INFORMATION FOR YOUR PHYSICIAN
MYOFASCIAL TRIGGER POINT THERAPY
A Treatment for Mvofascial Pain & Dysfunction Myofascial Trigger Point Therapy is a therapeutic discipline and technique used for the relief of mvofascial pain and dysfunction. The treatment of tender areas (myofascial trigger points) located within taut bands of skeletal muscle is the chief goal of treatment. The trigger point develops from some trauma to the muscle. This adjunctive therapy resulted primarily from the medical careers of Drs. Janet Travel], the White 1-louse Physician to President Kennedy. and David Simons. Myofascial Trigger Point Therapy is recognized by the American Academy of Pain Management for the treatment of myofascial pain and dysfunction.
Current literature recognizes the myofascial trigger point to be a tender area located within taut bands of skeletal muscle tissue. They often occur at the site of the motor end plate zone. Active myofascial trigger points refer pain. tenderness. and autonomic phenomenon to an area more distant from the trigger area. This is accompanied by a shortening of the taut band in which the trigger points can thus be clinically identified by the referred pain patterns. decreased range of motion. and focal point tenderness. Objective documentation is currently possible through pressure algornetrv. needle EMG. thermography, and chemical changes at the trigger point site.
Mvofascial trigger points are usually involved at some level in most pain syndromes. Patients generally benefit whether the muscular component is primary or secondary. Partial or complete relief is often noticed in the first treatment. In the presence of systemic or mechanical perpetuating factors the relief gained during treatment will not be long lasting until the perpetuating factors are addressed.
A Myofascial Trigger point Therapist takes an initial history of the patient to evaluate. locate and treat those factors responsible for initiating or perpetuating the patient's condition. Any initiating or perpetuating factors that are out of the scope of training of the Myofacial Trigger Point Therapist are reported to the referring physician for evaluation and treatment. Treatment includes Trigger Point Pressure Release and a therapeutic stretch exercise applied to the affected muscle. Trigger Point Pressure Release is applied to mvofascial trigger points to disperse any retained metabolites which sensitize the nerve endings. It also separates the actin and myosin filaments in the muscle and breaks the neuromuscular reflex arc responsible for maintaining the trigger point.
Patients are educated in a variety- of self-compression. range of motion exercise, and movement re-education.
David Simons. MD reports "Systemic [perpetuating] factors include enzyme dysfunction because of nutritional deficiency. metabolic and endocrine dysfunction. chronic infection or infestation, and psychological stress... Skeletal muscles are energy engines. They convert the energy stored in adenosinetriphosphate (ATP) to mechanical movement. Understandably, anything that interferes with energy metabolism of the muscles tends to compromise the energy function and increase muscle irritability." Mechanical perpetuating factors include tower strength inequality, articular dysfunction. Morton foot structure. short upper arms and a small hemipelvis.
Our patient in common had a mvofascial pain syndrome that we treated with trigger point pressure therapy and stretch exercises specific to the involved muscle. These specific exercises were taught to the patient, so as to maintain the improvements.
We thought as their physician you would like to know which muscle was injured and created trigger points that referred pain or weakness to a specific area of the body.
Enclosed is the reference from Travcll and Simmons "Myofascial Pain and Dysfunction", on the priman- muscle involved and its pain pattern of referred pain sites. Our therapists are grateful to the physicians who have pioneered. researched. and documented the amazing improvements that can be quickly achieved with trigger point pressure therapy. If you have any questions please don't hesitate to cal] me at 412.431.9180. www.thecenterforpaintrcatntent@verizon.net
Mark G. Spanos, CMTPT
