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Questions about Trigger Point, Myofascial.....

I am not a massage therapist - I hope it is okay to ask here some questions as a patient too. If not, then I am sorry and the moderator can delete the message here of course .

 

For over 4 years I am sick and my doctors say I have fibromyalgia. So far no treatments helped. Regarding massage I only got deep tissue massage for about 6 months. It was nice to have - BUT it didn't do anything for my pain and my dizziness.

 

That's why I wanted to try now some different types of massage, but have some questions about it:

1.)Is Trigger Point therapy and Myofascial Trigger Point the same or are these different techniques?

   What is Myofascial release?

 

2.)Could one or more of the three above mentioned massage techniques help with my symptoms

  (I  attached a drawing of my main symptoms of the head, muscle etc)?

 

   Symptoms that are not on the drawing are: constant dizzines, brain fog, nausea, sensitive to light (eyes), migranes/ headeaches every day, food allergies.

 

3.) Right now I am in physical therapy ( 2 days a week), but it really makes my symptoms and pain 

    worse. So, I don't know if I should continue PT or if I can combine it with massage.

 

4.) I live in a very small town where are not many massage therapist. How can I find a really good 

     therapist, who is really experienced and knowledged - is there maybe a special website or so 

    where I can find one?

 

I want to thank you in advance! And sorry for the bad English, it's not my mother language and I am still learning. 

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Permalink Reply by Gordon J. Wallis on May 20, 2014 at 4:05am

Ok, I watched that video twice.. I did not see anything that seemed like anything?   Like I have said.. Any one can say anything online.  But uhm, I have been able to help lots of people that thoght they were doomed to perpetual pain.. A lot... So uhm,  all I can do is show testimonials from people that I have helped.  And there is no way Im saying I can cure or help eveyone of their aches and pains...but I know most of the pain people suffer from is soft tissue pain. That I can eliminate. A lot of this stuff is mss diagnosed.   Most of it.   People think a certain way... clients and therapists a like.  But truth remains hidden.   The lady in the testimonial went to the Mayo Clinic , and they were injecting her spine.. They did not know the truth of her problem..  All Im saying is that OFTEN, Thingss are not as they seem. 

Maryshka said:

Here is a digital motion xray of a patient with a "broken neck" (ligament damage?). I don't believe this patient's broken neck would have been discovered on static xray films. This is an extreme example of joint instability! No amount of PT, massage, chiro care is going to repair that damage. I can only imagine the symptoms.

 

Broken Neck After A Car Crash | Digital Motion X-Ray | MRI

https://www.youtube.com/watch?v=xT9f8Nk0h44

 

Through all of my trials, my Tx has led me to become a believer in soft tissue therapy and a licensed massage therapist, so I am grateful for the trauma and life lessons.

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Permalink Reply by Maryshka on May 20, 2014 at 6:39am

I realize many people, including massage therapists/bodyworkers, do not know how to 'read' xrays, in this case this DMX of the upper cervical spine. In this video, there is severe instability in region of atlantoaxial joint that impacts the spinal cord, nerves, ligaments, other soft tissues, and even hard tissue (e.g. facet joints). All I can say is watch and learn.

C1-C2 instability with Dr. Ross Hauser: http://www.youtube.com/watch?v=YRBtisJhKlw

 

As massage therapists, it is our duty to understand these conditions and not be so proud as to think massage/TrP therapy is the only way. Yes people can say anything online. But I research medical journals AND I speak from personal experience. I am a massage therapist that offers options to my clients. One size does not fit all. We don't do our clients/patients justice if we think only one modality or form of Tx is the only way. That is the problem with conventional medicine...

