Tensegrity-Based Needling: An Integrative Rehabilitative Treatment for Post Covid-19 Widespread Musculoskeletal Pain

Post-COVID condition - the long-term illness seen after coronavirus infection - often presents with chronic refractory widespread musculoskeletal pain, for which no well-formulated treatment or rehabilitation strategy has so far been established in studies. Integrative medicine aims to optimize treatment outcomes while incorporating a holistic patient centered approach. A valuable yet underused modality available to practitioners since antiquity is the acupuncture practice of needling therapy, whose working mechanism of action remains poorly elucidated and disputed - which is part of the reason why it is often met with skepticism by many medical practitioners. One of the most difficult chronic pain conditions to treat, and for which modern medicine provides symptomatic and insufficient therapies, is the syndrome of fibromyalgia. Fibromyalgia is a prevalent pain condition of unknown etiology that manifests with a peculiar cluster of symptoms such as myalgia/arthralgia, fatigue, low mood, and cognitive difficulties. Its pathophysiology is largely attributed to dysregulated central neural pain pathways, although fascio-musculoskeletal pathology is evident. Recent studies indicate that fibromyalgia-type manifestations occur often after coronavirus infection, in what can be termed “long-covid-19 syndrome”, a condition which also seems to involve myofascial histopathological abnormalities in a significant number of affected individuals. Empirical studies suggest that needing therapy may improve chronic widespread pain and it has been recommended by professional medical societies to be used in fibromyalgia and “neuroplastic pain,” but the biological mechanisms are poorly known and are mainly attributed to central nervous system neurophysiology. In this manuscript a new mechanism of action for manual needling is formulated as a global percutaneous needle fasciotomy that respects tensegrity principles, and is discussed as part of the rehabilitative approach for the treatment of post-covid widespread musculoskeletal pain and stiffness. This approach, complementing known neurophysiological mechanisms, offers a more holistic understanding of acupuncture’s usefulness as a rehabilitative treatment for idiopathic chronic musculoskeletal pain and refractory post-covid myofascial and nociplastic-type pain. Tensegrity-based needling aligns with traditional medical principles of the body-mind as a unit by recognizing the global interconnectedness of the myofascioskeletal system and aiming to restore balance and function.