Tuesday, April 3, 2012

Myofascial Pain Syndrome

“If you put yourself in a position where you have to stretch outside your comfort zone, then you are forced to expand your consciousness.”

- Les Brown     

Myofascial Pain Syndrome

Myofascial pain syndrome (MPS) is a fancy way to describe muscle pain. It refers to pain and inflammation in the body's soft tissues.

Myofascial pain is a chronic condition that affects the fascia (connective tissue that covers the muscles). Myofascial pain syndrome may involve either a single muscle or a muscle group. In some cases, the area where a person experiences the pain may not be where the myofascial pain generator is located. Experts believe that the actual site of the injury or the strain prompts the development of a trigger point that, in turn, causes pain in other areas. This situation is known as referred pain.

Causes: Myofascial pain may develop from a muscle injury or from excessive strain on a particular muscle or muscle group, ligament or tendon. Other causes include: 
  • Injury to intervertebral disc
  • General fatigue
  • Repetitive motions
  • Medical conditions (including heart attack, stomach irritation)
  • Lack of activity (such as a broken arm in a sling

Symptoms: Myofascial pain symptoms usually involve muscle pain with specific "trigger" or "tender" points. The pain can be made worse with activity or stress. In addition to the local or regional pain associated with myofascial pain syndrome, people with the disorder also can suffer from depression, fatigue and behavioral disturbances.

Diagnosis: Trigger points can be identified by pain that results when pressure is applied to an area of a person's body. In the diagnosis of myofascial pain syndrome, four types of trigger points can be distinguished: 
  • An active trigger point is an area of extreme tenderness that usually lies within the skeletal muscle and which is associated with a local or regional pain. 
  • A latent trigger point is a dormant (inactive) area that has the potential to act like a trigger point.
  • A secondary trigger point is a highly irritable spot in a muscle that can become active due to a trigger point and muscular overload in another muscle.
  • A satellite myofascial point is a highly irritable spot in a muscle that becomes inactive because the muscle is in the region of another trigger pain.

Treatment: There are a choice of treatment for MPS. The most common are:
  • Physical Therapy
  • "Stretch and spray" technique: This treatment involves spraying the muscle and trigger point with a coolant and then slowly stretching the muscle.
  • Massage Therapy (see also: Skin Deep).
  • Trigger Point Injection

In some chronic cases of myofascial pain, combinations of physical therapy, trigger point injections, and massage are needed. In select cases, medication is used to treat other conditions that often occur with myofascial pain, such as insomnia and depression.

These are excerpts from an article written by Ephraim K. Brenman, D.O. for WebMD on March 01, 2007. Portions of this article are from the "The Cleveland Clinic" © 2000-2005.

- Leo Feraer-Oporto     

TP, DT, MFR, etc.

I have mentioned above that Massage Therapy is one of the most common way to address Myofascial Pain Syndrome. So what exactly can massage therapists do to relieve their client's symptoms of MPS? Here are the Five of the most common techniques that can affect the conditions of the soft tissue associated  with MPS:

1.) Deep Tissue Massage: A combication of various strokes that address deeper soft tissue layers: I discussed this modality in my older post: "Skin Deep";
2.) Medical Massage: is a combination of many techniques, and may include the rest of these five modalities:  see "Posture-ific";
3.) Looyen Therapeutic Massage: is based on the premise that pain does not cure pain, click here for details.

4.) Neuromuscular Massage/ Trigger Point Therapy

Pain in a muscle is sometimes due to spasm in a particular portion (not the entire muscle), which then reflects to other areas, leading to painful symptoms. The blood circulation to this affected muscle is decreased, causing lack of oxygen supply and overtime, buildup of lactic acid. This lactic acid deposition causes symptoms of muscle spasms and soreness. Neuromuscular massage therapy is aimed at alleviating muscle stress and healing pain by applying concentrated pressure on these area.

Myofascial trigger points on the other hand are palpable, irritable muscle lesions usually within tight muscle bands that refer pain to other areas when pressure is applied. Treatment consists of identifying the trigger points through palpation, followed by manual compression to remove excess metabolic waste and cross fiber friction to unstuck adjacent muscle fibers followed stretching to normalize shortened muscle fiber length.

You can experience a significant decrease in pain after just one treatment. Receiving neuromuscular massage with trigger point therapy on a regular basis can help naturally manage pain and stress from chronic injuries.

Do you want to learn more about Neuromuscular Massage Therapy? Click here.

5.) Myofascial Release Therapy

Myofascial Release is a hands on soft tissue release technique which often includes structural and functional assessment to determine which tissues may be causing dysfunction and pain. Fascia is the thin layer of connective tissue between the skin and the muscles (superficial fascia) or more extensive is the deep fascia which holds the muscles together but also separates them into functional groups. Deep fascia, when functioning properly, allows muscles to move independently of each other without impingement on surrounding nerves and blood vessels.

The objective of myofascial release is to identify shortened and or restricted myofascial tissue (deep myofascia is usually the culprit) and adhesions between muscles and muscle groups. Using steady directionally focused pressure, fascial restrictions and adhesions are normalized, resulting in elimination of pain, increased range of motion and rebalancing of the body's interdependent web of myofascia.

Do you want to learn more about Myofascial Release Therapy? Click here.

- Leo Feraer-Oporto      

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