Locate the Knot. Release the Spasm. Restore the Muscle.
Massage only touches the surface. We use precise medical filaments and targeted injections to reach the deep, locked trigger points causing your chronic tension, 'lamig', and pain.
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What is Myofascial & Perineural Therapy?
If you suffer from chronic muscle tightness, burning nerve pain, or stubborn "knots" in your neck and back, you already know that standard massage therapy only provides temporary relief. Severe muscle knots—medically known as myofascial trigger points—exist deep within the muscle belly, locked in a state of permanent contraction that human hands simply cannot press hard enough to release.
At TeraCare, we do not guess. Dr. Rabara utilizes a three-tiered interventional approach to soft-tissue pain: Medical Dry Needling (using an ultra-fine filament to mechanically reset the knot), Trigger Point Injections (delivering soothing anesthetics to deactivated hyper-irritable spots), and Perineural Injection Therapy (treating inflamed superficial nerves that cause burning and sensitivity). We diagnose the exact tissue layer causing your agony and apply the precise medical tool to resolve it.
Conditions That Respond to Needle Therapy
Is Needle Therapy Right for You?
You are an EXCELLENT candidate if:
- You have stubborn muscle knots that massage therapy cannot resolve.
- Pushing on a knot in one area causes pain in another (e.g., shoulder knot causes headache).
- You experience burning or tingly pain just beneath the skin.
- You want to avoid taking daily oral muscle relaxants that cause drowsiness.
You may NOT be a candidate if:
- You have a severe, unmanageable fear of needles (trypanophobia).
- Active skin infection or open wound over the targeted muscle.
- Current severe lymphedema in the targeted limb.
The Realities and Rules of Needling
These procedures are exceptionally safe when performed by an anatomy expert like Dr. Rabara. However, we prioritize complete clinical transparency:
- The Twitch Response: During dry needling, when the needle hits the trigger point, you may feel an involuntary muscle twitch. This is the 'reset' signal indicating the therapy is working.
- Localized Soreness: Expect localized soreness for 12 to 24 hours, similar to the feeling after a heavy workout, before profound relief kicks in.
- Proprioceptive Window: The needle resets the muscle, but physical therapy is required to 're-teach' the muscle how to stabilize your joints correctly.
Which Soft-Tissue Treatment Do You Need?
Medication-free filament needle directly penetrates the muscle knot for a neurological reset.
A tiny needle injects a localized anesthetic directly into the muscle knot to break the pain cycle.
Subcutaneous Dextrose blebs used to calm inflamed superficial sensory nerves.
The 3 Stages After Your Session
The Post-Workout Phase
The muscle may feel sore, heavy, or fatigued. We recommend staying hydrated and applying gentle heat to the area.
The Profound Relief Phase
Soreness subsides, revealing a dramatic decrease in chronic pain. Restoring resting length to the muscle makes movement feel freer.
The Reprogramming Phase
Crucial window for Physical Therapy. We teach the loosened muscle how to move correctly to prevent the knot from returning.
Clinical Science & Technical Details
For our medical colleagues and highly analytical patients, we provide these transparent technical details on the pathophysiology and interventional protocols.
Explore the Clinical Science: Mitochondrial Decay and The Twitch Response
A myofascial trigger point is caused by an 'energy crisis' at the motor endplate. Sustained release of acetylcholine causes permanent sarcomere contraction, creating localized ischemia. This traps acidic inflammatory biochemicals like bradykinin, continuously firing pain signals to the brain.
Medical Dry Needling disrupts this mechanically. The 'Local Twitch Response' (LTR) acts as a neurological circuit breaker, causing a massive release of acetylcholine and allowing the muscle fibers to relax back to their resting length instantly.
Detailed Diagnostic Pathways for Myofascial & Neural Syndromes
For tension headaches, we target the upper trapezius and suboccipital muscles, which frequently refer pain around the skull. In lower body cases, many 'sciatica' presentations are actually Piriformis Syndrome—a deep gluteal cramp.
Precision needles allow Dr. Rabara to penetrate deep into the gluteal or hip compartments—far deeper than manual therapy or massage—to deactivated fibers that are compressing the sciatic nerve.
Advanced Systemic Screening & Hemostasis Guidelines
Patient safety dictates our clinical protocols. Patients on significant anticoagulant therapy (e.g., Warfarin) must be carefully evaluated due to hematoma risk in deep muscle compartments. We strictly avoid limbs with active lymphedema or skin infections.
If a lidocaine allergy is present, we rely exclusively on filament-based Medical Dry Needling or Dextrose-based PIT to ensure a completely safe interventional experience.
The Physiatrist Advantage: Surgical-Level Anatomical Expertise
Dry needling is exceptionally safe when performed by a board-certified physician. In the thoracic region, the primary (though rare) risk is a pneumothorax. Dr. Rabara's surgical-level understanding of three-dimensional anatomy virtually eliminates this risk.
We utilize strict aseptic techniques and single-use, sterile filiform needles. For stubborn knots, we may pivot to 'peppering' TPI techniques with ultrasound guidance to ensure the medication washes out the localized acidic environment of the knot.
The 3-Step Clinical Process
Anatomical Mapping
Dr. Rabara conducts a hands-on physical exam, manually tracing muscle fibers and cutaneous nerves to locate the exact source of your pain.
Clinical Intervention
Using sterile technique, Dr. Rabara applies the appropriate modality—Dry Needling, TPI, or PIT—directly to the dysfunctional tissue.
Range of Motion Test
Immediately post-procedure, we re-test your movement. Most patients notice instant improvements in range and a sharp decrease in pain density.
Common Questions
Does the procedure hurt?
The needles used are ultra-thin (medically known as filiform), so the initial insertion is usually painless. When the needle strikes the active trigger point, you will feel a deep, momentary ache or a brief muscle cramp. While intense for 1-2 seconds, this is the sign of a successful 'reset'.
How many sessions will I need?
Acute, newly formed muscle knots may resolve in a single session. For chronic myofascial pain syndromes, a targeted series of 3 to 6 sessions, typically spaced a week apart, is often required to fully deactivate entrenched trigger points.
Is this just acupuncture?
No. Dry needling is a Western medical intervention based on modern anatomy and neurophysiology. While we use similar needles, we target palpable, anatomical muscle knots to elicit mechanical changes, rather than targeting traditional Eastern meridian points (Qi).
Is it covered by PhilHealth or HMOs?
Dry needling and specialized TPI/PIT are considered premium interventional therapies and are generally not covered by PhilHealth or basic HMO packages in the Philippines. We prioritize financial transparency for these sessions.
Can I exercise after my session?
We advise avoiding heavy weightlifting or high-intensity exercise for 24 hours. Light walking, gentle active mobility stretching, and warm compresses are encouraged to promote blood flow to the reset muscle tissue.