Myofascial Triggger Point Essay Example for Free

Myofascial Triggger Point EssayThis chapter is the review of the acquirable literature concerning the theoretic content that is necessary to understand the cowl energy heftiness and its role in the symptoms associated with f number back painful sensation. Particularly the issues some the types of spark off horizontal surfaces, including a discussion of myofascial get off point therapy and acupuncture creation point therapy. More importantly the aw arness and understanding on how to improve the quality of life by learning about the alternative options, making changes and applying self-help strategies on myofascial sparkle points. Given this points, a brief translation of the topics be noted It is painful to say that about 23 million persons, or 10 per centum of the U. S. population, overhear cardinal or more chronic disorders of the musculo senseless system (Imamura, Fischer, Imamura, Teixeira, Tchia Kaziyama, (1997). The most commonplace think for the break t hrough of pain and rigidity in the head, cervix uteri and bring up is the development of myofascial trip up points (MTrPs) activity in those beas.Factors responsible to set in motion introduction point in the vigours of the neck and shoulder vicinity include postural disorders, drooping of the shoulder girdle, deport and indirect overloading of the neck go throughs, acute trauma to the neck and anxiety (Baldry, 2002). For instance, the muscleman builder most oft affected by MTrPs is the trapezius muscle. Any position or task that requires the shoulders to carry out the weight of the pep pill extremities repeatedly or for prolonged periods of time overloads the f number trapezius muscle, and strongly boosts the development of MTrPs (Mense, 2001).Incident whollyy, MTrPs extremely common and became a painful cave in of nearly e trulyones life at one time or another. ), the upper trapezius industrious MTrPs are common in patients presenting neck pain (Simons Travell 1999 ). Surprising statistics suggested that neck pain has a lifetime incidence of 45%-54% in the general population (Fernandez-de-las-Penas, Alonso-Blanco Mangolarra, 2007). evocation points are tender to direct pressure or squeezing, they are painful and they are palpable as hard nodules. Rachlin, 2005). In fact, Simons Travell (1999) has described pain due to TrPs is a ca employment of pain in all split of the body and it has been describe as a semen of pain in numerous medical conditions. Patients presenting mainly with upper body pain or headaches are more likely to MTrPs pain than patients presenting with pain located elsewhere (Rachlin, 2005). Indeed, therapy for MTrPs has been used by Bilkstad and Gemmell, (2008) with anecdotal succeeder in patients with non-specific neck pain.Gemmell and all toldens (2008) study also proved that a session of cancel point therapy, has a clinical meaningful effects in the treatment of acute founding points of the upper trapezius muscle. C ertainly acupuncture for MTrPs is an effective and efficient technique for the treatment of myofascial pain and dysfunction. That is, an acupuncture needle is inserted through the skin and moved gently up and down through the MTrPs. The effect is to de-activate the set forth point and slow the muscle according to Travell and Simons (1999).Furthermore, studies of neck pain have proposed that manipulation is an effective therapy, especially when combined with wield (Rubinstein, Leboeuf-Yde, Knol, de Koekkoek, Pfeifle van Tulder, 2008). Gatterman (2005) stated that chiropractic treatment of the spine has a relaxing effect on the spinal muscle and a loosening effect on spinal articulations, hence making a difference in a number of ailments drawn by cervical structure.Historical Background ReviewBack to 1816, British physician Balfour, as cited by Stockman, described nodular tumors and thickenings which were painful to the touch, and from which pains shot to neighboring parts (Stockm an, 1904 p. 107-116). In 1841, trigger points have been documented in western medicine research. In the European literature, regional musculoskeletal pain conditions have been documented since the 18th century (Reynolds, 1983). Dr. Janet Travell (1901-1997) is generally credited for bringing MTrPs to the solicitude of healthcare providers.MTrPs have been described and rediscovered for several centuries by various clinicians and researchers as far back as the 16th century, de Baillou (1538-1616), Ruhmann (1940) described what is now known as myofascial pain syndrome (MPS). Bron Dommerholt, ( 2012, p. 1) acknowledges, myofascial pain syndrome is defined as the sensory, motor, and involuntary symptoms caused by Mypfascial actuate Points, and has become a recognized medical diagnosis among pain specialists.The first trigger point manual was published in 1931 in Germany nearly a decade before Dr.Janet Travell became enkindle in MTrPs These early descriptions and other historic paper s