Myofascial triggers points: What are they ?
by: Hans de Wit
Did you know that the Skeletal muscle structure (also called voluntary muscles) is the largest single organ of the human body and can weight 40% and more of our total body weight ? All this muscle mass can be divided into an astounding number of 696 individual muscles, that are made up by millions of fibres , nerves and blood vessels.
Today I hope to shed some light on why this complex network of soft tissues is playing a much larger role in your health than you might think. And also why its is so often overlooked by medical specialists who prefer looking at bones, joints , bursae and nerves for diagnosis and treatment.
Our muscles are extremely subject to the winding and grinding of our daily activities and even more so to our daily lack of activities. This causes trigger points in the fibers that can be classified into Active trigger points and latent trigger points.
They form as a local contraction in a small number of muscle fibers in a larger muscle or muscle bundle. The integrated hypothesis theory states that trigger points form from excessive release of acetylcholine which produces sustained depolarization of muscle fibers.
Unrecognized myofascial headaches, shoulder pain and low back pain that have become chronic are a major cause of lost time in the workplace and absenteeism in employees. Research has pointed out that chronic pain costs the american economy billions of dollars each year, and South Africa will be no different.
Some of the main causes of trigger points and pain are acute overload of muscles, overworking of muscles, chilling of the muscle fibers and traumatic events. Often times different diseases can cause soft tissue pain as well, with the heart, gallbladder and other visceral diseases being the major contributors. Emotional stress however , can play an even greater roll, causing the highest number of patients with muscle pain.
Trigger point are renowned for their ability to generate referred pain throughout your body. You might have a devastating headache on your temporal region of your skull , however the cause of your headache will be found down in your neck. This phenomenon can become very complex with different layers of muscle pain and stiffness surrounding a specific joint or vertebral body.
This is why different phases of rehabilitation is necessary. Stretch therapy will slowly remove all muscle stiffness and lack of range of motion. With this the outer and inner layers can be gently entered and trigger point therapy can be applied, putting pressure on very precise points in your body.
The therapist can also apply a stretch and spray technique. This technique involves an agent called vapocoolant, research has indicated that the use of a active coolant on the skin in combination with a stretch can inactivate trigger points very effectively.
Don’t hesitate to contact us to find a therapist near you www.stretchingsa.co.za
Common causes of back pain , Surgery or not ?
Slipped disk: A slipped disk is also called a herniated disc. Normally, disks in your spine provide space and cushioning between the bones in your spine. A slipped disk occurs when part of the much softer disk bulges out and pushes against nearby nerves. This causes severe pain and discomfort, as well as radiating pain symptoms down your legs or arms. Most cases of slipped discs heal over time, with the aid of physical therapy. ONLY most severe cases might need surgery.
Spinal stenosis: Spinal stenosis is a narrowing of the spaces between the spinal nerves and the spinal cord because of bony spurs and growths.. It is often caused by changes in the spine that get worse over time due to degeneration of the spine and arthritic changes. With severe spurs and osteophytes a surgical procedure can be beneficial to open the foramen and relieve pressure on the exiting nerve roots.
Sciatica: Sciatica is pain, weakness, numbness, or tingling in the leg. Sciatica is and overused term in the medical world, and should only refer to the actual hereditary condition where the sciatic plexus runs right through the hip external rotator muscle, called the piriformis. It is not caused by injury to or pressure on the sciatic nerve. This nerve starts in the lower spine and runs down the back of each leg. Sciatica is a symptom of another medical problem, not a medical condition on its own. Sometimes a condition called piriformis syndrome leads to sciatica. This condition affects a muscle in the buttocks and may cause pain or a dull ache in the buttocks. Surgery is not recommended.
Back strain: Back strain is injury to the muscles and ligaments in the back. Due to overworking the soft tissue by heavy lifiting or intense sport. The pain usually spreads to the muscles next to the spine. Muscle spasms (pain from muscles tightening in quick movements on their own) may also occur from back strain. The pain may move to the buttocks, but it does not usually go down the leg. No surgery recommended
Arthritis and degenerative spine disease: Many people with chronic back pain have arthritis and extra wear and tear on the spine. Osteoarthritis can affect any joint in the body, including the spine. The spinal disks dry out and become stiffer and can rupture more easily. You can lose movement in your spine. These changes can also develop in areas where you have a slipped disk or a spinal fracture. This problem may also be called spondylosis. This is the most common cause of chronic back pain in humans, and can cause many years of agony. This is also the segment of the population most operated on. In Fact, since 2003 the amount of low back surgeries has increased by well over 300% in the US alone. This is due to the general population’s lack of physical exercise, unhealthy diets and exposure to chemical components. Physical therapy is starting to play a bigger role than ever, and in time more than 75% of these cases will be managed without any surgery.
