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Myofascial pain has an association with Tension Type Headache, leading to a hypothesis that manual therapy to treat myofascial trigger points, through trigger point release, relieves Tension Type Headache.
Various studies have been performed to determine the efficacy of myofascial trigger point release on relieving tension type headache intensity, frequency and duration. These studies have relied on subjective pain measurement such as a visual analogue scale (VAS) or the McGill Pain Questionnaire to determine effectiveness of a treatment as biochemical evidence in the form of precise molecular identification remains unclear.
Definitions:
Myofascial Trigger Point:
Muscle referred pain is clinically expressed as myofascial trigger points
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The severity of MTrPs can be assessed through evaluation of pressure pain threshold (PPT) of a MTrP. PPT is inversely proportional to the severity, i.e. The higher the threshold, the less severe the MTrP.
There are several manual therapies used in the treatment of MTrP including ischemic compression, strain & counter strain, muscle energy techniques, traverse friction massage, spray and stretch, dry needling, ultrasound and thermotherapy. This review will only focus on trigger point pressure release as a means for MTrP treatment.
To assess the effects of massage treatments on pressure pain threshold (PPT), Albert F. Moraska conducted a randomized, placebo controlled trial on people with myofascial pain syndrome
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Subjects were randomly chosen into 3 groups of 6: one group receiving twice weekly massage for 6 weeks; one group to receive twice weekly sham ultrasound sessions for 6 weeks; one wait list control group that participated during the first and last assessments only.
During the assessments, the therapist used an Algometer to determine pressure (Newtons/CM²).
Moraska, A. F. et al found myofascial trigger point release to be effective in increasing Pressure Pain Thresholds, (decreasing myofascial tenderness), at myofascial trigger points.
In a randomized, placebo-controlled trial, immediate and continued improvement in PPT at MTrPs was observed in individuals with myofascial pain expressed as TTH. Gains in PPT of similar magnitude to the first session were also observed after the 12th massage treatment even though a significantly higher baseline was established. The present study underscores MTrP responsiveness to treatment yet also shows that attaining full resolution of trigger point pain may require multiple treatment sessions.(A. F. Moraska, Schmiege, Mann, Butryn, & Krutsch, 2017)
Interaction of Trigger Points and Tension Type
Headaches: Headaches are stem from misalignment of the cervical vertebrae. Our chiropractor may perform manual adjustments and/or utilize computerized spinal decompression techniques to restore normal alignment and elongate the spine.
The relationship discovered in the articles written by Denneson, et., al (2011) and Fletcher, et., al (2016) discuss how the Department of Veterans Affair is studying the significance of using complementary alternative medicine to effectively control chronic noncancerous pain versus the continuous use of opioids. Massage therapy was the most preferred and effective method for management of pain. In the article written by Fletcher, et., al (2016), about 60 percent of the outpatient was taking opioids for management of chronic pain.
Massage is a very common form of therapy for all sorts of things, from stress to chronic pain. There have been numerous studies that demonstrate the effectiveness of massage in helping to manage patients’ pain while keeping them off medication. The benefit of this type of treatment is pain relief through manipulation of the body. The mechanism of action is, once again, unknown, but it is thought to be related to stimulation of muscles and the blood flow being increased. There are
Tension Myositis Syndrome (TMS), also known as Tension Myoneural Syndrome, is a condition originally described by John E. Sarno, MD, a retired professor of Clinical Rehabilitation Medicine at New York University School of Medicine, and attending physician at the Howard A. Rusk Institute of Rehabilitation Medicine at New York University Medical Center. TMS is a condition that causes real physical symptoms, such as chronic pain, gastrointenstinal issues, and fibromyalgia, that are not due to pathological or structural abnormalities and are not explained by diagnostic tests. In TMS, pain symptoms are caused by mild oxygen deprivation via the autonomic nervous system, as a result of repressed emotions and psycho-social
We are grateful for the “Manual Therapy” reviewers thoughtful review and suggestions to improve our manuscript. Our author team has reviewed, considered, and responded to all comments and suggestions the reviewers proposed in accordance with “Manual Therapy” guidelines. Thus, we are submitting a revised manuscript “The Immediate Cardiovascular Response to Joint Mobilization of the Neck- A Randomized, Placebo-Controlled Trial in Pain-Free Adults” for follow-up consideration for publication in “Manual Therapy”. We are hopeful that our work will be deemed as valuable and disseminated for other manual therapists to consider.
