III. Proper Treatment of Musculoskeletal Pain
8. Aren't clinicians properly treating these chronic myofascial pain syndromes and releasing all the satellite and latent trigger points?
First of all, if the clinician has the knowledge and ability to identify and treat all primary, latent and satellite TPs it is very time and cost intensive. If the individual with chronic myofascial pain is lucky enough to find a clinician who can properly treat myofascial TPs that individual many times can not afford either the time or the cost to completely release all the primary, latent and satellite myofascial trigger points. So the patient's pain continues to recur. I have clinically found, as research has shown, that to successfully treat chronic myofascial pain syndromes; whether of the back, neck, extremities and especially in Fibromyalgia, you must take the time to consistently over a period of time remove or at least control all the primary, latent and satellite myofascial trigger points.
9. So how does the person with chronic myofascial pain or fibromyalgia overcome this time and cost obstacle to finally become pain free?
Again this question focuses right on the primary reason I invented and developed the Fenix Rehab Systems: The Fenix ~ 'Still Point,' The Fenix ~ 'Lotus Point,' and the Comprehensive Fenix Rehab System. The Fenix Rehab Systems and its support products allow individuals with chronic myofascial pain to properly treat their condition for about the cost of one visit to their doctor or therapist for trigger point therapy. The savings on health care costs is tremendous! The products also facilitate a slow and methodical deactivation of all active, latent and satellite myofascial trigger points over time. This way an individual can rehabilitate the myofascial pain over time and finally become pain free once and for all.
David G. Simons, M.D., one of the co-authors of "The Book" on myofascial pain "Myofascial Pain and Dysfunction - The Trigger Point Manual" Vol. 1 and Vol. 2, said it best: "There is no substitute for learning to control your own musculoskeletal pain. Treating myofascial trigger Points yourself addresses the source of that kind of common pain and is not just a way of temporarily relieving it."
In other words taking the time to properly treat your all trigger points not only active, but latent, satellite TPs will do more then just temporarily relieve pain over time it will rehabilitate the underlying problem. This is particularly true if you take the time to stretch and strengthen the muscles involved in your myofascial pain syndrome. The Fenix Rehab Systems include specific stretches and there are support products to help individuals lengthen and strengthen their muscles after releasing the involved TPs. Numerous studies have proven that individuals with chronic myofascial pain do better and recover quicker if they are involved in their own recovery. The more responsible an individual is in their care the more successful they are in achieving a pain-free life.
10. Why is trigger point therapy be more effective in treating chronic pain than vibrating massagers or heating products that are sold everywhere?
Whether have regional pain of the back or the global pain of fibromyalgia, trigger point therapy gets directly to the source of your chronic and recurring pain, the myofascial trigger point! The respected pain researchers Melzack and Wall stated that '.myofascial trigger points are often the major factor in the cause and/or maintenance of chronic pain states.' The researcher Dr. Hong said that, "The myofascial trigger point is the major cause of muscle pain in clinical practice."
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However, everybody loves vibrating massagers, expensive chair massagers, heating devices because they make us feel good for a moment, but they do nothing to really fix the underlying problem, the myofascial trigger point.
Vibrating massagers work by tricking our nervous system, here's how it works; chronic pain can be fired off by the myofascial trigger points in our back muscles, causing us low back pain. In another case trigger points in our neck and shoulder can create chronic shoulder/arm pain. These pain impulses from our deep myofascial tissues are carried to the spinal cord through sensory nerves.
In these examples, when we vibrate the surface overlying our back or shoulder, we stimulate surface nerves that carry impulses of the vibration to our spinal cord. These surface nerves carry the vibration impulses much faster to the spinal cord than the sensory nerves that carry the pain impulses from our painful deep myofascial tissues. So the surface vibration nerve impulses get to the spinal cord and override or block the incoming pain impulses.
