Editor’s note: Wellness Word is an informational column which is not meant to replace a health care professional’s diagnosis, treatment or medication.
Myofascial and Trigger Point Therapy
Pain can have a staggering effect on every part of our lives. It’s easy for it to cause a huge riff in one’s life without even noticing the correlation. Poor sleep, being irritable and distracted are side effects that can have a negative impact on our work life, home life, personal relationships, sleep and much more. The Practical Pain Management Journal reports that, chronic pain is the number one cause of disability in people under 45 years old in North America as well as the second most common reason people see their doctors. Problems are so prevalent, it has become one of the most expensive problems for Americans.
Resulting from a variety of sources, a commonly overlooked and underappreciated cause is muscle pain. Myofascial Pain Syndrome (MPS) is defined as a non-inflammatory muscle condition – ‘Myo’ meaning muscle and ‘fascia’ meaning a network of connective tissue located throughout the body. MPS is diagnosed by the presence of active trigger points. Trigger points are nodules in the muscle that are a result of muscle dysfunction and these nodules are notorious for causing pain that can be felt elsewhere in the body, known as referred pain. That shoulder pain you have been experiencing after taking a fall may be coming from a trigger point in the neck.
Trigger points can be formed due to poor posture, vitamin and mineral deficiencies, direct injury (such as a fall), sedentary lifestyle, and repetitive injuries. Symptoms of trigger point pain include muscle spasms, weakness, aching deep in the muscle, and a tender nodule located deep in the muscle. In a study of 283 admissions to a clinic, 85% were give a diagnosis of MPS (Argoff, C., MD, & Smith, H., MD. (n.d.). Myofascial Pain Syndrome: Epidemilogy. Retrieved from medmerits.com/index.php/article/myofascial_pain_syndrome/P4).
Pain is unique and may respond to different treatments. Treatment of MPS may require a multi-disciplinary treatment approach that may include massage, chiropractic care, physical therapy, occupational therapy, injections or medications.
An alternative treatment may include the implementation of trigger point and myofascial release. This treatment may can be administered by specially-trained healthcare clinicians such as Occupational Therapists, Physical Therapists, Chiropractors, and Massage Therapists. During a typical treatment, a client would be assessed to find the potential cause followed by trigger point and myofascial release work. Clinicians are trained to locate trigger points with their hands, gently apply pressure to release the trigger point and stretch the fascia.
An essential component of this treatment is education for self-treatment, changing body mechanics, safe ergonomics, and methods to reduce the risk of pain reoccurrence. This type of manual hands-on therapy is advantageous due to being non-invasive, drug free, and can assist in helping individuals to return to pain-free activities.
The protocol for this treatment is based on the work of Janet Travell, MD, David Simons, MD, and Bonnie Prudden. Their approach as cited by the National Association of Myofascial and Trigger Point Therapists (myofascialtherapy.org) includes a multi-step approach to achieve resolution of pain:
• Differential Diagnosis
• Patient History
• Mapping of Pain
• Range of Motion Evaluation
• Postural Analysis
• Identifying of possible causes and factors
• Correction of perpetuating factors
• Manual techniques to treat myofascial pain
• Personalized client stretching program
• Client Education
You may benefit from myofascial or trigger point treatment if you are experiencing pain affecting your ability to participate in desired activities. This treatment may be effective for individuals who have had limited success with other treatment approaches.
Hillary Kibgis, MOT, OTR/L