Visit Get-Active.info for some helpful myofascial trigger point information and illustrations.

EEG Stimulation: Neurotherapy and Fibromyalgia

Frequency Specific Microcurrent for Fibromyalgia and Myofascial Pain - January 2006

Segmental Neuromyotherapy

Measuring Fibromyalgia: Algotensiometry

Updated  Information on Guaifenesin

Nutrition

Healing the Dysfunctional Gut: A Common Hidden Key Perpetuating Factor

The papers and effects of Janet G. Travell, MD, one of the founders of myofascial medicine, have been carefully and lovingly archived at the Gelman Library in George Washington University.  If you plan to visit, please contact them beforehand and read through the carefully compiled list of documents that are available so that the archivists can have specific boxes ready and available for you. 

A myofascial trigger point (TrP) is always found in a taut band, which is structurally related to contraction knots caused by a thousand-fold increase in the release of acetylcholine, an important neurotransmitter.  This action takes place in an area of the muscle where nerves end, which is called a motor endplate (Gerwin, 1999).  The cause of TrPs appears to involve serious disturbances of the nerve ending, as well as dysfunction of the contractile mechanism at multiple dysfunctional endplates (Hong, 1999).  

Some TrPs lie within the pain pattern and refer pain in that general area, and some refer pain to an area distant from the TrP.  Some do both.  Myofascial TrPs can cause muscle weakness and dysfunction, severe pain, nerve and blood/lymph vessel entrapment, TMJD, Carpal Tunnel Syndrome, Thoracic Outlet Syndrome, impotence, low back pain, pelvic pain, frozen shoulder, tennis elbow, headaches, piriformis syndrome, and many other conditions, as well as pain that may be mistaken for many other ailments.  Unless you are trained to recognize these pain patterns and the TrPs to which they belong (as well as the non-pain symptoms which can occur with TrPs, you will be mystified.  Common appropriate therapies for myofascial pain provide substantial abrupt reduction in pain intensity (Skootsky, Jaeger and Oye, 1989).  Physical and occupational therapists, as well as doctors, often recommend strengthening exercises without understanding that the TrP is inhibiting the muscle, and you cannot strengthen a muscle with a trigger point.  Improper physical therapy and lack of adequately trained medical care providers can be prime perpetuating factors.

Hands-on training is available.  Information on the Janet G. Travell, MD, Seminar Series can be found here.  The clinicians who produce these seminars also run the “Focus on Pain” seminars, which feature the newest research in the field of musculoskeletal pain.  The 2005-2006 Myofascial Pain Syndrome Course Program can be accessed here.

Information on the International Myopain Society may be found here.

For information on "Myofascial Pain and Dysfunction: The Trigger Point Manuals", click here.

Clinical Mastery in the Treatment of Myofascial Pain, by Lucy Whyte Ferguson and Robert Gerwin.  In my opinion, this book should be read and reread by anyone who practices any form of myofascial pain medicine.  If you want to know which order to treat TrP-laden muscles and how to release difficult areas and so much more, it’s here, waiting for you.

The Winner’s Guide to Pain Relief, by myofascial pain specialist Hal Blatman, MD, and Brad Ekvall, BFA, is ready to teach you how to improve your quality of life.  For information on a complete guide for patient myofascial self-therapy written by a physician specializing in myofascial therapy, click here.

For extra information on myofascial TrPs by Tasso Spanos, the founder of the original Academy for Myofascial Trigger Point Therapy, including access to a diagnostic chart to help you figure out which TrPs are contributing to interscapular pain, and an exercise CD or video designed specifically for people with myofascial TrPs, click here.  Patients with chronic myofascial pain or multiple TrPs and fibromyalgia are advised to begin the exercise program slowly, doing only a small amount of the exercises the first day, with no repetitions.  If this is tolerated with minimal post-exercise soreness, more of the exercises can be added the next day.

A comprehensive clinical guide to fibromyalgia is now available for care providers.  "Fibromyalgia Syndrome: Canadian Working Case Definition, Diagnostic and Treatment Protocols – A Consensus Document", Jain, Anil Kumar et al.  J. Musculoskel Pain 11(4):2-107, can be ordered from the Haworth Document Delivery Service, 800-HAWORTH, 9:00 am - 5:00 pm EST, or docdelivery@haworthpress.com