did illustrate the basic features of MTrPs quite accurately (Simons, 1975). In 1966, Dr. Travell founded the North American Academy of Manipulative Medicine, together with Dr. John Mennell, who also published several articles about MTrPs (Mennell, 1976-1989). In the early 1960s, Dr. David Simons was introduced to Dr. Travell and her work, which became the start of a fruitful collaboration eventually resulting in several publications, including the Trigger Point Manuals (Simons Travell 1999).The Trigger Point Manuals are the most comprehensive review of nearly 150 muscle referred-pain patterns based on Dr. Travells clinical observations, and they include an extensive review of the scientific basis of MTrPs. twain volumes have been translated into several foreign languages. These books are considered the definitive reference on myofascial pain and locating trigger points. Trapezius musclebuilder This diamond shape muscle is situated in the neck and upper part of the back and inha bits most superficially (Moore Dalley, 2006).It was given its name because the muscles of the two sides form a trapezium. The main treat of the trapezius is to aid in head, neck and the clavicle movement. The trapezius commonly contains trigger points, and referred pain from these trigger points bring patients to the office more often than for any other problem. take in 2. 1 shows the trapezius- a bear-sized kite-shaped muscle, covering much of the back and posterior neck. There are three main parts to the muscle the Upper, middle, and lower part. Each part has its own actions and often different functions. Figure 2. 1 Trapezius MuscleNamely the upper portion of the trapezius muscle laterally flexes the head and the neck towards the same side, and assists in extreme rotation of the head so that the face turns to the opposite side. It can draw the clavicle rearward and raise it by rotating the clavicle. It usually helps to carry the weight of the upper limb during standing, or s upport a weight in the hand with the arm hanging. Acting bilaterally, the upper fibers extend the head and the neck . The upper trapezius can reflect headaches on the temples, dizziness, severe neck pain, intolerance to weight on your shoulders. period the middle trapezius reflects pain on the mid-back, headaches at the base of your skull and superficial burning pain impede to the spine. On the other hand lower trapezius on the mid-back refers pain to the neck, and/or upper shoulder region (Simons Travell, 1999). Figure 2. 2 Trapezius Trigger Points Myofascial Trigger Points The word myofascial means muscle create from raw stuff (myo) and the connective tissue in and around it (fascia). According to the most commonly accepted theory, a myofascial trigger point ( Figure 2. ) is an area of hypersensitivity in a taut band, or contraction knot of skeletal muscle with respect to pain (Simons, et al. , 1999), as opposed to healthy muscle, which does not contain taut bands or trigger p oint (Shah, et al. 2005). The trigger point feels like a pea embedded within the muscle to the touch. A trigger point is alship canal tender and becomes painful, like contracted knots that refers pain and tightness upon direct compression and is mediated by a local anesthetic twitch response (Hong, 2006 Simons et al. , 1999 Simons, 2004).Auleciems (1995) furthermore researched the incidence of MPS, reported to be as high as 85% at certain American pain clinics. Figure 2. 3 Myofascia Trigger Point Taut Band Myofascial Trigger Point Development There are existing studies to account for the development of trigger points and subsequent pain patterns, but scientific evidence is lacking. legion(predicate) researchers concur that an acute injury or repetitive small injuries may lead to the development of a trigger point which creates some degree of tissue damage (Rachlin, 2005). The damage to muscle and connective tissue can befall several ways.From lack of exercise, prolonged poor postur e, vitamin deficiencies, sleep disturbances, and joint problems (Simons Travell, 1999). Examples of predisposing activities such as typing/moussing, handheld electronics, gardening, home improvement projects, work environments, holding a telephone receiver in the midst of the ear and shoulder to free arms prolonged bending over a table seance in chairs with poor back support, improper height of arm rests or none at all (Simpson McCarthy, 2001) sustained loading as with heavy lifting, carrying babies, briefcases, boxes, wearing body armor or lifting bedridden patients. wound from falling down stairs or whiplash injury in a motor vehicle accident (Lavelle, Lavelle, Susti, 2007). Myofascial Trigger Point Classification Trigger points are classified as being active or latent. The active, painful phase of the trigger point is the one which motivates people to seek relief. The active trigger point hurts when pressed with a finger and causes pain around it and in other areas. (Hong, 2 006 Simons, 