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A typical experience
I had a new client the other day for an 80 minute massage. I asked him if there is anything that he wanted me to know. He told me that he suffers from a herniated disc that he has had for a few years. He has constant low back and right hip pain that at times radiates down the back of his leg to his knee. He told me that he has had two injections in his low back and has to stay on anit- inflamtory medication. Anything to avoid surgery. The pain is always there. I asked him if he ever saw a chiropractor for his pain. He said yes. But the adjustments hurt his hip so bad that he could not continiue. So here is a guy that thinks he is on the verge of surgery. I knew that there was a very strong probubllity that was not the case. The vast majority of pain people experience is nocioceptive pain( soft tissue- muscle, tendon, ligament, facia). MDs and Chiropractors see pain as neuropathic pain( nerve pain). With that asumption they give the wrong treatments and therapies. Now there is no denying that at times injections and surgery is needed. Not denying that. But most of the time - NOT. 70% to 85% of all pain comes directly from trigger points. Anyway I showed my client a testimonial from a client that I was able to help out of a very painful condition that she had delt with for a couple of years. I showed him that testimonial because all pain has a psychological eliment too it. I wanted him to start thinking maybe he is not on the edge of surgery. I palpated his entire back upper torso, both hips, and right leg. I found a very painful spot on his right L5 erectors. Another very painful spot on his right greater trochantor. A painful spot in the middle part of his lower right hamstrings. And also a tender spot on the right spinous of L3. I knew that if Iwas able to eliminate all those painful palaptory spots that I would most likely eliminate his pain problem. Because a healthy body had no painful spots even with deep massage. Ive been hunting and eliminateing trigger points for thirty years now. He walked out of the massage room pain free. He was pain free for the first time in years. All those other professional people misdiagnosed him because they assume neuropathic pain over nocioceptive pain. I assume the other way around. I'm a Massage Therapist.
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Replies to This Discussion
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Permalink Reply by Gordon J. Wallis on
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As a side note. The other day I met a nurse.. She told me that fibromyalgia is looked at as an auto immune disorder. So no wonder these fibromyalgia paitents dont get well. Now maybe thats true in some rare instance. But thats not my experience at all. My experience is that its massive amounts of trigger points and a heightend upregulated nervous system. There is no way I can eliminate an auto immune disorder via soft tissue work. Truth remains hidden.. as usual.
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Permalink Reply by Gary W Addis, LMT on
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Maybe in that nurse's bailiwick, the medical world associates FM with autoimmune disorder. But here they don't make that assumption. Osteoarthritis and psoriatic arthritis both are autoimmune disorders, but they attack bones--joints-- while FM affects the nerves, and through them, the muscles and fascia.
I think you're right that FM is scads of trigger points.
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I wish I could see more people with that diagnosis.
Gary W Addis, LMT said:Maybe in that nurse's bailiwick, the medical world associates FM with autoimmune disorder. But here they don't make that assumption. Osteoarthritis and psoriatic arthritis both are autoimmune disorders, but they attack bones--joints-- while FM affects the nerves, and through them, the muscles and fascia.
I think you're right that FM is scads of trigger points.
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Permalink Reply by Therese Schwartz on
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Fibromyalgia by its etymology is related to muscle pain and change in texture of the muscles (I don't know enough to know about the nerve connection but given that nerves govern muscles it certainly makes sense that it starts there!). I've never heard it referred to as an auto-immune disorder. As far as I have learned, it can be helped greatly by manual therapies and also doing emotional work to find out why the person has such a heightened CNS state.
