Ticchi Method: trigger points with Francesco Ticchi

My consultation never starts with the MRI or X-rays, but with the person: it always begins with the patient history. If I do not first listen to the patient’s story, how can I truly understand what they are experiencing?

Looking at reports before understanding the actual symptoms is one of the biggest mistakes a healthcare professional can make.

Images show anatomical structures, not pain.

Several problems or dysfunctions often coexist in the same patient, but almost always one predominates and is responsible for the main symptom. Listening carefully already helps establish a direction: is the pain myogenic (muscle tissue/trigger points), nociceptive (joint or tissue inflammation), or neuropathic (nerve root irritation)?

Only after forming a clinical hypothesis do I move on to the physical examination.

Clinical tests should confirm what listening has suggested.

If I suspect a neurological problem, I perform neurodynamic tests.

If the hypothesis is nociceptive or joint-related, I proceed with passive mobility and provocation tests.

If the presentation suggests myofascial dysfunction, I apply specific palpation and differentiation protocols to map active trigger points precisely, and perform specific tests that I have developed.

There is always a margin of uncertainty in medicine, but studying the pain signs of each tissue in depth helps minimise clinical error.

Only at the end of the assessment do I open the investigation reports.

I read them to check for contraindications or anatomical confirmation, but I do not let them dictate the diagnosis: the person’s clinical response remains the priority.

Thinking that herniations, protrusions or osteoarthritis automatically cause every pain is a myth: someone who treats only the image rather than the patient risks getting the diagnosis wrong in most cases.