The Auto Pilot Brain; Muscle and Movement Control: Answers to Chronic Soft Tissue Pain and Understanding Dry Needling of Trigger Points

By Carol Cote, PT, CCTT, CODN, CMTPT

In the general medical population we make the mistake that muscles are under 100% voluntary control. This is partially true, however, the majority of our muscles are more automatic (i.e. autonomic nervous system) than voluntary (somatic nervous system). Our muscles are controlled by 2 nervous systems. The somatic nervous system is our voluntary nervous system. When we bend our elbow and move our bodies voluntarily that is done through the somatic nervous system via our motor cortex.

Our second auto pilot nervous system is our autonomic nervous system which is more about bodily functions that help us survive (heart beat, body temperature, blood pressure, digestion, etc). Muscles are innervated by both nervous systems. For example, breathing. We have voluntary control with our breath but breathing is more automatic than voluntary. Muscles of our spine, shoulder blades and pelvis are more autonomic than voluntary. Autonomic muscle control has to do with how we hold our body against gravity. Our brain is blind to gravity, reflexes (such as balance) and habits (motor activation patterns ­
and muscle memory). Holding our head up and balancing is automatic very much like breathing. When it comes to neck and back pain and muscles this problem is an involuntary muscle problem.

Dry needling works to change our autonomic motor control affecting our auto pilot muscle activation pattern by releasing the trigger points (involuntary muscle contractures) that exist in chronic soft tissue pain. Dry needling works faster than traditional manual therapy like massage and even joint manipulations, treatment strategy needs to address the right level of where the problem is. Dry needling works at the three levels of how our bodies process pain:

1. Peripheral (skin, muscle, bones, joints)
2. Spinal (spinal cord, nerve roots) and
3. Brain (motor and sensory cortex along with our thinking/decision making and emotional brain).

Dry needling is a key treatment strategy which works at all levels (voluntary and involuntary) all at once and allows for permanent sustained change.

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