22.06.2015

Myofascial pain syndrome treatment lyrica

Myofascial Pain Syndrome is caused by injury or damage to the fascia, the soft, stretchy connective tissue that surrounds muscles, organs and other structures inside the body.
Myofascial Pain Syndrome is caused by injury or damage to the fascia, the soft, stretchy connective tissue that  surrounds muscles, organs and other structures inside the body. People who suffer from this syndrome often develop painful bumps under the skin called trigger points. Myofascial pain ranges from mild to severe, from dull, throbbing aches to stabbing or burning sensations. Associated symptoms can include popping sounds or limited range of movement in joints, numbness, headaches, weakness, problems with memory, balance, vision, hearing, and many others.
Myofascial Pain Syndrome can be treated with physical therapy, massage and stretching of the affected muscles, trigger point injections, and medications. One of the most common causes of buttock pain is myofascial pain, which is characterized by pain starting from tight bands of muscle or knots in the gluteal muscles. The gluteal muscles are strong muscles located at the back of the pelvis building up the buttock.
Gluteus minimus, gluteus medius and gluteus maximus start from the pelvis and insert into the upper side of the thigh bone i.e. The gluteal muscles help in straightening the hip while performing activities, stabilizing the pelvis and aiding in other movements of the hip like side elevation and hip rotation. The piriformis muscles and gluteus medius are the areas that are very much prone to develop the trigger points associated with myofascial pain in buttock muscles. Pelvic instability, lower back injuries and overuse of the gluteal muscles result in the formation of excessive tight bands of muscle called as knots or myofascial trigger points. Myofascial pain in the buttock muscles is caused by excessive tightness of the piriformis muscles and gluteals. Sometimes pain may also spread into the foot, ankle, calf and at the back side of the thigh. Exacerbation of pain in the buttock while stretching the affected muscles such as while bringing the knee toward the opposite shoulder and during forceful contraction of the gluteal or piriformis muscle such as while running and changing directions. Applying pressure on the trigger points may sometimes radiate the pain or symptoms down the leg. Starting a comprehensive stretching routine for the muscles of the hip, groin and lower back. Identification of the cause of the myofascial pain and trigger points, which can many a times be secondary to some other problem.
Application of deep tissue massage techniques with the combination of proprioceptive neuromuscular facilitation (PNF) stretching. Physical therapy for myofascial pain in the buttock muscles is important in speeding up the healing process. Gluteal Self Massage: This exercise is performed by keeping the Spiky massage ball beneath buttock.
A complete subjective and physical examination is performed to diagnose myofascial pain in the buttock muscles.
The main innovation of Travell’s work was the introduction of the myofascial pain syndrome concept (myofascial referring to the combination of muscle and fascia). An active trigger point is one that actively refers pain either locally or to another location (most trigger points refer pain elsewhere in the body along nerve pathways). A key trigger point is one that has a pain referral pattern along a nerve pathway that activates a latent trigger point on the pathway, or creates it. In contrast, a primary trigger point in many cases will biomechanically activate a secondary trigger point in another structure. When trigger points are present in muscles there is often pain and weakness in the associated structures. Myofascial Trigger Point Therapy & Massage for elimination of pain and dysfunction for a HAPPIER you! Myofascial Trigger Point Therapy by a Nationally Certified Myofascial Trigger Point Therapist with over 17 years experience helping people recover from injuries and eliminate pain and dysfunction. Specializing in pain management, headaches and migraines, repetitive motion injuries, computer worker pain complaints, "whiplash", "TMJD", "carpal tunnel" and much more. Everyone is welcome here, all AGES, genders, cultures, sizes, colors, beliefs and orientations! If you live in the Greater Pittsburgh, North Pittsburgh, Wexford, Cranberry, Seven Fields, Warrendale, Butler, Beaver or Allegheny county area, you are in luck! Thank you Janet Travell and David Simons for a lifetime of research on Myofascial Pain and dysfunction. Your pain is probably not caused by the lack of the "right drug" or $3000 worth of treatment! I am a Board Certified Myofascial Trigger Point Therapist and offer Myofascial Trigger Point Therapy, Medical Massage, massage and other non-invasive pain management modalities.
Once myofascial trigger points are activated, they may cause referred pain and dysfunction in various and disparate parts of the body unless treated by myofascial trigger point therapy.
MANY mystery pain complaints can be easily explained by myofascial trigger points and their referred pain patterns! Too many times a "pain diagnosis" is only big words that describe your pain, that is all!
Myofascial trigger point therapy is a safe, non-invasive and drug-free way to relieve the cause and symptoms of these and many forms of pain related to muscles and body mechanics dysfunctions.
This medical exhibit pictures the primary regions of pain associated with injury or dysfunction of the temporomandibular joint (TMJ).