 

Permalink Reply by Kay Warren on May 20, 2014 at 6:43am

Gordon,

I will cheerfully agree that too many people are gettting the wrong treatments for fibro. I've been working with it for 15 years. Trigger point work helps, but it isn't the whole enchilada. The food you eat can be a massive trigger, so is a badly impaired lymph system. Heavy pressure shuts down the micro-lymphatic vessels in the skin.... you know, the ones that carry wastes to the nodes? Proper treatment considers a number of variables.  Also they NEED a proper endocrinologist, especially if they are resistant to their own thyroid hormones, serotonin, or half a dozen others that regulate both metabolism and how the brain perceives pain signals. I've been doing trigger point for 30 years, and it does an enormous amount of good, but it has it's limits.

Gordon J. Wallis said:

Uhm, Kay, any body can say anything online.  But, my experience is that fibromyalgia is not anything but massive amounts of trigger points.  That numer of trigger points change things chemically in the body.  Pain causes all kinds of reactions.  Im not arguing with you.   I know you are an experienced therapist.   And I only know my experience. Not the truth.. Only my truth.  But I have cured people with that diagnosis more then once.  One lady even went to the Mayo Clinic for spinal injectoins... and I had her out of pain in six treatments... hour sessions... She had fibromyalgia for 15 years... o all Im saying is that sometimes things are not exactly as they seem... And as you know.   That diaghosis is wide open.
She had all those symtomes.. Brain fog and all.   So, Im not claiming to be able to cure that diagnosis.. but, gosh. But I think at least 70% of those people are getting the wrong treatments.  I feel it in my heart. From experience.
Kay Warren said:

First thing to do is to understand that fully half the people who have Fibromyalgia also have chronic myofascial pain syndrome. The two need different treatments.  

Brain fog & fatigue often happens when the body is producing too much acetylcholine.  It is the opposite of adrenaline, makes you really tired. Second, what physical traumaas have you has, especially head injuries.  You may need to see a chiropractor and a Cranio-Sacral therapist to improve neurological issues.  Fibromyalia is a complex syndrome with many activating and perpetuation factors.  There is no one way of treatment that works well for everyone.  You specific symptomology will help you head in the right direction.  What you've mentioned before makes me steer you in the chiropractic path, for now.  As you progress, your needs will change. Go to Amazon, or ABEBooks.com & grab a copy of Devin Starlanyl & Mary Ellen Copeland's book, "Fibromyalgia & Chronic Myofascial Pain a Survivor's Guide". There are also potential issues with dehydration, food allergies, etc.  This is more than a quick conversation, and you need a team, preferably with someone at it's head who has studied the small mountain of recent research on Fibro, and knows how to make sense of it.  Any body tell you they can cure this, easy... they're lying or badly uninformed. It's a Syndrome because it doesn't have a known and provable etiology. What will make it kick in will vary from person to person.  Get the book, it will make a big difference, and help you ask the right questions, of the right people. 

By the way, deep tissue is going to be too much for you right now. Light relaxation massage or lympatic massage would probably give you the most direct help, right now, especially from someone who has & uses Kinesio tape. Long-term, you need to identify & control your triggers, which will help you get this under control. I'm happy to answer what I can,  but I can't predict what will work best for you. Fibro is just too individual for it to be that easy.

Permalink Reply by Maryshka on May 20, 2014 at 6:48am

Really good points Kay.

Kay Warren said:

Gordon,

I will cheerfully agree that too many people are gettting the wrong treatments for fibro. I've been working with it for 15 years. Trigger point work helps, but it isn't the whole enchilada. The food you eat can be a massive trigger, so is a badly impaired lymph system. Heavy pressure shuts down the micro-lymphatic vessels in the skin.... you know, the ones that carry wastes to the nodes? Proper treatment considers a number of variables.  Also they NEED a proper endocrinologist, especially if they are resistant to their own thyroid hormones, serotonin, or half a dozen others that regulate both metabolism and how the brain perceives pain signals. I've been doing trigger point for 30 years, and it does an enormous amount of good, but it has it's limits.

