Gokavi Transverse Technique

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Gokavi Transverse Technique

Gokavi Transverse Technique (G.T.T.)

The Gokavi Transverse Technique (G.T.T.) was developed by Dr. Cynthia Gokavi, a physician with many years of experience treating myofascial pain syndromes. With an extensive background in both traditional acupuncture (AP) and dry needling, Dr. Gokavi herself has suffered from chronic pain for more than 25 years. Her quest, both personal and professional, for improved chronic pain treatment measures led to the development of this technique.

G.T.T. is a dry needling acupuncture technique used to treat myofascial pain (acute and chronic) and soft tissue restriction. G.T.T. differs from other dry needling AP techniques in that: A) it utilizes high frequency electrical stimulation pre-needling and B) advocates transverse orientation of the AP needle into target muscle tissue. Acupuncture needles are inserted in a specific transverse direction to form a closed circuit which encompasses the target treatment area. Needles are then electrically stimulated with two different high frequency currents. Electrical stimulation results in relaxation and analgesia of muscle tissue enclosed within the circuit. Muscles are then lifted and needled transversely through their entire thickness to release palpable trigger points and taut myofascial bands.

Advantages to using G.T.T. are many. They include: decreased dry needling pain. The relaxation/analgesic effects induced by the circuit, combined with the transverse orientation of the needle (generally recognized to be less painful than a perpendicular approach) results in less muscle cramping and spasm. This notably decreases both needling pain and post treatment soreness. Larger areas can be treated in a shorter period of time. Less needling is required during subsequent treatment sessions, fewer treatments are required and time between treatment sessions can be lengthened. Increased patient compliance is noted as a result. Muscle relaxation obtained with the circuit allows the practitioner to effectively target myofascial restrictions in deeper muscle layers. Results are immediate. The transverse orientation of the needle decreases the risk of injury (i.e.: perforation) to internal organs.

Possible side effects to any dry needling technique include the potential for: bruising/bleeding, discomfort, post treatment fatigue/soreness and syncope. Contraindications include: pregnancy, local infections/skin conditions, anti-coagulant use, bleeding disorders and cardiac pacemakers. Clients with pacemakers can be treated if the circuit is omitted.

Our physiotherapists at Corona Station Physical Thrapy are qualified to perform G.T.T., and it is frequently employed at the clinic in the treatment of individuals with chronic myofascial pain, fibromyalgia, adhesive capsulitis, muscle restriction post immobilization and total joint replacements (pre-surgical), to name a few. Results have been very favourable. For more information, please contact us at the clinic by phone or email and ask to speak to one of our physiotherapists.

Acupuncture and Dry Needling

Acupuncture and Dry Needling

How it Works:

Acupuncture (AP) has been shown to stimulate the release of endorphins and ACTH from within the central nervous system (CNS). Both are desirable in the body post injury or in disease.

Did You Know:

Naloxone has been shown to block the analgesic effects of low frequency (4 Hz) electrical acupuncture (Rapson, L. 1984). Naloxone’s ability to block the pain relieving effects of electrical acupuncture supports research hypotheses that acupuncture does in fact stimulate the release of natural opioids in the body. It has proven particulary effective in the treatment of musculoskeletal problems and headaches. Complications and side effects associated with acupuncture treatments are minimal.

Dry Needling:

In addition to their use in Traditional Chinese Medicine, AP needles are also employed for dry needling purposes. Several dry needling techniques currently exist internationally based on different models, the most common being the trigger-point model and the radiculopathy model. Recent insights into the nature and neurophysiology of myofascial trigger points (MTrPs) have progressed the understanding of their clinical presentation in myofascial pain syndromes. The trigger point model employs both superficial and deep dry needling techniques to specifically target MTrPs. Trigger points are believed to result from the excessive release of acetylcholine from motor end plates. “Active MTrPs can spontaneously trigger local pain in the vicinity of the MTrP, or they can refer pain or parasthesia to more distant locations. They cause muscle weakness, range of motion restrictions, and several autonomic phenomena.” (Dommerholt et al. 2006). The Gokavi Transverse Technique is another model which employs high-frequency electrical stimulation prior to transverse dry needling. The radiculopathy model, now known as intramuscular stimulation (IMS), is based on the work of Canadian medical physician Dr. Chan Gunn. IMS also targets the MTrP.

Impact on Clinical Practice:

Given the scope of acupuncture/dry needling in the management of acute and chronic pain conditions, it is worthwhile to consider it as a treatment option for not only those clients presenting with musculoskeletal problems and/or chronic myofascial pain but also clients who are unable to use specific medications and /or as a form of supplementary pain management.

Acupuncture and dry needling are treatment measures employed by several of the physiotherapists on staff at Corona Station Physical Therapy. In addition to needling techniques, our physiotherapists provide comprehensive management of the presenting condition. For more information, please contact us at the clinic by phone or email and ask to speak to one of our physiotherapists.