2004). The active trigger point referral symptom may feel like a dull ache, deep, pressing pain, burning, or a sensation of numbness and fatigue.If unaddressed or ineffectively treated, eventually other muscles around the dysfunctional one become stressed and develop secondary trigger points. It is not unusual for chronic pain patients to have multiple, overlapping referred pain patterns, making diagnosis and treatment more complex. Trigger points can also lie quietly in muscles, sometimes for years. This type of trigger point is called latent. possible trigger points are very common. Probably one wont know they are there for the fact that they cause pain unless it is compressed.Latent trigger points cause restricted movement, distorted muscle movement patterns stiffness and weakness of the affected muscle (Fricton, Kroening, Haley Siegert, 1985). When firm pressure is applied over the trigger point in a snapping often causes the muscle to jump or briskly contract a lo cal twitch response (Simons et al. , 1999). The reaction of a twitch response during palpation of a trigger point, or during a trigger point waive procedure, is a reliable confirmation that the trigger point has been accurately located.When a trigger point in one muscle can create pain in another area it is known as referred pain. This referred pain is felt not at the site of the trigger-point origin, but remote from it (Mense Schmit, 1977). For example (Figure. 2. 4), a direct trigger point in the upper trapezius muscle refers pain to the temple region of the head. All muscle tissue is potentially prone to developing trigger points. Fig. 2. 4 Referred Pain from Trapezius Trigger Points Treatment of Myofascial Trigger Points As a matter of fact treating each trigger point is relatively simple.Treating the whole myofascial pain syndrome so that pain fully goes away is a more complicated process. pharmacological treatment of patients with chronic muscle pain includes analgesics an d medications to induce sleep and relax muscles. Antidepressants, anti-inflammatory drugs are often prescribed (Imamura et al. , 1997). The long-term clinical efficacy of various therapies is not clear, because data that incorporate pre- and post-treatment assessments with control groups are not available. No laboratory test or imaging technique has been established for diagnosing trigger points (Fricton et al. , 1985).However, the use of ultrasonography, electromyography, thermography, and muscle biopsy has been studied. A variety of hands-on skills, such as stretching, massage, manipulation, mobilization and strengthening (Simons, 2002), and a wide variety of modalities namely, diathermy, transcutaneous electrical nerve stimulation, ethyl chloride Spray and Stretch technique, dry needling, and trigger-point injections with local anesthetic, saline, or steroid heat, ice, ultrasound, electrical stimulation, mechanical pressure and light energy, are available to physicians and therap ists for the treatment of trigger points (Edward Knowles, 2003).For instance trigger point therapies can help specifically a number of health issues such as 1) Relieve migraine and headache 2) Alleviate low-back pain and improve range of motion calm down dependence over the counter or prescription medication 3) Release endorphins that work as the bodys born(p) painkiller 4) Enhance immunity by stimulating the bodys natural defense system. 5) Increase seam scarper to bring oxygen (Dommerholt Huijbregts (2011, p. 18 ).The proposed principle of treatment of MPS is to inactivate the active MTrPs through the use of various therapeutic modalities (Hong, C. 2000). However, the various treatments are beyond the scope of this study, the main focus here is to regard the efficacy of acupuncture and myofascial trigger point therapy for upper back pain. Acupuncture Trigger point pain may result from old or new injuries, excessive work out, incorrect body chemical mechanism and poor body p osture.In this light, acupuncture treatments can help return the balance to muscles. It is one of the safetyst ways to address physical problems. Using FDA-approved grade of acupuncture needles, it stimulates the muscle fibers, generating involuntary twitching of muscles located on the suspect trigger point (Figure 2. 5). Usually leads to an immediate reduction of the tightness as well as a reduction or elimination of the related problems (Scholar Hong, 2000. Aside from relieving muscles from stress, acupuncture treatment releases endorphins, boosts the nervous system, enhances the repellent system, and causes a number of other biochemical and hormonal changes (Napadow, Webb, Pearson, et al. , 2006). Acupuncture is a time proven and safe method to optimize health. In restoring balance to brain and nervous system functions, it helps regulate blood pressure, blood flow and body temperature, which is indirectly beneficial to managing and relieving body stressor (Birch, Hesselink, Jo nkman, et al. , (2004).