Most of the techniques can be explained through understanding how muscular trigger points can be swiftly released by specific pressure points and stretches. No painful deep tissue massage is involved. A few techniques are best understood according to Chinese Medicine concepts.
After a standard examination of function and range of movement the therapist examines the muscles and soft tissues for tenderness. The most basic technique involves first identifying a tender trigger point and then applying specific stretches across the muscle or neighbouring muscles which instantly switch off the pain. The release is held for 20 seconds to make it "stick". One then proceeds to the next tender point. Not everybody responds to this treatment but when they do, the technique can be incorporated into the physical examination in such a way that when the exam is completed the pain is gone and function is restored. The presence of muscular pain limits movement because the body tries to protect itself by tensing up. Normal movement is usually restored once the pain is relieved.
Most people require several visits to prevent it from recurring, especially if they have habitual postures or activities which perpetuate the muscular pain or re-injure the tissue, but occasionally one treatment is sufficient.
Here are a few examples of the many people who find this helpful:
- a lady came in with a stiff wrist and painful forearm after having her cast removed following treatment for a Colle's fracture of the wrist. I was concerned that a tight cast may have affected her circulation in her arm but when she was examined she was found to have tender muscles at several points in her forearm. PNT was applied to each tender point and within a few minutes her stiffness and pain were gone and her wrist movement had returned to normal.
- a fit patient who works out regularly at the gym presented with low-back pain and pain across her shoulders. She could only bend her back a few inches and she had a lot of muscular tension in her shoulders. Each tender point was released, several PNT techniques were applied to her lower back and hip muscles, and a few minutes later she could put her hands flat on the floor when bending her back.
- a lady fell at work on her outstretched hand and came in complaining of wrist pain. In fact, she had tender points in her wrist, forearm, upper arm and shoulder. PNT was applied systematically to each area and her pain was gone by the end of the visit.
- a gentleman came in with plantar fasciitis after a walking tour around Europe. He had tenderness in the sole of his foot, heel, and in his calf muscles. PNT was applied across the plantar fascia and calf muscles and his painful limp resolved. Most patients with this condition need trigger point injections, exercises and muscular stretches, or obtain expensive orthotics, but his was one of a number of instances in which PNT alone was sufficient.
Clearly these techniques cannot cure serious diseases but myofascial pain often responds very quickly. We often start with PNT when treating muscular pain; if it is effective, then no other treatment may be needed. If not, then further testing and other options are available.