Diagnostically, DDN can assist in differentiating between pain that originates from a joint, an entrapped nerve, or a muscle. Mechanical stimulation or deformation of a sensitized MTrP can reproduce the patient’s pain and may assist in the differential diagnostic process. One of the unique features of MTrPs is the local twitch response (LTR), which is an involuntary spinal cord reflex contraction of the muscle fibers in a taut band following palpation or needling of the band or MtrP.
Despite a growing body of literature exploring the etiology and pathophysiology of MTrPs, the exact mechanisms of DDN remain elusive. Possible explanations of its efficacy include normalisation of the chemical environment of the active MTrP or lengthening of the cytoskeletal structures secondary to induced stretch reflexes