Gordon J. Wallis said:

Uhm, Kay, any body can say anything online.  But, my experience is that fibromyalgia is not anything but massive amounts of trigger points.  That numer of trigger points change things chemically in the body.  Pain causes all kinds of reactions.  Im not arguing with you.   I know you are an experienced therapist.   And I only know my experience. Not the truth.. Only my truth.  But I have cured people with that diagnosis more then once.  One lady even went to the Mayo Clinic for spinal injectoins... and I had her out of pain in six treatments... hour sessions... She had fibromyalgia for 15 years... o all Im saying is that sometimes things are not exactly as they seem... And as you know.   That diaghosis is wide open.
She had all those symtomes.. Brain fog and all.   So, Im not claiming to be able to cure that diagnosis.. but, gosh. But I think at least 70% of those people are getting the wrong treatments.  I feel it in my heart. From experience.
Kay Warren said:

First thing to do is to understand that fully half the people who have Fibromyalgia also have chronic myofascial pain syndrome. The two need different treatments.  

Brain fog & fatigue often happens when the body is producing too much acetylcholine.  It is the opposite of adrenaline, makes you really tired. Second, what physical traumaas have you has, especially head injuries.  You may need to see a chiropractor and a Cranio-Sacral therapist to improve neurological issues.  Fibromyalia is a complex syndrome with many activating and perpetuation factors.  There is no one way of treatment that works well for everyone.  You specific symptomology will help you head in the right direction.  What you've mentioned before makes me steer you in the chiropractic path, for now.  As you progress, your needs will change. Go to Amazon, or ABEBooks.com & grab a copy of Devin Starlanyl & Mary Ellen Copeland's book, "Fibromyalgia & Chronic Myofascial Pain a Survivor's Guide". There are also potential issues with dehydration, food allergies, etc.  This is more than a quick conversation, and you need a team, preferably with someone at it's head who has studied the small mountain of recent research on Fibro, and knows how to make sense of it.  Any body tell you they can cure this, easy... they're lying or badly uninformed. It's a Syndrome because it doesn't have a known and provable etiology. What will make it kick in will vary from person to person.  Get the book, it will make a big difference, and help you ask the right questions, of the right people. 

By the way, deep tissue is going to be too much for you right now. Light relaxation massage or lympatic massage would probably give you the most direct help, right now, especially from someone who has & uses Kinesio tape. Long-term, you need to identify & control your triggers, which will help you get this under control. I'm happy to answer what I can,  but I can't predict what will work best for you. Fibro is just too individual for it to be that easy.

Permalink Reply by Maryshka on May 20, 2014 at 7:05am

What many people don't realize is that the body 'self splints' when there is an injury, specifically ligaments/tendon injuries. The muscles take over the work of trying to stabilize joint instability when ligaments/tendons cannot do their jobs of holding joints (for example) in proper position -- this 'chain reaction' causes muscles to stay contracted, causes microspasms, ischemia, etc. The job of the muscles is not to stabilize joints/bones -- that is the job of ligaments and tendons. Think of lax ligaments as stretched-out elastic that doesn't hold its shape -- like when your underwear or socks no longer stay in place... No amount of PT, massage, or TrP work is going to 'retighten' that overstretched tissue. Regenerative medicine (such as PRP/prolotherapy/prolozone therapy) becomes an important consideration for those individuals.

If someone's experienced 'whiplash' (medically known as an acceleration-deceleration injury), s/he knows the pain cascade that follows -- but they don't always associate their chronic pain conditions with such -- until your consult with them asks pointed questions. Could be something from 30 years ago, and when you ask them, that proverbial lightbulb goes on. "Oh, I see..."

I worked on a 60+ y/o lady who was in a car accident (when she was 7 y/o) with her mom. The impact of the accident caused my client's head to hit the seat so hard it ripped the fabric of the seat. That was umpteen years ago. Still, everyone thought she was okay after the accident... yes, no external injuries (no obvious bleeding, no fractures, etc.) but the injuries are on the inside where nobody sees them. Even today with our advanced diagnostic imaging, soft tissue injuries are routinely missed.

