Tag Archive for: Myofascial trigger points

Treatment Options for Fibromyalgia

Treatment Options for FibromyalgiaScientists estimate that over 6 million North Americans suffer from fibromyalgia, and experience widespread pain throughout their muscles and joints.

Fibromyalgia symptoms include deep muscle pain, fatigue, tingling or numbness in hands and feet and painful trigger points.   Additional symptoms can include anxiety, depression, difficulty concentrating, restless leg syndrome and TMJ.

Conditions that frequently overlap with fibromyalgia are severe headaches, chronic fatigue syndrome, myofascial pain syndrome,  teeth grinding, allergies, and other autoimmune disorders.

The onset of fibromyalgia has been linked to traumatic events, such as accidents, certain diseases and long term or excessive stress.

The first step in treating fibromyalgia is to track your symptoms. Keeping track of your symptoms will help your health care practitioner to choose the best treatment option for you.

The next step is to maintain a healthy lifestyle.

  • Reduce stress – limit overexertion and emotional stress
  • Get enough sleep – establishing good sleep habits are essential
  • Exercise regularly – appropriate exercises may include walking, swimming, and water aerobics
  • Eat whole foods – eat healthy foods, limit caffeine and “stay-way” from sugary processed foods

The third step is to seek treatment from your health practitioners, and this can include:

Acupuncture: There is evidence suggesting acupuncture causes changes in blood flow and levels of neurotransmitters in the brain and spinal cord, and helps pain relief in fibromyalgia.

Massage therapy: Massage can relax your muscles, improve range of motion in your joints and increase production of your body’s natural painkillers, relieving stress.

eToims: If you are living with chronic pain,  or fibromyalgia, there is a non-invasive treatment called Electrical Twitch Obtaining Intra-Muscular Stimulation, or “eToims” for short.

Class IV Laser: During each painless treatment laser energy increases circulation, drawing water, oxygen and nutrients to the damaged area.  This creates an optimal healing environment that reduces inflammation, swelling muscle spasms, stiffness and pain.  As the injured area returns to normal, function is restored and pain is relieved.

IMS/Dry needling: This treatment can greatly reduce tightness and pain, while increasing flexibility and range of motion. The needle sites  target taut, painful muscle bands, and areas near the spine where the nerve root may have become irritated and super-sensitive.

Please contact our health care practitioners for more information on these treatment options for fibromyalgia.

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What is Myofascial Pain Syndrome? | Health Care Victoria

What is myofascial pain syndrome?Myofascial pain syndrome is a chronic musculoskeletal pain disorder that can involve either a single muscle or a muscle group. 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).

The pain associated with this condition can range from burning, stabbing, aching sensations to include a combination of these symptoms.   With myofascial pain syndrome, excessive strain on a particular muscle, muscle group, ligament or tendon can prompt the development of a “trigger point” that, in turn, causes pain.

Where a person experiences the pain may not be where the myofascial pain generator is located. This is known as referred pain.  Myofascial pain symptoms usually involve muscle pain with specific “trigger” points which can be made worse with activity.

What causes myofascial pain & what are the symptoms?

Myofascial pain typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions, injury to an intervertebral disc, or lack of activity (such as a broken leg).

The main symptom of myofascial pain is ongoing muscle pain, in areas such as the low back, neck, shoulders, and chest.  These symptoms may include a muscle that is sensitive or tender when touched, or a pain that feels aching, burning, stinging, or stabbing and does not lessen in intensity.  Another symptom is reduced range of motion in the affected area and a feeling of weakness in the affected muscle.

How is myofascial pain diagnosed?

Trigger points can be identified by pain produced upon digital palpation (applying pressure with one to three fingers and the thumb). 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.

How is myofascial pain treated?

Treatments may include any of the following:

  •     Massage Therapy
  •     Physiotherapy
  •     Lifestyle changes -adjusting your workstation, improving posture, avoiding muscle tension
  •     IMS | Trigger point dry needling
  •     Transcutaneous electrical nerve stimulation | TENS
  •     Laser
  •     Ultrasound

Often a combination of physical therapy, trigger point dry needling and massage are needed in chronic cases.  Please talk with one of our health care practitioners to discuss myofascial pain syndrome.

