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Pain Management Strategies and Alternative Therapies
Published in Nazar N. Amso, Saikat Banerjee, Endometriosis, 2022
Myofascial pain secondary to active myofascial trigger points likely constitutes another source of initiation, amplification and perpetuation of pain (23) in women with endometriosis. There is evidence that 10–30% of cases have abdominal wall trigger points as pain generators (23). Trigger points are hyperirritable sites in the muscle or its fascia giving rise to pain, tenderness and dysfunction which is usually remote from their site. In endometriosis-related pelvic pain, trigger points can be identified in various muscles including the pelvic floor and the abdominal wall muscles mainly the rectus abdominis, as well as the posterior pelvic wall such as the piriformis, obturator muscles and the psoas muscles. They can be part of myofascial syndrome or visceral pain with viscero-somatic hyperalgesia (23).
Myofascial Trigger Point Therapy
Published in David Lesondak, Angeli Maun Akey, Fascia, Function, and Medical Applications, 2020
A trigger point is a hyperirritable spot in a taut band of a skeletal muscle that is painful on compression, stretch, overload or contraction of the tissue which usually responds with a referred pain that is perceived distant from the spot.14
The Role of Trigger Points in the Management of Head, Neck, and Face Pain *
Published in Michael S. Margoles, Richard Weiner, Chronic PAIN, 2019
A trigger point may cause restriction of movement and weakness of the affected muscle or body part (arm, leg, jaw, etc.). It may also “refer” pain to other areas of the body, producing symptoms that are often misdiagnosed, such as bursitis, ruptured vertebral discs, and earache.5
Short-term effects of dry needling of thenar muscles in manual laborers with carpal tunnel syndrome: a pilot, randomized controlled study
Published in Physiotherapy Theory and Practice, 2023
Maedeh Rezazadeh, Atefeh Aminianfar, Daryoush Pahlevan
The second hypothesis of this study was that due to the transmuscular course of the terminal branch of the median nerve through the thenar muscles, the taut thenar muscles can also act as a functional point of nerve compression. In CTS, nerve irritation and inflammation might be due to the dysfunction in muscular taut bands that can disrupt axoplasmic flow and potentially cause venous congestion (Coppieters and Butler, 2008). Thus, neural ischemia may result in greater mechanical sensitivity of the nerve, followed by a reduced nerve motility associated with adhesion to surrounding tissues and perineural fibrosis (Chen and Devor, 1998). This can lead to increased nociceptor activation and eventually pain (Sauer, Bove, Averbeck, and Reeh, 1999). As a result, referral pain from the trigger points of these muscles can directly reproduce the patient’s symptoms such as CTS. Accordingly, it might be postulated that DN might lead to the release of the transmuscular terminal branch of the median nerve by restoring the resting length of the sarcomere through the mechanical disruption of the thenar taut bands.
The assessment of affective temperament and life quality in myofascial pain syndrome patients
Published in International Journal of Psychiatry in Clinical Practice, 2022
Sevtap Badil Güloğlu, Serhat Tunç
Myofascial Pain Syndrome (MPS), which is a non-inflammatory disorder, is related to pain and muscle stiffness and is originated from the musculoskeletal system. It is described by the appearance of hyperirritable palpable nodules in the muscle fibrils, which are named myofascial trigger points (MTrPs) (Simons et al. 1999). The pain can spread to remote regions accompanied by sensational disorders (an abnormal sensation, typically tingling or pricking, dysesthesia) and autonomous phenomenon (piloerection, sweating). Current studies recommend that neurogenic inflammation, following central sensitisation, might start and encourage the occurrence of the localised hyperirritable MTrP locus resulting in chronic pain excluding local peripheral muscle trauma. Numerous physiological and mental difficulties like anxiety, depression, and decrement of working capability and life quality (LQ) may be caused (Simons et al. 1999; Taşoğlu et al. 2017). MPS affects about 30% of patients in the general population. Therefore, it is one of the reasons for the loss of working hours (Taşoğlu et al. 2017). For this reason, the importance of research on etiopathogenesis and management of treatment that has not been fully explained yet in MPS is undeniable.
Treatment of shoulder pathologies based on irritability: a case series
Published in Physiotherapy Theory and Practice, 2020
Kristin Somerville, Zachary Walston, Tye Marr, Dale Yake
Both moderate- and low-irritability patients were treated with manual therapy to address tissue impairments and mobility restrictions at trigger points located at the shoulder, cervical spine, and thoracic spine. Simons, Travell, and Simons (1999) defined a myofascial trigger point in the literature as “a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is tender when pressed, and can give rise to characteristic referred pain, motor dysfunction, and autonomic phenomena…”. Manual intervention through trigger point pressure release has been shown to be effective in treatment of tissue dysfunction. It is hypothesized that the manual pressure along the trigger point affects the neuromuscular junction where the alpha-motor neuron synapses on the target muscle fiber and leads to a mechanical uncoupling of actin and myosin to reduce ATP demand (McPartland and Simons, 2006). Research has shown myofascial trigger points may produce symptoms such as shoulder pain at rest, pain with movement, and sleep disturbances and therefore needed to be addressed during the treatment session (Bron et al., 2011). Palpation is currently the only reliable method for diagnosing myofascial trigger points and therefore manual tissue work was used as a treatment in this case series to reduce irritability (Al-Shenqiti and Oldham, 2005; Bron, Franssen, Wensing, and Oostendorp, 2007).