Symptoms, causes and the ladder treatment system

MYOFASCIAL PAINDid you know that Fibromyalgia and myofascial pain syndromes share many of the same symptoms and tender/trigger points, but each condition has different causes?

Did you know that pain in your neck or shoulder can manifest or show up as a variety of conditions such as; a tension headache, tinnitus (ringing in the ears), TMJ pain, eye symptoms or a stiff neck?

For an example; shoulder pain can be caused by referred pain from your upper arms, shoulder tendonitis, bursitis or even intestinal problems. Lower back pain can be triggered by points in the gluteus maximus and gluteus medius( your butt muscles) or from an attack of gallstones. Read on to find out why and how your muscles create this referred pain and how to alleviate the pain and discomfort.

Myofascial Pain Syndrome is a fancy way of describing chronic muscle pain and dysfunction. It relates to pain, spasms and inflammation in the body’s soft tissue. Myofascial pain affects the fascia (connective tissue that surrounds individual muscles, as well as muscle groups). Myofascial pain arises from a prolonged contraction of either a single muscle or a muscle group, which leads to reduced blood flow and the accumulation of various toxic body chemicals. The muscle can be shortened as with a stiff neck, or lengthened as in the upper shoulder muscles, like when your shoulders are rounded forward. With-in this taut-band (tight) of muscle fibers a hyperirritable area develops. Sometimes, it can hurt just at one spot called a tender point. Tender Points that refer symptoms and pain elsewhere in the body are known as Trigger Points.

About 10% of the population have one or more chronic musculoskeletal disorders.

Injury to an individual muscle or muscle group, tendon or ligament from excessive strain or trauma is one such cause.

Other causes maybe:
. General fatigue (poor sleep, physical and/or
emotional stress)
. Disc or vertebrae dysfunction
. Repetitive or static motions (computer work,
stockers, or cradling a phone)
. Medical conditions (heart attack, abdominal organ
. Lack of or unbalanced activity (arm in a sling,
walking with foot boot or cast)

The causes of myofascial pain involve muscles and specific points, the pain can be local or referred to other areas of the body. They can be made worse with certain activities or stress. Due to the close link between the nervous system and our emotions long term myofascial pain sufferers can have depression, fatigue and behavioral disturbances.

People with Fibromyalgia suffer with these symptoms also and it’s common for the two conditions to co-exist. There are many similar symptoms between myofascial pain syndrome and Fibromyalgia. Therefore, it takes a trained professional to differentiate between them. Two common types of trigger points are active and latent. Not only do Trigger points developed in particular spots, but also these points match many acupuncture points. Active trigger points are extremely painful local spots and refer pain to other areas. Latent points are not painful until they are touched or squeezed. These trigger points can restrict movement or cause muscle weakness. If you have had someone rub your shoulders or had a massage know this quite well. Trigger points and their referral patterns have been studied extensively by Dr.‘s Janet Travell and David Simons starting back in the 1940’s. Their extensive work has lead to the formation of charts that show the specific trigger point sites and their referral patterns and relate many of the common symptoms.

Some common problems that have been linked to trigger points/ myofascial pain in the neck and shoulder region can present as; TMJ( temporal mandibular joint) pain of the jaw, stiff neck and headaches. Trigger points of the thigh or calf muscles may lead to limited range of motion of the knee or ankle. Depression, sleeplessness, fatigue and intestinal problems can also arise from chronic myofascial pain and can usually exist with Fibromyalgia as well.

What are some of the treatment
options available?
Since some of the symptoms of myofascial pain and Fibromyalgia are similar, especially trigger points, tight muscles and stiffness you would expect some of the same treatments to be used. Yes, but the outcome and treatment plan would be different. With both, there’s a progression of treatment that is used. Where you start depends on many factors. How much pain are you in, how long and what might have caused the dysfunction. Generally, we start from self help, if results aren’t satisfactory we move up. Sometimes we have to start at the top with medical evaluation and pain management and work down.

The level of manual therapy can and should include massage therapy, especially trigger point therapy (a specific modality designed to decrease tender/
trigger points and release trapped components), not your relaxing type massage. Licensed Massage Therapists are specifically trained in soft tissue dysfunction. Once trigger points are alleviated, the effected muscles need to be actively moved through it’s FULL range of motion to reset its proper length. To enhance my clients healing I have massage therapists at each office.

My clients experience faster and more complete results by combining treatments.

Did your pain start from a onetime event or did it build up of time from work conditions, life, or many little events. Depending on the causes and duration of your myofascial pain, treatment may only be a few sessions, followed by home care. More severe type and /or longer in duration may take longer to eliminate. Zeroing in on the cause of the pain and dysfunction and the actual effected muscles is crucial. Sometimes, treatment will take a team approach with various health care providers providing service and follow-up.

Have questions? We’ll be happy to answer your questions concerning your pain or discomfort.

Come in to the Estero Medical Center and speak with us, or attend our monthly, HEALTHY BACK AND WELLNESS classes. Classes are open to the public. Date and times are posted in the lobby.

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