I found out about the enormous importance of myofascial trigger points from more than 30 000 treatments. In my supraregional practice, many patients with acute, chronic, and therapy resistant pain are treated according to the "TriAS" concept (needling techniques: superficial, intramuscular, minimally invasive). An evaluation of the effectiveness of this treatment (736 patients from 2003 to 2005) showed very good improvement in pain in 59% of patients, and slight to good improvement in another 34%.
Trigger points were involved in the development of pain in almost all patients, alone or accompanying other causes. The referral of muscle pain therefore needs emphasis: mislocalizations of the causes of pain were the rule. Patients almost never experienced spontaneous pain at the site of the active, and therefore etiologically relevant, trigger points. I have never had to inject into the trigger points; suitable acupuncture techniques are sufficient.