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What is Dry Needling or IMS physiotherapy?

Dry Needling or IMS | physiotherapy victoria bcTrigger point dry needling, also referred to as intramuscular stimulation (IMS) and/or intramuscular therapy (IMT) is an invasive procedure in which an acupuncture needle is inserted into the skin and muscle. 

It’s actually considered part of physiotherapy, and is not acupuncture.

IMT treatments at Diversified. Read more about here.

What is Trigger Point Dry Needling?

Trigger point dry needling is physical intervention that uses dry needles to stimulate trigger points, diagnose and treat neuromuscular pain and functional movement deficits. 1

As the name implies, dry needling is primarily directed at myofascial trigger points, which are defined as “hyperirritable spots in skeletal muscle that are associated with a hypersensitive palpable point in a taut band”.2

Physical therapists around the world practice trigger point dry needling as part of their clinical practice and use the technique in combination with other physical therapy interventions.  A high degree of kinaesthetic perception allows a physical therapist to use the needle as a palpation tool and appreciate differences in the density of those tissues pierced by the needle.3

Although some people refer to trigger point dry needling as a form of acupuncture, it did not originate as part of the practice of traditional Chinese acupuncture. The difference being that there are distinct anatomical locations of myofascial trigger points within muscle tissue, whereas acupuncture points have point specificity on the body.

There is substantial medical literature on IMS and dry needling that has been subjected to peer review. Trigger point dry needling has been used following a variety of different schools and conceptual models.  According to these models, when the flow of nerve impulses is restricted to an area of the body, all innervated structures, including muscle, spinal nerves, sympathetic ganglia, adrenal glands, sweat cells, and brain cells become atrophic, irritable, and supersensitive.4,5

Many common diagnoses, such as achilles tendonitis, lateral epicondylitis, frozen shoulder, chrondromalacia patellae, headaches, plantar fasciitis, temporomandibular joint (TMJ) dysfunction, myofascial pain syndrome (MPS), and others, might in fact be the result of neuropathy, and associated myofascial trigger points.4

Intramuscular therapy has been very successful for patients with chronic low back pain and sciatica symptoms. Shortening of the paraspinal muscles, particularly the multifidi muscles, can lead to disc compression, narrowing of the intervertebral foramina, and/or cause direct pressure on the nerve root, which subsequently would result in peripheral neuropathy and compression of super sensitive pain receptors, resulting in pain and dysfunction. 4,5

In layman’s terms, the treatment uses acupuncture needles, to target specific muscles that have contracted and become shortened. These shortened muscles compress and irritate the nerves. This treatment can greatly reduce tightness and pain, while increasing flexibility and range of motion.

The treatment involves dry needling of affected areas of the body without injecting any substance. The needle sites can be targeted at the site of taut, painful muscle bands, and/or can be near the spine where the nerve root may have become irritated and super-sensitive.

An important note is needling  of a normal muscle is painless. In contrast a shortened, muscle will ‘grasp’ the needle and produces a  cramping sensation. Intramuscular dry needling can reduce pain and soften these trigger points, while increasing flexibility and range of motion.

  1. 1.Dommerholt J, Mayoral del Moral O, Grobly C.  Trigger point dry needling. The Journal of Manual & Manipulative Therapy 2006; 14(4): E70-87.
  2. Simons DG, Travell JG, Simons LS. Travell and Simons’ Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol 1. 2nd ed. Baltimore, MD: Williams & Wilkins, 1999.
  3. Mayoral del Moral O. Fisioterapia invasiva del sindrome de dolor myofascial [Spanish; Invasive physical therapy for myofascial pain syndrome]. Fisioterapia 2005;27(2):69-75.
  4. Gunn CC. Radiculopathic pain: Diagnosis, treatment of segmental irritation or sensitization. J Musculoskeletal Pain 1997;5(4):119-134.
  5. 5.  Cannon WB, Rosenblueth A. The Supersensitivity of Denervated Structures: A Law of Denervation. New York, NY: MacMillan, 1949.

 

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