This is a very simple explanation of the Melzack and Wall "Gate Phenomenon" of Pain. But, most important to realize is that this vibrating massager does not change the underlying problem it only covers it up for a short period. People love these vibrating massagers, buy them by the millions, but no real change in myofascial trigger points is achieved.
This is also what takes place when we use vibrating loungers that cost thousands of dollars, we feel good for a short while but nothing is really getting fixed. This same "Gate Phenomenon" or momentary blocking of pain impulses happen with heating devises, or even with a light surface relaxation massage. A relaxation massage improves blood flow and helps us relax, as does heating devices, but it does not change the myofascial trigger point. Therefore the mechanisms that cause our chronic and recurring pain are left to continue to plague us.
11. How does trigger point therapy overtime, as with The Fenix Rehab System, actually correct the problem of chronic pain?
I will try to keep this as simple and straight forward as I can. First of all myofascial trigger points start with "taut bands" in muscles. These bands are contracted shortened muscle cell that squeezes out the blood and obstructs good blood flow.
This lack of blood to the muscle tissue means there is a lack of oxygen and nutrients. With a lack of oxygen and nutrients the taut band runs low on energy. This low energy state, and any added physical, chemical or emotional distress causes the formation of the myofascial trigger points in that taut band.
These myofascial trigger points in the taut bands are created by dysfunction of sensory and motor nerve endings. This dysfunction of nerve ending is what creates the painful nerve reflex of trigger points in muscles and tendons. Furthermore, with this lack of energy the taut band can not relax because it actually takes energy to relax contracted muscle tissues. This way the taut bands with myofascial trigger points become a self-sustaining vicious cycle.
Our muscles are made of myofascial tissues composed of three components: collagen, elastin, and ground substance. Collagen is a tough as steel and in trigger points these fibers become shortened and form cross-links. Also the all important ground substance in the myofascial trigger point becomes more gelatinous, like concrete. So the myofascial trigger point is a region of congealed gummed up, shortened and contracted tissue with irritated nerve endings firing pain impulses to our spinal cord.
When you apply sufficient deep sustained digital pressure to this knotted up trigger point you actually change these three tissue components. You stretch the collagen, release its cross-linkages. Also with about a minute of sustained pressure you change the ground substance from a gelatinous state to a more fluid state.
Research has shown that these physical changes in the tissue, achieved with sustained deep pressure on the point, allows you to then stretch the muscle and actually release the taut band. This is why it is vital to stretch the tissue after applying trigger point therapy, more on this later.
12. I beginning to see why trigger point therapy can be so effective, but how does it help with the lack energy in the muscle?
Research has shown that by creating these changes in the taut band, by utilizing sustained pressure, and then stretching you will substantially increase blood flow in and metabolic toxins out of the myofascial tissue. One primary way this happens is by creating a more fluid or soluble state in the ground substance allowing oxygen and nutrients to move into the myofascial trigger points. The muscle tissue can then produce more energy allowing it to relax. You can now possibly see why rubbing the surface with a massage lotion, a vibrating massager, a heating device or even an expensive vibrating lounger is not going to change the tissue of a single trigger point. Let alone change the numerous primary latent and satellite trigger points involved in chronic pain states.
As effective as trigger point therapy is, to truly be effective, it takes repeated treatments over time with stretching of the myofascial tissue after each treatment. The problem with this is that it is very expensive to have someone properly do this for us over many treatment sessions. Especially if they were to release all primary, latent, and satellite trigger point involved in a chronic back pain, neck pain, or shoulder-arm pain case.
The answer is to turn this amazingly effective therapy into a home care program with a comprehensive self-treatment system. This is where the Fenix Rehab Systems really excel. They can reach virtually anywhere on the body, create heavy or light pressure depending on the area and the individual and they come with comprehensive instructions: guidebook, video, and website. So for less then one office visit for trigger point therapy an individual can have a complete self-treatment system with complete instructions to treat them anytime and anywhere they are hurting.
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