I hope this information opens a window of new thought... I will never be of the mindset that only my work is the be all and end all answer for everyone. Yes I do TrP work and I understand TrP's impact in chronic pain but I do know more about soft tissue damage that may require more that what I have to offer. How do you handle facet joint damage? Surgery should be the last option. I'm not that proud that I cannot make suggestions to my clients.


Gordon J. Wallis said:

Ok, I watched that video twice.. I did not see anything that seemed like anything?   Like I have said.. Any one can say anything online.  But uhm, I have been able to help lots of people that thoght they were doomed to perpetual pain.. A lot... So uhm,  all I can do is show testimonials from people that I have helped.  And there is no way Im saying I can cure or help eveyone of their aches and pains...but I know most of the pain people suffer from is soft tissue pain. That I can eliminate. A lot of this stuff is mss diagnosed.   Most of it.   People think a certain way... clients and therapists a like.  But truth remains hidden.   The lady in the testimonial went to the Mayo Clinic , and they were injecting her spine.. They did not know the truth of her problem..  All Im saying is that OFTEN, Thingss are not as they seem. 

Maryshka said:

Here is a digital motion xray of a patient with a "broken neck" (ligament damage?). I don't believe this patient's broken neck would have been discovered on static xray films. This is an extreme example of joint instability! No amount of PT, massage, chiro care is going to repair that damage. I can only imagine the symptoms.

 

Broken Neck After A Car Crash | Digital Motion X-Ray | MRI

https://www.youtube.com/watch?v=xT9f8Nk0h44

 

Through all of my trials, my Tx has led me to become a believer in soft tissue therapy and a licensed massage therapist, so I am grateful for the trauma and life lessons.

Permalink Reply by Kay Warren on May 20, 2014 at 7:06am

ok, I just did some more extensive back reading.  Have you had head or neck trauma? if so when, and what kind? Maryshka metnioned digital motion x-ray (DMX),  and I'm going to second her. It's not hard to have a small accessory ligament tear after an accident or head trauma. They are very difficult to see. What to they do? Well, like all ligaments they hold bone to bone, the the specific action of these particular ligaments is that when you tilt or shift your head from side to side, they help the bones spring back into their proper vertical position. If they are torn, they will leave the vertebrae tilted tone side, leaning on the nerve, which could definitely cause your light sensitivity, headaches, nausea etc.  I believe that this may very well be the issue.

Digital x-ray takes 30 frames per second.  It takes 450 shots to equal the x-ray exposure of 1 traditional x-ray. They will need to shoot from the front with your mouth open to see these tiny ligaments.

As for chiropractors. Some are great, some... well, some of them shouldn't be practicing. There is a chiropractic methodology call orthagonal chirporactic. The force is very light, about a pound, delivered very precisely. Once the instability is found, short of surgery, this would be the safest way to correct it. There is one in Augusta GA that I know of, and probably more.  I'd like to suggest that you Google "DMX" and your town's name. There is probably one within 50 miles of you, if not 100. If I'm correct, and you do indeed have an instability, you're going to have to be very careful about massage, and chiropractic from here on out. Trigger point doesn't need to be rough, and you will probably need a little of it, and you should definitely find a good craniosacral therapist. But honestly, at this point, and after this amount of time, I think a DMX is your smartest next move, and I'll thank Maryshka for reminding me of it.

Permalink Reply by Kay Warren on May 20, 2014 at 7:32am

Gordon,

You watched the video twice, and you didn't see it? Really?  Holy Moly!  Maybe you think you're looking for a broken bone.  You're not. What you're seeing in the video is a terrifyingly damaged transverse alar ligament. This is potentially lethal!

