Myofascial pain is a universal type of myalgia. Simply put – muscle pain. It differs from the type of pain that is experienced as a “diffusely aching type of pain” caused for example by a virus. Myofascial pain originates in a section or band of skeletal muscle which has become taut, tender upon palpation and usually in spasm. This hyperirritable spot in the muscle is called a trigger point.
Most of the general population has experienced myofascial pain at some point, if not frequently in their lives. The intensity of the pain can range anywhere from mild to debilitating. Even so it has been often overlooked and misunderstood by the medical community in general.
It was the renowned Dr Janet Travell M.D. ( White House Physician in the 1960’s) who spent her long career (working into her 90’s) developing and practicing the comprehensive method of diagnosing and treating myofascial pain syndrome. In the 1980’s Dr. Elmajian had the good fortune of studying with Dr. Travell. He adopted her concept and technique of evaluating and treating myofascial pain and it is still a very powerful tool for treating pain in his practice.
Myofascial pain has many causes. The important point is that the pain is the alarm. Simply turning off the alarm by taking pain killers or trying not to use the afflicted muscle(s) could be equated to taking the battery out of a sounding smoke detector without exploring where and what was causing it to go off in the first place.
Myofascial pain syndrome can be simple or it can be complicated, depending on many factors. An afflicted muscle or group of muscles can be directly painful when palpated or the trigger points in those muscles can refer pain to a completely different muscle or even organ in a distant part of the body. It takes a good knowledge of anatomy, kinesiology and experience in evaluating the musculoskeletal system to correctly diagnose and treat myofascial pain.
An initial consultation reviewing a comprehensive history of the patient and a thorough hands-on examination and palpation of the suspected muscles is important to get to the root of the problem.
Myofascial Therapy is the preferred treatment for the all encompassing condition known as myofascial pain syndrome. The treatment involves injecting procaine (local anesthetic) along with homeopathic remedies into the trigger points (muscle spasm) to relax or melt them. A series of treatments are usually recommended.
Perpetuating factors are underlying issues that can affect and complicate muscle pain. In chronic situations of myofascial pain it is crucial to determine and deal with these “Perpetuating Factors” that may exist and interfere with the success of the treatment.
There is a long list of possible perpetuating factors that may or may not be obvious to a person suffering from unresolved myofascial pain or other significant health problems but it is important to determine if there are any and what they are. Doing so can influence treatment success.
Mechanical or Physical Stresses such as poor occlusion (bad bite), body asymmetry (one leg shorter that the other) and postural stresses (poor posture, poor ergonomics on the job and repetitive use of certain muscles) can aggravate already susceptible trigger points in muscles and can cause relapses even after successful treatment.
Poor ergonomics and repetitive use of muscles, once pointed out can usually be corrected with some minor adjustments and awareness on the part of the patient.
Body asymmetry is common and usually can be treated manually by having the proper chiropractic adjustments.
Dental malocclusion and clenching and grinding of the teeth due to tension can overload the facial and neck musculature perpetuating headaches, facial pain and TMJ pain. A dental examine can determine if these factors are perpetuating a patient’s problem and the appropriate corrective procedures can be recommended.
Nutritional Inadequacies are often underlying and predisposing a person to certain myofascial and other types of pain. They are best determined by a lab test.
For example, migraine like headaches not improved by physical treatments such as acupuncture, craniosacral or myofascial therapies could be a result of a Vitamin D deficiency. A lack of Vitamin C can be responsible for post exercise muscle soreness or stiffness and several minerals are needed for normal muscle function and a deficiency in any of them can increase the irritability of muscle spasm and pain.
Metabolic and Endocrine Inadequacies such as suboptimal thyroid function can impair muscle metabolism and therefore perpetuate myofascial pain not to mention other health issues. Adrenal tests can give an overall picture and indication if hormonal irregularities may be an underlying factor to a person’s pain and/or other health concerns.
Psychological Stress such as depression, anxiety and tension can be closely associated with chronic pain and are often overlooked in the overall picture of a person’s physical health.
It could be as simple as dealing with one’s stress in a more positive fashion or it could be a much more complicated issue of past trauma that requires some delving into. The point is emotional issues can and do affect our physical states and can aggravate and increase pain in the body.
Chronic Infection of viral, bacterial and parasitic origin all can play a role in perpetuating myofascial pain and should be controlled in order to obtain lasting relief of such pain.
Other Factors such as allergies, nerve impingement and impaired sleep should also be considered in the management of myofascial pain syndromes
Sleep impairment is becoming a common complaint in a growing number of the population. One particular and mounting problem in this area is the condition known as sleep apnea.
Recognizing one or more of the perpetuating factors mentioned above may be a piece to the puzzle of your chronic pain or ongoing, unresolved health concerns. It is often the reason a particular treatment may have limited or temporary results. It could be the one of the keys to obtaining optimal health!!