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I'm going to talk like I know it all now. But I just know what I know from my experience. I've had many clients diagnosed with fibromyalgia. Unbelievably some have just had a few trigger points here and there. And I just wonder who in the hell gave them that diagnosis. A couple good massages with a little trigger point focus and its all taken care of. But some with that diagnosis really do need a diagnosis of some kind. They hurt all over. One example I remember earlier this year. A new client came into the spa on a gift certificate for an 80 minute massage. Somehow she got me. When she came into the room I asked her what she needed from this massage.. She said just to relax, I have fibromyalgia. She has had painful massages that didn't do anything for her, and she just wanted to relax. I asked her where she hurt.. She said all over. When she layed down on the table and I started palpating her. Just about everywhere I touched on her body she would jump and would vocalize pain. Im talking calf up to her neck. However, dispite that. I was able to determine that she had much more pain on her right side then her left. Now the right hemisphere of the brain controles the left side of the body. And the left hermisphere of the brain controles the right side of the body. So her left hemisphere was upregulated comparred to her right hemisphere. The left hemisphere was much more active and agitated compared to the right hemisphere. So I wanted to balance that out. So I could either upregulate the the right hemisphere or down regulate the left hemisphere. I chose to upregualate or stimulate the right hemisphere in order to bring it in more of a balance with the over active left hemisphere. So I did that by turning down the lights. Sitting down next to the left side of the table and her body as she was laying on her stomach. And with her body covered by the sheet only, I lightly carresed the left side of her body from her sacrum to her upper shoulder in one light tactile continius motion. One hand after the other. I did that for a half hour without loosing contact with her body. Very light tactile carressing. A full half hour. Light skin touching sensations travel to the brain on wide neural pathways. Nocioceptive(hurt pain) travels to the brain at a much slower speed because it travels on a very narrow neural pathway. It gets complicated to explain.. but.. basically Im stimulating the understimulated part of her brain by only stroking the left side and Im flooding the brain with light tactile sensations that travel I think four times as fast as the painful sensations to the brain.. Anyway some how that helps block some of the very painful nocioceptive pain to the brain. Thats the same principle as the Tens Units that use to be so popular. Then after a half hour I was able to start eliminating the trigger points.. Now the vast majority of her trigger points were on the right side from about T6 or T7 to around L3. It was like a chain link of trigger points. She had trigger points on other parts of her body. But they were spread out and not near as intense. She had been seeing medical doctors and others for six years. On meds and not improving. The docs wanted to start injecting her spine with something.. It took seven sessions to completely eliminate all her Trigger points. I had to use the half hour of tactile carressing maybe three of those sessions. Then the rest of the sessions I didnt need too. Anyway her fibromyalgia completly went away. I saw her a few months later and it was still gone. She got a regular massage with no TP work. All my experiences with that diagnosis has been Trigger Points. And their nervous system is in such a hightend state because of the pain. Initially she jumped everywhere I touched even though there was no trigger point there... After I was able to calm and balance her nervous system out some. I was able to individually start cleariring out the trigger points. One of my main weapons in her case , sense her pain was primarily on her right side was to stress and contract the spinal muscles on the left side of her body, utilizing the reciprocal inhibition reflex. If you side bend each side of the spine is an antagonist of the other. So you make the brain start sending signals of relaxation to the inflamed side. Well anyway she got well and I got a big hug from her.. The other fibro people that Ive worked on were different. But it was all trigger points. So my perspective I just assume its trigger points. And as a massage therapist thats pretty much what I can take care of most of the time anyway. So if it's ever anything else? Well then I don't know?
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Her nervous system was in such a hyperactive state because of the trigger point pain. Once the TPs were eliminated she no longer had fibromyalgia. It doesnt start from the nervous system. It starts from the trigger points. Thats the cause. At least in her case. For sure.