Facet joint pain: Facet joints are joints that connect the vertebrae (bones of the spine). They allow the spine to move and make twisting and bending movements. Facet joint pain cannot be diagnosed using x-rays or MRI scans. A doctor who treats back pain may be able to diagnose this problem based on your symptoms and physical exam. Facet joint pain are treatable by physical therapy and should not be operated on.
Other causes of back pain
Osteoporosis occurs when the body does not form enough new bone, when too much old bone is absorbed by the body, or by both of these things.
- Your bones contain the minerals calcium and phosphate, which make them strong. As you age, your body may absorb these minerals, and this weakens your bones. Weak bones are brittle and fragile, and they can break easily, even without injury.
- A compression fracture of the vertebra occurs when one of the vertebra collapses.
- When more than one vertebra may be affected. Osteoporosis is the most common cause for problems with multiple vertebrae.
Other types of arthritis, besides osteoarthritis, can also cause back pain. They make the joints of the spine become swollen and inflamed, and this leads to pain. These types of arthritis are called psoriatic arthritis, reactive arthritis, ankylosing spondylitis, and rheumatoid arthritis.
Stress fractures in the spine (also called spondylolysis) are a common cause of back pain in young athletes. Sometimes a stress fracture may not show up for a week or two after an injury. Stress fractures are more common in athletes who are gymnasts, defensive football linemen, weightlifters, and cheerleaders. Spondylolysis can cause spondylolisthesis, a condition in which the spine becomes unstable and the vertebrae slip over each other.
Grinding Teeth causes symptoms like Headaches, Neck and Shoulder pain
Teeth grinding can be the cause of different symptoms which include facial pain, migraines, headaches, ear-ache, tightness and stiffness in the shoulders, pain and stiffness in the jaw joint, abnormal tooth wear and restless or disrupted sleep.
Although teeth grinding can be caused by stress and anxiety, it often occurs during sleep and is more likely caused by an abnormal bite or missing teeth. However involuntary clenching of the teeth and jaw bracing in reaction to certain stimuli plays a role too. So while we’re awake we could be clenching jaw in reaction to stress or other factors like the style of work we do, some people clench whilst concentrating or doing physical work like lifting and pushing heavy objects. Whilst sleeping teeth grinding is automatic with rhythmic and sustained jaw muscle contractions. There are certain medications that can cause teeth grinding such as antidepressants or recreational drugs such as cocaine and ecstasy, and disorders such as Parkinson’s disease, depression and major anxiety.
The jaw, jaw joint and surrounding facial muscles control chewing and moving the jaw. Disorders with these are incorrectly called TMJ which stands for temporomadibular joint. The TMJ is the hinge joint that connects the lower jaw to the temporal bone of the skull, which is immediately in front of the ear on each side of your head. The joints are flexible, allowing the jaw to move smoothly up and down and side to side and enabling you to talk, chew, and yawn. Muscles attached to and surrounding the jaw joint control the position and movement of the jaw. Injury to the jaw, TMJ, or muscles of the head and neck such as a heavy blow or whiplash can naturally cause problems in this area. Other causes are grinding of the teeth, which puts a lot of pressure on the jaw, and Stress, which can cause a person to tighten facial and jaw muscles or clench the teeth. Migraines, headaches, TMJ and jaw pain have long been treated using drugs, aimed at settling symptoms produced by the Trigeminal ‘Migraine’ nerve. Jaw pain, Headaches and Migraines often occur together as the same nerve supplies the same area of the jaw and head.
Research shows that around 48% of Migraines are reported to begin in the mornings, mainly from the effects of grinding and clenching your teeth at night combined with muscle spasm and pain at rest in the muscles of your face, neck and shoulders.
People suffering from Migraines & Jaw Pain have several habits and physical characteristics in common which irritate the Jaw & Migraine nerve:
- Grinding and clenching your teeth at night
- Stiffness, tightness & pain in the muscles of your face, neck and upper shoulders
- Problems with the joints in your neck
- Poor posture, habits and Ergonomics (in general poor posture)
We at our Stretching SA Rehabilitation Clinics can assist in physical therapy in regards to the above mentioned.
We assess the muscles and joints in the face, neck and upper back which can irritate the Migraine and Jaw nerve. We then treat these with specific manual therapy techniques to relieve the compression stresses they place on the structures and nerves supplying the head. You will undergo specific assisted isolated stretching , strengthening and balancing therapy techniques , which will address the cause of your problem, and biomechanically start to bring structures in the state and in condition it should be..
If you think this article applies to you then please do not hesitate to contact us !
Sources: http://www.intulohealth.com / StretchingSA- Moreletapark / myofascial pain syndrome