MyoActivation for the treatment of pain & disability

Chronic musculoskeletal pain is common in our society. One in five people suffer with chronic pain in Canada. We need alternatives to pharmacologic interventions that are cost effective, safe, and available to most patients. Ideally, these alternatives would be covered by MSP. Most importantly, alternative treatments could decrease our reliance on opiates.

I am a retired family physician who underwent right hip replacement surgery in 2018. I was skeptical when a colleague suggested I try myoActivation during my rehabilitation. A compensatory flexion and adduction contracture of my right hip was slowing my recovery. I also had weak hip abductors, hamstrings, and gluteus muscles.

What is myoActivation? It is a refined injection technique that targets damaged fascia, scars, and other trigger points in the body. Using multiple needling with hollow bore cutting needles with minute amounts of normal saline, soft tissue contractures are released.

I am now pain free and back to doing all of the activities I love to do.

Here are some interesting details that I picked up during my visits:

  • A detailed history of all past injuries is considered in terms of myofascial contractures and scars.
  • A series of standardized movement tests is used to define painful areas.
  • The most painful sites are treated first, followed by re-evaluation of movements. Then the next painful area is treated.
  • Multiple cycles of injections, followed by evaluation and further injections, are carried out at each appointment.
  • Tissue realignment takes place the first few days after treatment, followed by stabilization.

The technique was pioneered by Dr Greg Siren,[1] a family physician with a focused practice in chronic pain in Victoria, BC.

At the time I write this letter, myoActivation is also available in Vancouver at the CHANGEpain Clinic, the Downtown Community Health Centre (Downtown Eastside), and the Complex Pain Service at BC Children’s Hospital. It has been shown to be effective in treating chronic pain originating in the soft tissues in the elderly as well as children.

I hope this letter raises awareness about this technique. It can be practically delivered in primary care patient encounters and could be part of a multidisciplinary approach to treatment of chronic musculoskeletal pain.
—Suzanne Montemuro, MD, CCFP


1.    Lauder G, West N, Siren G. MyoActivation: A structured process for chronic pain resolution. IntechOpen. Accessed 5 March 2019.

Suzanne Montemuro, MD, CCFP. MyoActivation for the treatment of pain & disability. BCMJ, Vol. 61, No. 3, April, 2019, Page(s) 111 - Letters.

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