When the calf muscle group become tight your body’s center of mass shift anteriorly, causing your thoracolumbar paraspinal (low back) muscles to over-activate and increase lumbar lordosis to maintain erect posture during standing and walking. Getting effective massage work here can be very painful for some individuals but without proper treatment here, you may see your doctor because of low back pain and his recommendation may be surgery.
Some research findings that we found say about 15% of low back pain can be traced to tight soleus muscles, now imagine going under the knife for chronic low back pain to only find out later on that you still have pain here, due to tight calves. Other contributing factors for developing trigger points in the soleus muscle should be considered. The nervous system 'communicates' with muscle via neuromuscular (also called myoneural) junctions.
The cell membrane of a muscle cell is called the sarcolemma, and this membrane, like that of neurons, maintains a membrane potential. The sarcoplasm is the specialized cytoplasm of a muscle cell that contains the usual subcellular elements along with the Golgi apparatus, abundant myofibrils, a modified endoplasmic reticulum known as the sarcoplasmic reticulum (SR), myoglobin and mitochondria.
Myofibrils are contractile units that consist of an ordered arrangement of longitudinal myofilaments. A muscle fiber is excited via a motor nerve that generates an action potential that spreads along the surface membrane (sarcolemma) and the transverse tubular system into the deeper parts of the muscle fiber. The calcium-calmodulin complex 'activates' myosin which then binds to actin & contraction (swivelling of cross-bridges) begins.
The syndrome causes chronic pain in muscles throughout the body, especially in the neck and jaw. The syndrome can develop after muscles are injured or overworked, because of skeletal abnormalities, or in conjunction with other disorders such as fibromyalgia or depression. These small, tight knots can form at the point where the fascia comes into contact with muscle tissue.
This may also lead to soft tissue and muscle shortening, increased pressure on nerves and local tissue followed by pain which ultimately results in myofascial pain in buttock muscles.
Myofascial pain in the buttock is caused due to lower back injury, pelvic instability or subsequent overuse of the gluteal muscles. Now with the help of hands bring the knee towards the opposite shoulder until a mild to moderate pain-free stretch is felt in the buttocks or at the front side of the hip. Keep the leg stretched beneath the chest and stomach in such a way so that the knee should come in front of the hips and the foot should come side way.
Now with the help of legs and arms gradually move the body in forward and backward direction and from side to side in order to allow the Spiky ball to rub the buttock region.
This is described as a focal hyperirritability in muscle that can strongly modulate central nervous system functions. These trigger points, when they become active or latent, show up in the same places in muscles in every person. A latent trigger point is one that exists, but does not yet refer pain actively, but may do so when pressure or strain is applied to the myoskeletal structure containing the trigger point. They form as a local contraction in a small number of muscle fibers in a larger muscle or muscle bundle. These pain patterns in muscles follow specific nerve pathways and have been readily mapped to allow for identification of the causative pain factor. NationWide Auto Insurance has chosen to deny or severely limit your choice to have medical massage in Pennsylvania, switch before you are in an accident! Does it return as soon as the meds wear off or you try to return to your regular activities?
I have 650 hours of very specific training in Myofascial Trigger Point Therapy, > 1000 hours specific, related continuing education and over 16 years experience.
Many pain complaints are due to dysfunction of muscle and soft tissue, which can be addressed using Myofascial Trigger Point Therapy, Medical Massage, Neuromuscular Therapy and some other modalities.
Pharmaceuticals such as pain meds and anti-inflammatory seldom work for long-term relief where as addressing the trigger points and other soft tissue dysfunction actually REMOVES the problem in many cases. It features a right lateral (side) silhouette view of a generic head and neck with the skull ghosted within. They range from extremely tiny strands such as the stapedium muscle of the middle ear to large masses such as the muscles of the thigh. So, impulses travel along muscle cell membranes just as they do along nerve cell membranes. Hundreds or thousands of muscle fibers (cells) bundle together to make up an individual skeletal muscle. Transverse (T)-tubules invaginate the sarcolemma, allowing impulses to penetrate the cell and activate the SR. Myofilaments can be either thick filaments (comprised of myosin) or thin filaments (comprised primarily of actin). A receptor protein (DHP) senses the membrane depolarization, alters its conformation, and activates the ryanodine receptor (RyR) that releases Ca2+ from the SR. In skeletal muscle, these myofilaments are arranged in a very regular, precise pattern: thick myofilaments are typically surrounded by 6 thin myofilaments (end view). Trigger points canbe felt beneath the skin, and, when pressed,cause pain and twitching in the underlying muscle. Many smaller muscles are also present in the deeper side of the gluteal muscles such as the piriformis muscle. Myofascial pain in the buttock more frequently occurs with activities and sports that involve repeated use of the gluteal muscles such as jumping, running particularly while changing direction, squatting, lunging and sprinting. Now by keeping the back leg in a straight position slowly bring the upper body towards the ground until a mild to moderate pain-free stretch is felt in the buttocks.


