Female Focus
Page 21
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Trigger points
It is most satisfactory for a physiotherapist when you can help a patient with a long lasting and unexplained pain. Some 25 years ago I invested 300 Dutch florins on two textbooks written by Dr. Travell, an army doctor in the U.S., about myofascial pain syndrome. I still use them every week.
Muscle pain is an important problem. Trigger points in the muscles are a key factor in headaches, neck, and lower back pain. A lot of patients tell me about their muscle knots which in fact are often trigger points (TrPs).
A TrP is a small patch of tightly contracted muscle, that cuts off its own blood supply, which leads to a “metabolic crisis”. A collection of too many TrPs is called a “myofascial pain syndrome”. TrPs may explain many severe and strange aches and pains. The trigger point is characterised by a painful spot in a muscle that refers its pain to a specific zone for each muscle, so the pain might be felt at quite some distance from its origin.
Chronic jaw pain, headaches or toothaches may be symptoms of trigger points in the muscles around the jaw, face, head and neck. A hip pain can be due to a trigger point in the piriformis muscle and sciatica is often caused by TrPs in the piriformis or gluteal muscles and not by irritation of the sciatic nerve. The good news for you is that TrPs can be treated in just a few sessions.
How? With local pressure on the TrP, ultrasound, or if the patient can tolerate it with “dry needling” which is an acupuncture needle stuck into the TrP. After this the muscle will be stretched, sweeping a cold spray over the muscle in order to momentarily block a spinal reflex and achieve a brief relaxation. Finally the patient is informed and instructed how to continue this work at home, stretching, and what is most important - how to prevent future development of trigger points.
Cas Van Voorthuizen,
Telephone 696 971 988. See advert above for more information.
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