Gordon J. Wallis said:I'm going to talk like I know it all now. But I just know what I know from my experience. I've had many clients diagnosed with fibromyalgia. Unbelievably some have just had a few trigger points here and there. And I just wonder who in the hell gave them that diagnosis. A couple good massages with a little trigger point focus and its all taken care of. But some with that diagnosis really do need a diagnosis of some kind. They hurt all over. One example I remember earlier this year. A new client came into the spa on a gift certificate for an 80 minute massage. Somehow she got me. When she came into the room I asked her what she needed from this massage.. She said just to relax, I have fibromyalgia. She has had painful massages that didn't do anything for her, and she just wanted to relax. I asked her where she hurt.. She said all over. When she layed down on the table and I started palpating her. Just about everywhere I touched on her body she would jump and would vocalize pain. Im talking calf up to her neck. However, dispite that. I was able to determine that she had much more pain on her right side then her left. Now the right hemisphere of the brain controles the left side of the body. And the left hermisphere of the brain controles the right side of the body. So her left hemisphere was upregulated comparred to her right hemisphere. The left hemisphere was much more active and agitated compared to the right hemisphere. So I wanted to balance that out. So I could either upregulate the the right hemisphere or down regulate the left hemisphere. I chose to upregualate or stimulate the right hemisphere in order to bring it in more of a balance with the over active left hemisphere. So I did that by turning down the lights. Sitting down next to the left side of the table and her body as she was laying on her stomach. And with her body covered by the sheet only, I lightly carresed the left side of her body from her sacrum to her upper shoulder in one light tactile continius motion. One hand after the other. I did that for a half hour without loosing contact with her body. Very light tactile carressing. A full half hour. Light skin touching sensations travel to the brain on wide neural pathways. Nocioceptive(hurt pain) travels to the brain at a much slower speed because it travels on a very narrow neural pathway. It gets complicated to explain.. but.. basically Im stimulating the understimulated part of her brain by only stroking the left side and Im flooding the brain with light tactile sensations that travel I think four times as fast as the painful sensations to the brain.. Anyway some how that helps block some of the very painful nocioceptive pain to the brain. Thats the same principle as the Tens Units that use to be so popular. Then after a half hour I was able to start eliminating the trigger points.. Now the vast majority of her trigger points were on the right side from about T6 or T7 to around L3. It was like a chain link of trigger points. She had trigger points on other parts of her body. But they were spread out and not near as intense. She had been seeing medical doctors and others for six years. On meds and not improving. The docs wanted to start injecting her spine with something.. It took seven sessions to completely eliminate all her Trigger points. I had to use the half hour of tactile carressing maybe three of those sessions. Then the rest of the sessions I didnt need too. Anyway her fibromyalgia completly went away. I saw her a few months later and it was still gone. She got a regular massage with no TP work. All my experiences with that diagnosis has been Trigger Points. And their nervous system is in such a hightend state because of the pain. Initially she jumped everywhere I touched even though there was no trigger point there... After I was able to calm and balance her nervous system out some. I was able to individually start cleariring out the trigger points. One of my main weapons in her case , sense her pain was primarily on her right side was to stress and contract the spinal muscles on the left side of her body, utilizing the reciprocal inhibition reflex. If you side bend each side of the spine is an antagonist of the other. So you make the brain start sending signals of relaxation to the inflamed side. Well anyway she got well and I got a big hug from her.. The other fibro people that Ive worked on were different. But it was all trigger points. So my perspective I just assume its trigger points. And as a massage therapist thats pretty much what I can take care of most of the time anyway. So if it's ever anything else? Well then I don't know?
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http://umm.edu/health/medical/reports/articles/fibromyalgia
This is how the medical comunity looks at fibromyalgia. Not one mention of trigger points. Pretty much everything they say is wrong. Way wrong. hmm. How can I be so smart? I can't. I'm not. TRUTH IS OFTEN HIDDEN.......LIKE A SHADOW IN DARKNESS.
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Gordon, that is amazing, what you were able to do for her. It makes so much sense! I have been able to use heated bamboo to get into areas that were too sensitive for manual work. Not quite the same thing, but it's worth remembering that when people have a strong reaction, deeper is not better! Lymph work can help too, but again it's light touch repeated over and over. And lymph work will definitely shift the CNS, helping people relax.
I've had more people than usual lately need really light touch work; heavier work hasn't been useful to them. I'm trying to get it really ingrained into my whole system that lighter is better - and I don't do really deep work because it's hard on my body. Anyway...
