated, they can remain latent for weeks, months or even years, but all have the potential to become active
All veterinary professionals should be familiar with myofascial pain syndrome and how it can negatively impact a dog's recovery
from surgery, injury or illness. Fortunately, treatment can be extremely effective in improving the lives of these dogs.
Currently there are no formal training programs to learn how to treat myofascial pain in animals. The International Veterinary
Academy of Pain Management will offer a one-day seminar on the topic in association with the 2013 American Animal Hospital
Association conference in Phoenix. You also can learn more about trigger-point therapy by contacting the Colorado Veterinary
Medical Association/CSU acupuncture program or by visiting Myopain Seminars at http://myopainseminars.com/.
Michael C. Petty, DVM, CCVP, CCRT, is a faculty member of the Canine Rehabilitation Institute, Wellington, Fla., and owner of Arbor Pointe Veterinary Hospital,