Sunday, April 28, 2013

DIAGNOSIS OF TRIGGER POINTS AND MYOFACIAL PAIN SYNDROMES

Pain is a common complaint that is often refractory in its response to treatment. The successful treatment of pain in these conditions often involves identification of trigger points and referred pain patterns.
The clinical application of high voltage microsecond pulses provides an important diagnostic ability, along with its therapeutic benefit. The pulsed voltage can elicit mild pain when applied over trigger points. The patient will complain of no discomfort in the surrounding area, yet feel will slight pain over active trigger points. This is due to localized inflammation that changes the local cell membrane voltage, making the cells more responsive and reactive.
This diagnostic and therapeutic, ability is referred to by Bonica, M.D., in his seminal JAMA article "Management of Myofascial Pain Syndromes in General Practice".
Dr. Bonica says:
 "Trigger areas likewise may be quickly located with ultrasound/electrical stimulation which can also be used for treatment"

Dr. Bonica further writes:
“many cases which in the past have been diagnosed as subacromial bursitis, tendinitis, arthritis, periarthritis, and brachial neuritis were actually myofascial pain syndromes, with trigger areas in the muscles of the back and shoulder girdle and pain referred to the shoulder and arm."  (Example: Thoracic Outlet Syndrome)

Dr. Bonica adds:
"A very significant consideration, which makes this group of disorders particularly important to the general practitioner, is that they are relatively simple to manage, since most of the therapeutic procedures can be carried out in the physician's office, and, when treatment is properly executed, prompt cure ensues. On the other hand, if therapy is incorrect, chronic disability results."
 
Painful areas are often symptomatic of the underlying structural imbalance, injury or inflammation. This ability to identify myofascial pain syndrome, saves time and helps to uncover the underlying problem that has manifested as a pattern of chronic pain.


 Note: to identify reactive areas and points use negative polarity with voltage set at 80% of sensory level without lotion or ultrasound.


No comments:

Post a Comment