The article is at least interesting in some of what it has to say. I agree with them that CBT is useful, but then again I think everyone would benefit from CBT! As a result of doing CBT on my own years ago, I simply don't have depression any more (after something like 25 years of real trouble!). As you know, I do have a lot of physical pain and it is easier to deal with these days. I saw this in the article:
Certain factors may inappropriately trigger a person's stress response and contribute to the development of fibromyalgia, including:
- Infections (Epstein-Barr virus, Lyme disease)
- Physical trauma (such as a car accident)
- Emotional stress
- Hormonal changes (such as an underactive thyroid gland)
I have all of those! EBV, tons of physical trauma from many, many horse accidents (my leg is 99% now, more than a year later!), tons of emotional stress from all angles, and low thyroid (and other hormonal changes that are equally challenging).
So I think what I need to do is find a really interesting CE class in Anchorage and then come see you a couple of times while I'm there! I'm really considering that quite seriously.
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This kind of follows along this same thread. A few days ago a lady came in complaining of severe shoulder pain. She said it hurts from the bottom of her shoulder blade on up into her neck. I asked her how long has she had this shoulder pain. She told me two years. I then asked her if she has seen anyone else for her shoulder pain over the last two years. She was seeing a chiropractor and also has recieved several massages. She commented that the adjustments did nothing for her pain and that the massages were very uncomfortable because it was difficult to relax with her shoulder hurting so much. It was her left shoulder. I palpated the exacct area of her complaint. Her entire left shoulder up to the base of her neck. I found three painful palpatory areas( trigger points). They were very easy to find. She flinched noticeably when I touched them. The most painful one was just off the inferior angle of the shoulder blade. Another one on the erectors at the T5 level. And the last on the transverse process of C5. All on the left side. It took me maybe four minutes to find them. And another 15 minutes to eliminate them. She had a longer massage scheduled, so I carried on massaging her feet and so on. Durring the rest of her massage she kept laughing and commenting on how her shoulder doesnt hurt and that she can't believe it. Her problem was very simple. I don't know what was going on in the minds of the people that were treating her over the last two years? I experience this type of thing almost on a daily basis.
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Gordon, that is the most complete explanation of downgrading/upgrading sensory nerve signals in order to decrease TP nociceptive pain prior to ever touching a TP you have ever given. Excellent description! Thank you!
Gordon J. Wallis said:I'm going to talk like I know it all now. But I just know what I know from my experience. I've had many clients diagnosed with fibromyalgia. Unbelievably some have just had a few trigger points here and there. And I just wonder who in the hell gave them that diagnosis. A couple good massages with a little trigger point focus and its all taken care of. But some with that diagnosis really do need a diagnosis of some kind. They hurt all over. One example I remember earlier this year. A new client came into the spa on a gift certificate for an 80 minute massage. Somehow she got me. When she came into the room I asked her what she needed from this massage.. She said just to relax, I have fibromyalgia. She has had painful massages that didn't do anything for her, and she just wanted to relax. I asked her where she hurt.. She said all over. When she layed down on the table and I started palpating her. Just about everywhere I touched on her body she would jump and would vocalize pain. Im talking calf up to her neck. However, dispite that. I was able to determine that she had much more pain on her right side then her left. Now the right hemisphere of the brain controles the left side of the body. And the left hermisphere of the brain controles the right side of the body. So her left hemisphere was upregulated comparred to her right hemisphere. The left hemisphere was much more active and agitated compared to the right hemisphere. So I wanted to balance that out. So I could either upregulate the the right hemisphere or down regulate the left hemisphere. I chose to upregualate or stimulate the right hemisphere in order to bring it in more of a balance with the over active left hemisphere. So I did that by turning down the lights. Sitting down next to the left side of the table and her body as she was laying on her stomach. And with her body covered by the sheet only, I lightly carresed the left side of her body from her sacrum to her upper shoulder in one light tactile continius motion. One hand after the other. I did that for a half hour without loosing contact with her body. Very light tactile carressing. A