Unexplained pain and restricted range of motion can severely limit a patient's ability to function normally. Selecting the doctor with the correct training and knowledge can help reveal the source of the problem, and result in an effective treatment. Chiropractic and trigger point therapy are often useful modalities for relieving these types of problems.
Chronic pain and stiffness can often result from causes not clear to the sufferer, or to most treating physicians. Causes could be sudden, acute, chronic muscle overload or repetitive motion involving improper body mechanics. These injuries may not have been remarkable at the time and therefore are not recalled or recognized by the patient as a cause of the present discomfort. Other possible causes include direct trauma, automobile accidents, disease, homeostatic imbalance, infection, radiculopathy or improper nerve function, psychological distress, and health issues like smoking.
When pain is present, muscle spasm is often employed by the body as a protective mechanism. In this way further injury is prevented by restricting movement.
A related condition can arise within a myofascial band of the muscle. When this type of hyper-irritable condition occurs within a muscle fiber, it is known as a trigger point. This can be reliably identified by someone with the proper diagnostic knowledge and training. More than 620 such potential points have been identified within the human body.
Diagnosis of this condition is by pain patterns, heat differential, palpation, and potentially by magnetic resonance imaging. A palpable nodule, bump, or knot can be sensed manually. There will be a state of maximum, continuous contraction at the affected spot. Stiffness may be fifty percent greater than in the surrounding muscle. There may be asymmetries evident in the muscle, as well. This will be accompanied by localized tenderness, localized twitch response, or referred pain felt elsewhere in the body.
This continually contracted muscle band produces fatigue toxins, like lactic acid, which may not be carried away due to accompanying capillary constriction. A burning, gripping pain or a heavy dull ache may result.
While this is a condition manifesting in the muscle tissue, it can pull on tendons and ligaments, causing pain within a joint. Misdiagnosis as arthritis, fibromyalgia, carpal tunnel syndrome, or some other condition is common.
Once this hyperactive spot is identified, treatment usually takes the form of deep pressure applied for an appropriate length of time to relax or release the trigger. Other possible treatments include mechanical vibration, cool spray and stretch, pulsed ultrasound, electro stimulation, ischemic compression to regulate blood flow, injection, low level laser, and dry needling.
The surrounding muscles may also need to be massaged and relaxed to prevent them from returning to the same positions they previously occupied. This would cause a reactivation of the condition.
This branch of medicine, originally created in 1942 by Janet Travell, MD, is not commonly taught in medical schools, and therefore is unknown to most medical doctors. It is commonly practiced only by chiropractors, massage therapists, osteopaths, and physiatrists engaged in rehabilitation medicine. Chiropractic and trigger point therapy is often an effective means or relieving pain, stiffness, or immobilized joint problems.
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