OK everybody, let's go back to anatomy class, i'm sure there are non-therapists and people here new enough to the profession to not know what they've just seen. ...  The transverse alar ligament is in C1, and is positioned from side to side behind the vertical protrusion of the second vertebrae, which is the dens. Right behind the transverse alar ligament is the spinal column itself. The transverse alar ligament prevents the weight of the head from crushing the bony dens against the spinal column when the head is tilted forward. The two vertebrae together are called that atlas & axis. The head rests on Atlas, which rotates around Axis. get it?  In the is video, you don't see the ligament directly, you're seeing the C1 move in a way that that ligament is supposed to prevent.  Ok, watch it again.... when the head tips forward, and looks to be moving normally, then the top vertebrae C1 slides forward on C2 much more than the other ones move on top of theirs, and the head sort of bounces... THAT is what you're looking for.  I wouldn't be at all surprised if that patient didn't pass out cold. You've seen someone in a "Halo" where they have a frame screwed into their skull, and braced to their shoulders? It's to allow that ligament to heal.  If after 2 months in a halo you have no healing, they screw the top 2 vertebrae together, because otherwise, a sharp blow to the head in the correct direction will kill you instantly.

Gordon J. Wallis said:

Ok, I watched that video twice.. I did not see anything that seemed like anything?   Like I have said.. Any one can say anything online.  But uhm, I have been able to help lots of people that thoght they were doomed to perpetual pain.. A lot... So uhm,  all I can do is show testimonials from people that I have helped.  And there is no way Im saying I can cure or help eveyone of their aches and pains...but I know most of the pain people suffer from is soft tissue pain. That I can eliminate. A lot of this stuff is mss diagnosed.   Most of it.   People think a certain way... clients and therapists a like.  But truth remains hidden.   The lady in the testimonial went to the Mayo Clinic , and they were injecting her spine.. They did not know the truth of her problem..  All Im saying is that OFTEN, Thingss are not as they seem. 

Maryshka said:

Here is a digital motion xray of a patient with a "broken neck" (ligament damage?). I don't believe this patient's broken neck would have been discovered on static xray films. This is an extreme example of joint instability! No amount of PT, massage, chiro care is going to repair that damage. I can only imagine the symptoms.

 

Broken Neck After A Car Crash | Digital Motion X-Ray | MRI

https://www.youtube.com/watch?v=xT9f8Nk0h44

 

Through all of my trials, my Tx has led me to become a believer in soft tissue therapy and a licensed massage therapist, so I am grateful for the trauma and life lessons.

Permalink Reply by Kay Warren on May 20, 2014 at 7:41am

Agreed.

Maryshka said:

I realize many people, including massage therapists/bodyworkers, do not know how to 'read' xrays, in this case this DMX of the upper cervical spine. In this video, there is severe instability in region of atlantoaxial joint that impacts the spinal cord, nerves, ligaments, other soft tissues, and even hard tissue (e.g. facet joints). All I can say is watch and learn.

C1-C2 instability with Dr. Ross Hauser: http://www.youtube.com/watch?v=YRBtisJhKlw

 

As massage therapists, it is our duty to understand these conditions and not be so proud as to think massage/TrP therapy is the only way. Yes people can say anything online. But I research medical journals AND I speak from personal experience. I am a massage therapist that offers options to my clients. One size does not fit all. We don't do our clients/patients justice if we think only one modality or form of Tx is the only way. That is the problem with conventional medicine...

 

Permalink Reply by Therese Schwartz on May 20, 2014 at 7:46am

I just watched the video - how is this person tolerating having the imagery done?  That is seriously terrifying.  I'm glad this injury was discovered.  I'm glad to have seen it, and a little freaked out at the same time!

Thanks, Kay, for all of your information here.  It's well-thought, and clearly explained.

I, too, ask my clients all kinds of questions about their history.  I have worked on a woman who went through the windshield of a car when she was 18 - in 1937.  She had a miserable life.  Another client is in her 60's and also went through the windshield when she was 18.  It's a long list, but you know exactly what I'm talking about.  I feel very privileged to be able to help people (I'm an advanced CST practitioner as well as an MT.  I do MFR and LDT as well). 