Travell and followers distinguish this from fibromyalgia, which is characterized by widespread pain and tenderness and is described as a central augmentation of nociception giving rise to deep tissue tenderness that includes muscles.
Latent trigger points can influence muscle activation patterns, which can result in poorer muscle coordination and balance.
Successfully treating the key trigger point will often resolve the satellite, either converting it from being active to latent or completely treating it.
These in turn can pull on tendons and ligaments associated with the muscle and can cause pain deep within a joint where there are no muscles. Many trigger points have pain patterns that overlap, and some create reciprocal cyclic relationships that need to be treated extensively to remove them. I have worked with Chiropractors and Medical Doctors to provide, in many cases, far better pain management than OTC pain meds, pharmaceuticals, PT or time can provide.
Large areas of red color and labels designate the areas of pain in the temple, ear, cheek, neck and shoulders.
In your normal walk, as your ankle bends and unbends, your lower leg (shin) passes over the center of your foot.
Skeletal muscles may be made up of hundreds, or even thousands, of muscle fibers bundled together and wrapped in a connective tissue covering. Muscle cells are long, cylindrical structures that are bound by a plasma membrane (the sarcolemma) and an overlying basal lamina and when grouped into bundles (fascicles) they make up muscle. As shown in the figure, the SR forms a network around the myofibrils, storing and providing the Ca2+ that is required for muscle contraction. The characteristic 'striations' of skeletal and cardiac muscle are readily observable by light microscopy as alternating light and dark bands on longitudinal sections.
Ca2+ then bind to troponin and activates the contraction process (Jurkat-Rott and Lehmann-Horn 2005). Sarcoplasmic reticulum is very abundant in skeletal muscle cells and is closely associated with the MYOFIBRILS (and, therefore, the MYOFILAMENTS).
Studies estimate that in 75–95 percent of cases, myofascial pain is a primary cause of regional pain. When muscle fibers contract, they use biochemical energy, and depletion of these biochemicals leads to accumulation of fatigue toxins such as lactic acid. Just because they are not "broken" does not mean the pain is NOT REAL and SERIOUS! If your ankle is unable to complete this full range of motion, you begin to lose the ability to point your foot up or turn in or out. Fascicles are also surrounded by connective tissue (called the perimysium) and each fascicle is composed of numerous muscle fibers (or muscle cells).
To understand how a muscle contracts, you need to know a bit about the structure of muscle cells. The sarcolemma forms a physical barrier against the external environment and also mediates signals between the exterior and the muscle cell.
The light band, (known as the I-band) is made up of thin filaments, whereas the dark band (known as the A-band) is made up of thick filaments. The membrane of the SR is well-equipped to handle calcium: there are "pumps" (active transport) for calcium so that calcium is constantly being "pumped" into the SR from the cytoplasm of the muscle cell (called the SARCOPLASM).
Applying sustained pressure to a specific tight spot for about 15 to 60 seconds or until the muscle relaxes may also be helpful. Myofascial pain is associated with muscle tenderness that arises from trigger points, focal points of tenderness, a few millimeters in diameter, found at multiple sites in a muscle and the fascia of muscle tissue.
The tightened muscle fibers constrict capillaries and prevent them from carrying off the fatigue toxins to the body’s recycling system (liver and kidneys)[citation needed] . Muscle cells, ensheathed by endomysium, consist of many fibrils (or myofibrils), and these myofibrils are made up of long protein molecules called myofilaments. The Z-line (also known as the Z-disk or Z-band) defines the lateral boundary of each sarcomeric unit.
The function of T-TUBULES is to conduct impulses from the surface of the cell (SARCOLEMMA) down into the cell and, specifically, to another structure in the cell called the SARCOPLASMIC RETICULUM. As a result, in a relaxed muscle, there is a very high concentration of calcium in the SR and a very low concentration in the sarcoplasm (and, therefore, among the myofibrils & myofilaments).
The buildup of these toxins in a muscle bundle or muscle feels like a tight muscle—a slippery elongate bundle. There are two types of myofilaments in myofibrils: thick myofilaments and thin myofilaments.
Contraction of the sarcomere occurs when the Z-lines move closer together, making the myofibrils contract, and therefore the whole muscle cell and then the entire muscle contracts (Source: Davies and Nowak 2006). Each bundle of muscle fiber is called a fasciculus and is surrounded by a layer of connective tissue called the perimysium. Within the fasciculus, each individual muscle cell, called a muscle fiber, is surrounded by connective tissue called the endomysium.
Generally, an artery and at least one vein accompany each nerve that penetrates the epimysium of a skeletal muscle.



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