by Alice Demetrius Stock
When Richard Finn was knocked off his bicycle by a
hit-and-run driver in college, he was left in chronic pain.
Emergency room personnel told Finn he was fine, but after the accident, he seldom felt well.
"I was taking eight to 12 aspirin every day for headaches, and for the next two years, I was always sick because aspirin destroys vitamins," he said.
So he started reading health books to try to find another way to ease his headaches. He found a text on Trigger Point Myotherapy by Dr. Janet Travell Powell, a specialist in pain management who served as John F. Kennedy's physician when he was president.
Research on muscle therapies by Travell and others focused on locating and treating "myofascial trigger points."
Myo means muscle, and a trigger point is an irritated spot in a muscle that makes it tighten, limiting function and motion, and causing weakness or pain.
The nervous system often "refers" such pain to other parts of the body, making it difficult for those not familiar with Trigger Point Myotherapy to determine the pain's source. For example, common trigger points in the major neck muscle may refer pain to areas of the head; trigger points in a neck muscle can irritate nerves causing tingling in the arm on the same side.
After reading the text, Finn, now 36, of Penn Hills, was so taken with this method, that he changed his career plans: from minister to physical therapist.
He now practices at the Center for Pain Treatment on the South Side, where he and other certified Trigger Point Myotherapists work to inactivate painful trigger points, often just by pressing on them. They also try to prevent their recurrence by prescribing exercises, proper footwear, or seating.
Trigger Points are tender spots that can develop anywhere in a muscle or connective tissue following chronic overload to muscles, caused by poor posture or trauma, such as a broken bone, surgery or whiplash, or from repetitive motion.
Relief, not a cure
Practitioners claim this therapy is beneficial for a variety of muscle related conditions, including back, shoulder and neck pain, headaches, migraine, repetitive motion injuries, menstrual cramps and sports injuries, among others.
They emphasize, however, that myotherapy does not cure disease, but rather helps relieve pain and ease recovery.
According to literature at the center, some specialists recommend deep finger pressure on trigger points for seven seconds. Other therapists press the point until the pain subsides.
Because long-term relief from trigger point pain requires much more than simply pressing on sore muscles, practitioners caution consumers to select only certified practitioners.
Pressing the wrong spot is not dangerous, but one not trained in this specialty could actually make the pain worse, they say.
Tasso Spanos, founder of the Center for Pain Treatment, said to become certified, a candidate must take preliminary college-level courses in such subjects as anatomy and physiology, then 500 hours of specialized training in Trigger Point Myotherapy from a school approved by the National Association of Myofascial Trigger Point Therapists, and pass the association's 3 hour examination.
"It's important to work with a certified myotherapist," Spanos said. "Otherwise, you might be getting someone who had only 10 hours training over a weekend ... the whole effort begins to deteriorate."
In addition to the four at his center, he believes there are three other certified myotherapists in the Pittsburgh area.
The costs
At the center, Trigger Point Myotherapy involves an initial evaluation by a myotherapist and a chiropractor and follow-up sessions. The number of sessions depends on the practitioners evaluation.
The center charges $140 for an initial evaluation and roughly $100 for follow-up sessions. Worker's compensation or auto-accident insurance may cover costs, according to Carol Laubscher, a clinic spokeswoman.
"Chiropractic adjustments alone often don't hold," Finn said. "Bones get pulled out of alignment when muscles are tight. We find the best results combine a muscle-bone approach using chiropractic along with Trigger Point Myotherapy."
Among the center's patients are physicians.
Dr. Karen Rehder, 41, of Allison Park, is a gynecologist. Her third pregnancy weakened her pelvic ligaments so severely that walking became very painful. An operation left her with scar tissue and chronic pain until, she said, she heard about the pain center.
"All the regular doctors had given up on me," Rehder said. "They just didn't know what to do for me because there's too much for one person to study in medical school. As a doctor, I was afraid I'd be abused at a place using alternative medicine, but I felt comfortable with Trigger Point Myotherapy because it was developed by a doctor."
Nancy Lynches, 43, of Sewickley, had chronic back problems that resisted traditional treatments.
"My right hip was higher than my left due to degenerated discs in my spine. I couldn't get through a full day of work at the office. I'd gone to an orthopedic surgeon, a neurologist and two neurosurgeons. I was on pain medication and steroids. I went to physical therapy, massage, and chiropractic. The center was a last resort."
Lynches said after eight months of treatment there, she's back to a normal life. She returns for maintenance as needed.
John Bernheisel, 41, of Penn Hills, had given up on finding relief for the pain in his "frozen neck."
"Over the past 12 years, arthritis had inflamed my joints, limiting my neck movement until my head stuck out forward at an odd angle," Bernheisel said.
After several months of weekly sessions at the center, he feels mobility in his neck coming back and the pain level "is only about 10 percent of what it was."
"This [trigger point] method works very fast," Finn said. "A person will know in the first two or three visits if it is going to help or not. They'll have less pain or they'll sleep better or have a higher energy level or an increase in motion."