Myofascial Trigger Points in chronic muscle pain: Causes and Treatment

Many people have experienced this trigger point pain at some time in their life and many, like those with fibromyalgia and other muscle disorders such as myositis, live with this pain everyday. 

Trigger points are caused by a muscle reflex that misfires. 

Sensitive areas of tight muscle fibers can form in your muscles after injuries or overuse. These sensitive areas are called trigger points. A trigger point in a muscle can cause strain and pain throughout the muscle. When this pain persists and worsens, doctors call it myofascial pain syndrome. ~ MAYO CLINIC

Myofascial pain has been defined as a regional pain syndrome with: 

(1) the Trigger Point,(TP) a localized area of deep muscle tenderness or hyperirritability, and 

(2) a predictable, zone of deep aching pain, which may be located in the immediate region of or remote from the TP, may be quite extensive and is worsened by palpation of the TP.

The video, below, shows how to identify trigger points on yourself and shows how they radiate in your body to other areas. Dr Jonathan Kuttner, a pain specialist, discusses trigger point pain in this video. 

According to research this myofascial pain may develop into fibromyalgia in some people. Some doctors believe myofascial pain syndrome may play a role in starting this process. The common important feature to both conditions is muscle pain along with the taut or rope like bands in the muscles

Personally I have found great success in relaxing my muscles and reducing pain and highly recommend this myofascial pain release.

Non pharmacological therapies for MPS and FMS:

Due to lack of definitive etiological elucidation and treatment of FMS many alternative approaches have been advocated by pain therapists. The popular approaches have been mentioned below:

i) Choosing correct chair, mattress, and posture to sit or sleep.

ii) Back braces can be used to stabilize the vertebral column or support fatigued muscles.

iii) Traction devices can be used carefully as a temporary pain relief method.

iv) Mechanical massage: Regular massage by the devices available can penetrate deeply through a tapping or percussion action dispersing lactic acid in the soft tissue causing improvement in circulation and relaxation of knotted muscles.

v) Whole body vibration with traditional exercise programme for six weeks was also found to reduce pain and fatigue score.

vi) Chiropractic management combined with aerobic exercises and cognitive behavioral therapy, acupuncture and spa therapy also have strong evidences in their favour.

vii) Yoga: Regular yogic breathing practices, muscle stretching and progressive deep relaxation by “shavasana” are known to have positive effect on FMS.

viii) Ischaemic acupressure or ‘Shiatsu’: In this technique the clinician applies thumb pressure (TP) in a particular manner for 1 minute. In next minute the pressure is increased suddenly aggravating pain and a sensation of “giving away” is felt underneath the thumb in muscle as the pressure is released gradually.

ix) Hot and cold therapies:

– Cold and hot packs: Ice packs can reduce inflammation and pain if applied within 72 hrs of an injury. Ice should not be applied in a single area for more than 20 mins owing to ‘reverse reaction’ phenomenon.

– Hot packs are effective if applied after third day of injury. Moist heat is believed to be better in pain and inflammation improvement.

– Whirlpool and Jacuzzi jet massaging therapy are also examples of moist heat treatment.

– ‘Waon’ (soothing warmth) therapy employs far infrared ray dry sauna bath at 60° C for 15 min followed by transferring the patients to a room at 26° C covered with blanket for 30 min. Such 2-5 cycles in a week have significant effects on pain reduction.

x) Electrical stimulation: Such devices also prove effective but under medical supervision. Often called “dry needling” the technique of electrical stimulation by a needle passed in to TP has been successfully demonstrated to relieve shoulder and cervical myofascial pain as well as improve microcirculation.

xi) Ultrasound therapy: Sound waves from ultrasound machine are transmitted through sound conducting gel to the tissues. The ultrasound waves break down scar tissue, relax muscle and improve local circulation.

xii) Laser therapy: Short period application of infrared low level 904 nm Ga-As laser therapy have been found to be effective in pain relief and functional ability but its benefit when combined with muscle stretching physiotherapy has been questioned.

Have you tried any of these therapies?

SOURCES

• Fibromyalgia and Myofascial Pain Syndrome - A Dilemma: H. C. Chandola and Arunangshu Chakraborty
• Mayo Clinic: Understanding myofascial pain syndrome and fibromyalgia
• Practical Pain Management: Fibromyalgia & Myofascial Pain Syndromes
• Myofascial Pain, Fibromyalgia or Fibrositis? Pearce J.M.S.

THIS POST WAS LINKED UP AT FIBRO FRIDAY WEEK 7