Before your first appointment

Your doctor will physically examine you and ask you where it hurts the most in a number of different positions. The doctor will insert the needle into the points he or she identifies as causing the problem. Very often the needling site is not where pain is felt. For example, low back pain often comes from trigger points in the abdomen rather than the back. The body is all connected!! After TPI, your trigger points or fascia will likely relax and your pain will decrease.

Evidence shows that most patients need from 5 to 8 treatments to get sustained resolution. Currently myoPain patients have an average of 4 treatments. We use this average to guide our policy in establishing an initial treatment plan for each new patient. Currently we book newly referred patients in a series of 3 appointments 1 to 2 weeks apart to ensure continuity of care. We will later cancel these appointments if they are not needed.

We completely understand that feeling nervous or anxious about needles is a perfectly natural response for many individuals. Ensuring your comfort and safety is our top priority when it comes to needling. This is a place where your well-being matters most, and there's no need to endure anything you're uncomfortable with. We always proceed at a pace that suits you, and if you ever feel you've had enough, we'll stop immediately. Our approach is gentle and gradual, and we carefully time the needles with breathing techniques designed to help relax your nervous system. It's entirely normal to feel a bit apprehensive before or during your first visit, but we've found that after the second or third visit, most people become significantly more relaxed. Your body and mind start to sync up, reducing anxiety, especially as you experience the pain relief that makes the entire process worthwhile. You're never alone in this journey, and your concerns are always acknowledged and respected.

Trigger Points Trigger points can be found not only within muscles but also in ligaments, near bones, and even in non-muscular facial tissues. They're like small, tight knots within your muscle fibers, and sometimes they can affect an entire muscle area. When you apply pressure, like touch, to a trigger point, the resulting pain isn't always confined to that exact spot. It can travel to different parts of your body, a phenomenon known as referred pain. Trigger points can also create other effects, leading to symptoms like visual disturbances, eye redness, tearing, dizziness, unsteadiness, changes in blood flow, and alterations in skin temperature. Additionally, they're linked to conditions such as tension headaches, tinnitus, temporomandibular joint pain, limited pelvic, leg, and ankle mobility, as well as lower back pain. Trigger Point Injection (TPI): In trigger point injection (TPI), we use a precise medical procedure that involves inserting a needle into trigger points, the fascia (the membrane that surrounds muscles), and scars. During TPI, we typically introduce tiny amounts (micro aliquots) of 0.9% saline solution. This solution is balanced to match the natural concentrations in your body tissues. Importantly, it doesn't lead to any numbing effect like lidocaine and doesn't result in toxic buildup.* The goal of TPI is to release trigger points, promoting muscle relaxation and reducing pain. However, it's important to note that TPI has its limitations, especially for patients with chronic, long-standing pain. In such cases, muscle spasms often reoccur. To address this, we employ a combination of therapies, including myoActivation. myoActivation helps identify the original sources of fascial insults and tissue injuries that lead to muscle spasms. By treating these underlying issues, we aim to prevent the reoccurrence of painful trigger points. It's important to understand that our approach may involve treating areas that might seem unrelated to your primary pain site. For more details on myoActivation, please refer to the dedicated section on this approach.

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Myoactivation is different from dry needling, acupuncture, and IMS (Intramuscular Stimulation) in several important ways. Acupuncture, a core component of traditional Chinese medicine, primarily focuses on promoting the flow of "Chi" energy along meridians in the body. This often involves the insertion of multiple needles that remain in place for up to 20 minutes. IMS, on the other hand, employs acupuncture needles (solid core needles) that are inserted directly under the skin to target muscle knots or trigger points. Myoactivation, on the other hand, focuses on the same tissues but with a unique method.(see below) It uses hypodermic /cutting needles that make tiny bleeds in the treated areas, helping release healing substances like collagen, hyaluronic acid and platelet growth factors, which speed up the healing process. Hypodermic needles can easily penetrate even tough tissues like scars and fibrotic tissue efficiently making them well-suited for treating larger areas of the body. In myoactivation, we insert and remove needles swiftly without having to redirect them, which most patients find less uncomfortable. Needles are inserted and removed swiftly without redirection, a feature many patients find less uncomfortable. For more comprehensive information, please refer to the "What is MyoActivation?" section.