Permalink Reply by Gordon J. Wallis on May 20, 2014 at 10:22am
Everybody is right in here. When people need surgery or medical intervention. They need it. But I have had so many clients that were told they had fibromyalgia or needed surgery. They did not, and they are fine now. There is no way I can help someone if they really need surgery. Thats what bothers me. And how can someone really have fibromyalgia for years, and be totally cured in seven massage sessions? Thats what bothers me. And thats why Im in here.
Permalink Reply by Gordon J. Wallis on May 20, 2014 at 12:28pm

Uhh, yea I watched it twice.  But uhm, I was drunk.   So thats why I didn't see anything.  Lol.    

Kay Warren said:

Gordon,

You watched the video twice, and you didn't see it? Really?  Holy Moly!  Maybe you think you're looking for a broken bone.  You're not. What you're seeing in the video is a terrifyingly damaged transverse alar ligament. This is potentially lethal!

OK everybody, let's go back to anatomy class, i'm sure there are non-therapists and people here new enough to the profession to not know what they've just seen. ...  The transverse alar ligament is in C1, and is positioned from side to side behind the vertical protrusion of the second vertebrae, which is the dens. Right behind the transverse alar ligament is the spinal column itself. The transverse alar ligament prevents the weight of the head from crushing the bony dens against the spinal column when the head is tilted forward. The two vertebrae together are called that atlas & axis. The head rests on Atlas, which rotates around Axis. get it?  In the is video, you don't see the ligament directly, you're seeing the C1 move in a way that that ligament is supposed to prevent.  Ok, watch it again.... when the head tips forward, and looks to be moving normally, then the top vertebrae C1 slides forward on C2 much more than the other ones move on top of theirs, and the head sort of bounces... THAT is what you're looking for.  I wouldn't be at all surprised if that patient didn't pass out cold. You've seen someone in a "Halo" where they have a frame screwed into their skull, and braced to their shoulders? It's to allow that ligament to heal.  If after 2 months in a halo you have no healing, they screw the top 2 vertebrae together, because otherwise, a sharp blow to the head in the correct direction will kill you instantly.

Gordon J. Wallis said:

Ok, I watched that video twice.. I did not see anything that seemed like anything?   Like I have said.. Any one can say anything online.  But uhm, I have been able to help lots of people that thoght they were doomed to perpetual pain.. A lot... So uhm,  all I can do is show testimonials from people that I have helped.  And there is no way Im saying I can cure or help eveyone of their aches and pains...but I know most of the pain people suffer from is soft tissue pain. That I can eliminate. A lot of this stuff is mss diagnosed.   Most of it.   People think a certain way... clients and therapists a like.  But truth remains hidden.   The lady in the testimonial went to the Mayo Clinic , and they were injecting her spine.. They did not know the truth of her problem..  All Im saying is that OFTEN, Thingss are not as they seem. 

Maryshka said:

Here is a digital motion xray of a patient with a "broken neck" (ligament damage?). I don't believe this patient's broken neck would have been discovered on static xray films. This is an extreme example of joint instability! No amount of PT, massage, chiro care is going to repair that damage. I can only imagine the symptoms.

 

Broken Neck After A Car Crash | Digital Motion X-Ray | MRI

https://www.youtube.com/watch?v=xT9f8Nk0h44

 

Through all of my trials, my Tx has led me to become a believer in soft tissue therapy and a licensed massage therapist, so I am grateful for the trauma and life lessons.

Permalink Reply by Kay Warren on May 20, 2014 at 1:03pm

Too many doctors are lazy diagnosticians. Can't tell you the number if times I've seen someone who thought they had a rotator cuff tear.  They were told so by a doc who didn't even touch them much less do any direct physical testing.  the only thing wrong was a slight anterior dislocation of the humeral head. 2mm is enough to make your life a misery, but not enough to show up on an x-ray. the other ting that mimicks both Fibro and MS is Lyme Disease.

Gordon J. Wallis said:

Everybody is right in here. When people need surgery or medical intervention. They need it. But I have had so many clients that were told they had fibromyalgia or needed surgery. They did not, and they are fine now. There is no way I can help someone if they really need surgery. Thats what bothers me. And how can someone really have fibromyalgia for years, and be totally cured in seven massage sessions? Thats what bothers me. And thats why Im in here.

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