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| “What can I do?”
You need to treat all three elements involved in a chronic pain syndrome: the muscles, the joints, and the chemical imbalance. First, the muscles.
More on muscle trigger points:
There are several things you can do to try to get rid of the areas of trapped-in pain producing substances called trigger points. These areas range in size from pinhead size to as large as a lemon. Typically, we think of them like a ball, but the shape can be very irregular. In a sense, if you can get rid of the trigger points, you can get rid of the pain.
My favorites are:
- trigger point injections
- deep muscles pressure
- and muscle strengthening and stretching exercises.
Trigger point injections: relating this to something you know already:
A. Most people are aware of acupressure, and acupuncture. Some people are aware of the concept of trigger point injections. I’m going to present and compare the three the way I explain them to my patients.
B. I tell my patients to think of the trigger points like a watch battery, that needs a certain chemical-electrical balance in it to fire properly.
1. Acupressure:
If you were to take a pliers and squeeze the watch battery, the fluid would leak out, and it wouldn’t work. I think of acupressure (deep muscle pressure, not massage) as working to get rid of trigger points because you squeeze the fluid out.
2. Acupuncture:
If you were to stick a knife in a watch battery, and let the fluid leak out, it wouldn’t work anymore. I think of acupuncture as sticking a needle in the trigger point, and letting the fluid leak out.
3. Trigger Point Injection:
But if you were stick a needle in the battery, and introduce a foreign substance, the fluid in the battery would be forced out, and you would also destroy the chemical balance in the battery, doing the most damage to the battery.
Trigger point injections go one step further than acupuncture because after sticking a needle into the trigger point, you also introduce a foreign substance. When you introduce a foreign substance, you upset the chemical-electrical balance in the trigger point.
C. Most people who are aware of trigger point injections think of large doses of steroids, “cortisone”, they’ll say. I prefer a local anesthetic, like Novocain. Actually, there are several choices of categories of things that tend to be injected, but most doctors that treat chronic pain, in my experience, prefer a local anesthetic.
Deep muscle pressure:
A. I believe deep muscle pressure is a very important. Not just pressing directly over the trigger points, but sometimes involving an entire body of tissue, like the forearm . (They call that Rolfing.) I began doing deep muscle pressure in 1982 (I was introduced to the subject by seeing a picture in the newspaper of a woman pressing with her elbow). I called it acupressure, before the term came into use. Ever since, I’ve found it to be one of the most important things leading to a patient’s recovery.
B. I’ve found it to work best right after doing trigger point injections, over the area I just injected.
Muscle stretches:
A. There is a certain way to stretch muscles way beyond what they would ordinarily stretch (toward normal, that is), which I find to be very helpful, if not dramatic. It goes by many names. I call it, “fatiguing the muscles that don’t want to stretch, and they stretch”.
B. The beauty of it is that it can work in any area of the body. Not just the neck for headache or neck pain, or the back, but wherever muscles or joints are involved. Even like with the wrist, or even the foot, or fingers or toes.
C. This kind of muscles strengthening and stretching will compliment and greatly enhance the benefit of trigger point injections, and deep muscle pressure that precede it. |
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