Myoactivation offers benefits to a wide range of individuals, from those struggling with chronic pain to individuals recovering from sports injuries. It also caters to proactive individuals looking to address fascial concerns before they escalate into larger issues. It involves exploring the initial insults and injuries that can lead to muscle contractions and fascia disruptions, often as a consequence of embracing the full spectrum of experiences of being human. Myoactivation and Trigger Point Injection (TPI) share the same needling technique but differ in their approach. TPI primarily targets immediate pain relief, addressing symptoms. In contrast, myoactivation delves deeper, seeking the root causes of the problem. It involves investigating the initial insults and injuries that lead to muscle contractions resulting from pulling against fascial tension lines as a result of trauma. This approach may even include releasing scars, burns, or road rash. What makes myoactivation unique is its ability to identify the origins of discomfort by using a standardized series of movements tests for different pain sources. Myoactivation's comprehensive method, utilizing the same needling technique as TPI, ensures enduring pain relief. For instance, conditions such as back pain and knee pain may find their origins in the abdominal wall, while ankle and foot discomfort may be linked to issues in the pelvis and upper thighs. This comprehensive approach aims to address pain at its source, in the hopes of offering long-lasting relief. Myoactivation is a holistic process focused on untangling the narratives stored within your body. Sometimes, the places we may be reluctant to address or hesitant to treat are the very areas that require attention. Ensuring your comfort and creating a safe environment is of utmost importance. During myoactivation, emotional releases may occur, like tears. These moments shouldn't be suppressed; instead, they offer an opportunity for integration. A quote by Bessel A. van der Kolk aptly reminds us that trauma isn't just a past event; it leaves imprints on our mind, brain, and body. Our approach is trauma-informed, guided by a physician trained in relational trauma-informed somatic therapy who uses both myoactivation and TPI in the same treatment sessions.

If you're covered by the Medical Services Plan (MSP), obtaining a referral from a Medical Doctor (MD) or a Nurse Practitioner (NP) is REQUIRED. However, we understand that locating a family doctor or securing a prompt appointment at a walk-in clinic can sometimes be challenging. The good news is that you can streamline this process by accessing any provincial-wide telehealth program. Thiese programs offers a convenient solution, allowing you to schedule an online medical appointment with a healthcare provider in BC. During this appointment, you can request a referral for trigger point therapy to Dr. Davina Kraubner at our myoPain clinic for your pain issue. Feel free to use any ones you may be familiar with. To get started, you can visit https://virtualclinics.ca/ 1. Click on "Book Now." 2. When asked if you want to book with your family doctor, select "NO." 3. Indicate your reason for booking as "Referral and Medical notes followed by Referral to a Specialist." Once we receive the referral via fax to 250-871-1946 our team will contact you to arrange your initial appointment. In the meantime, please take a moment to familiarize yourself with myoActivation/Trigger Point Therapy and prepare for your upcoming appointment.

Scar tissue is different from your normal skin because it's made up of collagen fibers that are laid down in a more straight and parallel way, unlike the crisscross pattern in regular skin. This makes the scar tissue stiffer and less flexible than the surrounding healthy skin. This stiffness can cause muscle tension and pain, limiting your movement. Some scars, especially those from childhood, can distort the nearby tissues and affect their normal growth, leading to uneven development in that area. As time passes, scar tissue tends to become even tighter and more rigid. This effect is more noticeable with childhood scars, as our tissues become less flexible as we get older, typically from middle age onward. myoActivation needle insertion can help by releasing this built-up tension in scar tissue, which, in turn, can ease these issues and help you move more freely and comfortably

After myoActivation/TPI, It is common to feel varying degrees of soreness in the treated tissues and/or fatigue for one or more days following treatment. But here's the good news: as your body adjusts and tension is released, your movements will become smoother, and pain will gradually decrease. Typically, you'll regain better flexibility and improved range of motion before you feel complete relief from pain. It's also useful to let us know if the pain shifts to different areas; sometimes, pain migrates, which is normal. In fact, this may help to reveal the original cause of the pain, which is valuable information for us. Seeing some of your symptoms return, after they initially improved can also occur. Keep in mind, this doesn't imply that your treatment has been ineffective. It indicates that we've targeted the right areas, but your tissues may need some additional time to strengthen and adapt to your body's new position or form. If you notice this happening, it might just mean it's time for a quick reminder about post-treatment care and activity levels. Sometimes, when people start feeling better, they're so eager to get back to activities they've missed that they overdo it.

