Myofascial Trigger Point Massage Therapy – What Is It?
The word myofascial means muscle tissue (myo) and the connective tissue in and around it (fascia). Myofascial pain often results from muscle injury or repetitive strain. When stressed or injured, muscles often form trigger points, like contracted knots, that cause pain and tightness.
Myofascial trigger points are an extremely common cause of pain. Trigger points are painful when pressed on, cause a shortening of the muscle fibers, and have a special property called referred pain. Referred pain means that a trigger point in one muscle can create pain in another area.
For instance, when the muscle at the top of your shoulder (trapezius) has a trigger point it will refer pain up the side of your neck and head causing a headache. Active myofascial trigger points in the muscles of the shoulder neck and face are a common source of headaches. In many instances the headache has the features of so-called tension headache, but there is increasing acceptance that myofascial trigger points may initiate classical migraine headaches or be part of a mixed tension/migraine headache complex.
Treating trigger points or “muscle knots”
Since a trigger point is the contraction mechanism of the muscle locked into a shortened position, the treatment of the trigger point involves unlocking that contraction mechanism (sarcomere). This can be achieved in several ways. Trigger Point Pressure Release involves applying pressure with a finger or other instrument to the ‘muscle knot” and increasing the pressure as the trigger point “releases” and softens. Once trigger points are released the muscle needs to be moved throughout its full range. Simple limbering movements done by the patient at home are important in the retraining of the muscle.
Trigger Point therapy can help with the following issues:
• Back pain
• Neck pain
• Rotator cuff (shoulder) pain
• Jaw pain (TMJD)
• Tennis elbow
• Carpal tunnel syndrome
• Hand and arm pain
• Repetitive Strain Injuries
• Pelvic pain
• Hip pain
• “Sciatic” pain (buttock and leg pain)
• Leg and knee pain
• Plantar fascitis (foot) pain
• Disc pain (bulge/rupture/herniation) and radiculopathy
• Frozen shoulder
What to Expect From Treatment
Many patients experience relief from pain during the first treatment. For others several treatments are needed before their pain starts to diminish. It is common for patients to experience some soreness for one to two days after treatment. This usually resolves after the first few treatments.
Your rate of improvement depends on many conditions:
• Type of injury and length of time since it occurred.
• Overall physical health and level of fitness
• Perpetuating factors (many can be eliminated, others can not)
• Underlying skeletal abnormalities
• Nutrition (vitamin and mineral deficiencies, poor diet etc.)
• Quality of sleep
• Depression or anxiety
• Patient compliance with self-care and eliminating or reducing perpetuating factors.
• Other medical conditions (i.e. allergies, diabetes, thyroid dysfunction, etc.)
Prices: $85- 60minute session
(covered by most extended medical plans)
FAQ – MYOFASCIAL TRIGGER POINT THERAPY
DO DOCTORS KNOW ABOUT THIS THERAPY?
Muscles have been an under-treated cause of pain. In fact, with a specialized area of medicine for almost every area of the body (heart, eyes, lungs, intestines, kidneys, etc), oddly, there is no muscle specialty in medicine. Myofascial pain from trigger points is often over-looked as a possible source of pain by those seeking relief.
Unfortunately, common though the condition may be, the diagnoses and treatment of Myofascial Pain has yet to be included in most medical training. The majority of patients seeking relief from pain are still treated with the traditional approach of anti-inflammatory medications, muscle relaxants, anti depressant medications and/or strengthening programs. These prove ineffective, if not detrimental, as trigger points do not respond to them and may be aggravated by further straining (strengthening exercises). Currently there is no evidence that any form of drug treatment eliminates myofascial trigger points. NSAIDs and other analgesics usually provide moderate but very temporary symptomatic relief.
It is encouraging that myofascial trigger points are becoming more commonly considered when physicians diagnose their patients. Some primary care physicians, regularly administer trigger point injections. Some recognize the presence of trigger points and refer to Myofascial Trigger Point Therapists. Those that do, enjoy an enhanced success rate and grateful patients.
HOW ARE THESE TRIGGER POINTS FORMED?
Muscles make up between 36-42% of body weight, on average. They are a large percentage of our total weight and have a corresponding impact on our health. When all is in working order, muscles allow us to perform normal activities with ease. When our muscles harbor trigger points, we experience pain, stiffness and tension, physical limitation and loss of normal function.
Factors commonly cited as predisposing to trigger point formation include but are not limited to: de-conditioning, poor posture, repetitive mechanical stress, mechanical imbalance (e.g. leg length inequality), joint disorders, non-restorative sleep and vitamin deficiencies.
A diagnosis of Myofascial Pain Syndrome or Chronic Myofascial Pain means that the primary source of your symptoms are from these myofascial trigger points. Often, trigger points are present secondary to other sources of pain, such as arthritis or bulging discs. The trigger points may actually be causing the painful symptoms attributed to with these conditions. As such, they are often called “the great mimickers”.
The damage to muscle and connective tissue which results in trigger points can occur several ways. It can happen as the result of:
• Repetitive overuse injuries (using the same body parts in the same way hundreds of times on a daily basis) from activities such as typing/mousing, handheld electronics, gardening, home improvement projects, work environments, etc.
• Sustained loading as with heavy lifting, carrying babies, briefcases, boxes, wearing body armor or lifting bedridden patients.
• Habitually poor posture due to our sedentary lifestyles, de-conditioning and poorly designed furniture
• Muscle clenching and tensing due to mental/emotional stress.
• Direct injury such as a blow, strain, break, twist or tear. Think car accidents, sports injuries, falling down stairs and the like.
• Surprisingly, trigger points can even develop due to inactivity such as prolonged bed rest or sitting.
HOW MANY TRIGGER POINTS CAN I HAVE?
Since a trigger point is an abnormal biochemical and mechanical area in contracted muscle tissue, the number and exact location on each person can vary. All muscle tissue is potentially prone to developing trigger points. Sometimes people have one trigger point but more often they have many. Prolonged referral of pain and weakness from a one trigger point to another area of the body will generally cause other trigger points to develop in that area. These, in turn, if left untreated, can activate and also refer pain, creating multiple pain patterns. The more areas that have pain and the longer you have had the pain, the more trigger points you are likely to have. It is rare for someone with pain to only have one or two muscles with trigger points.
A skilled practitioner who has been trained to recognize the symptoms of myofascial pain and palpate muscles for myofascial trigger points can assess whether myofascial trigger points are present. There are no commonly available lab tests or imaging studies that can confirm the diagnosis at this time. Myofascial trigger points can be seen on special MRI scans and special ultrasound but these are currently only used in research.