Have they already tried:
- Physical Therapy?
- Chiropractic care?
- Steroid injections?
- Pain pills?
- Muscle relaxers?
When everything else has failed, proper soft tissue work is typically missing as a part of the solution.
There are several soft tissue abnormalities that are a direct cause of pain. Somatic and visceral disorders will form excessive motor commands that are delivered to other somatic tissue innervated by the same level of the spinal cord. When this happens over a period of more than 2-3 weeks, reflexes (abnormalities) begin to form in the soft tissue receiving these excessive commands. These reflexes include:
- Cutaneous Reflex Zones– These are abnormalities that form in the skin and include: edema, cutaneous trigger points (these have a burning sensation even at rest), tingling, numbness, hyper/hypothermia, sudomotor reactions). They are often the first sign of an underlying problem and they they can be uncomfortable to the patient.
- Connective Tissue Zones– These are areas where the superficial and/or deep fascia develops thickened fibrotic bridges that “bind down” the area. There is vasoconstriction, swelling, increased tension and a loss of elasticity. The increased tension in the fascia restricts muscular movement and is directly responsible for the formation of muscular abnormalities.
- Skeletal Muscle Trigger Points– Local ischemia and increased resting muscle tone, along with changes in the local PH, cause hypertonus and active trigger points to develop in skeletal muscles. The trigger point itself is the area of greatest spasm within a hypertonus (muscle “knot”). An active trigger point causes pain during movement and can cause pain at rest. It can refer pain to other areas and weaken the muscle. It can cause new trigger points to form in the area of the referral pain. Trigger points can go through periods of latency and reactivation. Even when they are latent, they continue to weaken a muscle and cause muscular stiffness, especially in the morning. PROPER trigger point therapy, followed by specific stretching to reset muscle length, must be performed in order to eliminate trigger points without damaging surrounding tissue. READ MORE ABOUT THE SCIENCE BEHIND TRIGGER POINT THERAPY .
- Periostal Trigger Points– these area trigger points that form in the periosteum of bone as a result of chronic somatic and visceral conditions, direct trauma or physical overload. They cause sharp in and around the joint that increase with activity. Periostal trigger points are treated with compression and friction to create a histamine release. The practitioner produces controlled inflammation in order for the body to send in fibroblasts to heal the area.
When a nerve is compressed, it is quite evident to the patient and the medical practitioner. The pain can be sharp and debilitating. The compression may result from scar tissue, a herniated disc, stenosis, bone spurs or spasm in skeletal muscle. In all scenarios, the soft tissue needs to be addressed. There will always be protective muscle guarding when there is nerve pain and this guarding creates additional pressure around the nerve. When the soft tissue is left untreated, the reflexes described above will develop, resulting in additional pain.
However, when a nerve is not compressed, but only slightly irritated by tight muscles, it is almost always overlooked. Slight irritation of a peripheral nerve results in the the formation of reflexes in the skin, connective tissue, skeletal muscle and bone. It will cause a disturbance first at the end of the nerve innervation.
A good example of this is Plantar Fasciitis caused by a tensed piriformis muscle irritating the sciatic nerve. These are patients that conventional measures to solve their problems fail because the nerve irritation is never addressed. Each week we treat patients with nerve irritation who did not receive a proper diagnosis. Nerve irritation can cause knee pain, elbow pain, wrist pain, shoulder pain and more. We perform simple compression tests and sensory tests to confirm the exact location of irritation in order to properly help the patient.
Read a recent testimonial from a patient whose knee pain was solved by treating her piriformis muscle on our nerve pain page. And please visit our pages on Lymphedema Therapy and Manual Lymphatic Drainage to understand additional ways we may be able to help your patients. Learn how massage can help patients with Respiratory Disorders in this article: Massage and Respiratory Disorders and visit the Medical Massage page for information on our current case study.
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