Please see our Side Effects page. You might not be able to have this procedure if: You have an infection You are on blood thinners You are pregnant You are immuno-compromised or immuno-suppressed Please let your doctor know if you have any of these conditions. The doctor will tell you if it is safe for you to be treated.

We usually recommend no more than one treatment per week, to a maximum of 8 treatments. If you haven’t had sustained benefit after 5 treatments, your physician will re-examine your care plan and change the course of treatments if that is right for you.

This is a common and mild side effect. When myofibrils release you may feel momentary discomfort. The sensation varies with each individual. Patients have variously described the feeling as a pulling, tugging, burning, electrical or “weird” sensation. Others feel a heat release or a muscle twitch. Muscle twitches, either observed or felt, are clear indications that muscle fibres are releasing. A twitch reaction is a good indicator that the treatment will have good results. The greater the twitch, the more fibres are being released. Some patients experience a very brief radiation or an electrical signal to a limb or up and down the body. This is a positive reaction indicating release of fascial tissue associated with the treatment site.

Sometimes as patients get pain relief in the treated areas, they experience a migration of pain to new areas. Pain migration generally reflects one of two positive treatment results. Muscle fibres treated are released and pain is resolved at that specific site. Sometimes, the patient has other longstanding muscle fibres in sustained contraction which were subordinate to or eclipsed by the pain from the treated areas. When the dominant painful area is resolved, other muscles in sustained contraction become dominant and the patient feels pain in new areas. A follow-up treatment that addresses the new painful sites can resolve the issue of migrating pain. Sometimes new pain results from a realignment of the interrelated muscular framework resulting from the newly relaxed muscles. The mechanism for this is unclear but may reflect disruption of the long established muscular interrelationships of shortened muscles that must readjust to a new relationship with functional muscles. Generally, patients find their bodies readjust and pain disappears within a few days. Less commonly, individuals may experience short-term worsening or flare-up of pain following treatment which generally resolves within 24 hours. Please call the clinic for assessment if a pain flare-up lasts more than 24 hours. Your doctor may recommend an alternative treatment to relieve the pain.

This is a common and mild side effect. When myofibrils release you may feel momentary discomfort. The sensation varies with each individual. Patients have variously described the feeling as a pulling, tugging, burning, electrical or “weird” sensation. Others feel a heat release or a muscle twitch. Muscle twitches, either observed or felt, are clear indications that muscle fibres are releasing. A twitch reaction is a good indicator that the treatment will have good results. The greater the twitch, the more fibres are being released. Some patients experience a very brief radiation or an electrical signal to a limb or up and down the body. This is a positive reaction indicating release of fascial tissue associated with the treatment site.

Patients commonly experience a bruised feeling at the treatment sites. This sensation usually disappears within a day or two after treatment.

This is more likely to result in someone who has had previous history of similar symptoms following immunization or visualizing blood. Fainting or loss of consciousness is rare. It is important to tell your physician immediately if you feel lightheaded, dizzy, nauseous or faint.

Patients who have a significant amount of muscle release may experience fatigue and need for a longer sleep following the first treatment. This is largely a phenomenon following the first treatment and doesn’t seem to occur after subsequent treatments. New patients may want avoid driving immediately after their first treatment.

Physicians assess each patient for infection risk and follow appropriate precautions according to best practices. Overall, there is a very low risk of infection, which would be evident by skin redness, soft tissue swelling, increasing pain and/or fever. The risk of infection increases for patients with diabetes, immune-compromised states or if the treatment included many separate insertion sites. Increased pain that begins several days after the injection may be a sign of infection. This may suggest cellulitis or infection of soft tissues. You should call us if this occurs.

Rarely, a patient might experience nausea during or immediately post treatment. In general, this symptom only occurs in those who have had nausea from similar medical procedures previously.

These rare symptoms may suggest a pneumothorax. Seek treatment immediately if this occurs. Call the clinic to speak with your treating physician, or if after hours, seek treatment at an urgent care facility or emergency room. Note - this complication would only result where treatment was applied in skin over the lung fields, most likely in the upper back or lower neck area