full half hour. Light skin touching sensations travel to the brain on wide neural pathways. Nocioceptive(hurt pain) travels to the brain at a much slower speed because it travels on a very narrow neural pathway. It gets complicated to explain.. but.. basically Im stimulating the understimulated part of her brain by only stroking the left side and Im flooding the brain with light tactile sensations that travel I think four times as fast as the painful sensations to the brain.. Anyway some how that helps block some of the very painful nocioceptive pain to the brain. Thats the same principle as the Tens Units that use to be so popular. Then after a half hour I was able to start eliminating the trigger points.. Now the vast majority of her trigger points were on the right side from about T6 or T7 to around L3. It was like a chain link of trigger points. She had trigger points on other parts of her body. But they were spread out and not near as intense. She had been seeing medical doctors and others for six years. On meds and not improving. The docs wanted to start injecting her spine with something.. It took seven sessions to completely eliminate all her Trigger points. I had to use the half hour of tactile carressing maybe three of those sessions. Then the rest of the sessions I didnt need too. Anyway her fibromyalgia completly went away. I saw her a few months later and it was still gone. She got a regular massage with no TP work. All my experiences with that diagnosis has been Trigger Points. And their nervous system is in such a hightend state because of the pain. Initially she jumped everywhere I touched even though there was no trigger point there... After I was able to calm and balance her nervous system out some. I was able to individually start cleariring out the trigger points. One of my main weapons in her case , sense her pain was primarily on her right side was to stress and contract the spinal muscles on the left side of her body, utilizing the reciprocal inhibition reflex. If you side bend each side of the spine is an antagonist of the other. So you make the brain start sending signals of relaxation to the inflamed side. Well anyway she got well and I got a big hug from her.. The other fibro people that Ive worked on were different. But it was all trigger points. So my perspective I just assume its trigger points. And as a massage therapist thats pretty much what I can take care of most of the time anyway. So if it's ever anything else? Well then I don't know?
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The introduction to this book (see attachment) pretty much says what I've been saying and experiencing. That most pain is soft tissue pain( 75%) and that the medical proffession is not trained to deal with it.
And its my opinion the chiropractors can't deal with it either( muscles move bones), unless they themselves do soft tissue work. And very saidly, most massage therapists are not trained to realize the maximum potential of their profession.
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In the attachment below is a review from a women that came into see me less then a year ago. She was in a lot of pain. I'm not posting it to brag about how good I am. Trust me, I've been nearly fired a half a dozen times and have had clients and patients want their money back after I've worked on them. The point I want to make is that she was in severe pain and had seen many highly educated peaple and recieved several massages prior to seeing me for all most two years.. I've posted this review in other threads, but it really fits in this thread and supports what I've been trying to say in here. That we have within our license the ability to help the vast majority of people out of pain. If only our education system would support that. Instead we are trained to fit into an already dysfunctional medical system that puts us in at low man of the totem pole. Behind the doctors, chiropractors, and physical therapists. Ive met many massage therapists that have run to other types of professionals when their backs, wrists, and necks hurt. Most pain that anyone experiences is muscle pain( 70% to 95%). And most of the time they are running to people that don't know that. Read that review carefully. Sounds like Im a miracle worker. You know what her problem was? Anyone reading this thread guess? Two trigger points on her erector spinae group, right side at about the T9 and T10 level. They were very painful palpatory areas. When I found them I asked her if any of the other professional people she saw had touched her there. She said no. Not even the massage therapists. No one. Not the medical doctors or the physical therapists. I was able to down grade those two painful spots durring the first session. And she recovered very shortly after. I saw her again a short while ago and she is doing well. Our education system conditions us to believe we are infirior or some how only able to work under the guidence of other health care providers no matter how many CEUs we take. I don't think that way at all. Its impossible.
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