The implementation of pain management based on the best available evidence implies the comprehensive assessment of pain with a reliable and valid assessment instrument, the application of pharmacological and non-pharmacological interventions based on the findings of the evaluation, the frequent re-evaluation of pain to know the level of response to treatment. Although evidence-based pain management
Current research suggests that trigger points are caused by a dysfunction in the nerves that signal the muscles to contract (Simons, Travell, & Simons 1999). When the neural activity becomes unsynchronized, it can cause muscles to contract without relaxing (Simons et al. 1999; Ge, Fernandez-de-las-Penas, & Yue 2011). This constant contraction results in a trigger point, which restricts blood flow to the taut muscle area and causes both localized and referred pain (Ge et al. 2011). Researchers theorize that DN interferes with the malfunctioning nerve signals and resets them to their normal function (Simons et al. 1999; Giamberardino, Affaitati, Fabrizio, & Costantini 2011).
TENS is used as an adjunct to core treatment for symptomatic relief of inflammatory, neuropathic and musculoskeletal pain (8). TENS is regularly used as a standalone treatment, and is used for mild to moderate pain relief. TENS can be used alongside with several other modalities such as exercise, acupuncture, medication, etc, to increase effectiveness of pain relief. TENS is a preferred method because it is an safe, non-invasive, inexpensive (8) and easy technique to perform yourself. TENS is available for use by healthcare professionals, and nurses, midwives and physiotherapists support patients in the use of this technique (8). The goal of TENS is to stimulate peripheral nerves to decrease the flow of pain related information in a manner
Massage therapy can help with alleviating muscle tension, diminishing stress, and bringing to mind feelings of calmness, along with helping chronic fatigue syndrome, easing chronic constipation, and enhancing self image. It also manipulates the activity of the musculoskeletal, circulatory, lymphatic, and nervous systems in the body. Clinical studies have revealed that massage relieves chronic back pain more effectively than other treatments and most times it is more cost effective than other treatments ("University of Maryland Medical Center").
The purpose of the study is to assess the factors associated with neck disability among chronic neck pain sufferers. Chronic neck pain is largely non-specific in nature and requires a biopsychosocial understanding of risk factors to mitigate their poor outcome. Practice guidelines highlight the importance of classifying these patients based on these biopsychosocial clinical findings for effective intervention. Recent evidence also points to the success of personalized pain management that is anchored on specific neurophysiologic mechanism underpinning the pain experience of each individual. There is emerging evidence that simultaneously evaluating this neurophysiologic mechanism, along with biopsychosocial variables identified risk factors
Massage therapy is a non-invasive method for treating various issues in the body, including aching, tense muscles. You may already understand this if you have ever enjoyed a massage after participating in a physical activity. The fact may not be aware, though, is that there are various types of massage available to fulfil your specific needs. We share with you details on the two of the types of massage in the following facts along with how they can help alleviate your sore
The researchers inferred that the evidence discovered optimistic advantages of massage physiotherapy to bestow alleviation of bone pain in cancer patients; however, additional research analysis is essential to ascertain long-lasting impacts (Running & Turnbeaugh, 2011). A nonrandomized single-group pre and posttest design of a randomized two-period crossover of approximately 230 contributors and a substantial result over a three-year interval were appraised in the therapy of visceral pain (Running & Turnbeaugh, 2011). The researchers determined that the evidence champions the utilization of massage remedy in the therapy of visceral pain of cancer patient whilst the evidence is dated (Running & Turnbeaugh,
I'm pretty sure you know that massage can do a whole lot more than relieving pain and soothing sore muscles.
From a massage therapist’s point of view, it is way more important to me to understand how YOU are feeling, rather than conveying what I “assume” you “might” be feeling. However, as research is progressing, we are learning that pain is weirder and more complex than we thought. This is both wonderful and confusing news.
The last group of rats received no TENS at all. “Thermal and mechanical pain thresholds were assessed in right hind paw before and 12 days after the CCI surgery.”(Somers & Clemente) 2 The results concluded several things about TENS managing neuropathic pain. “Applying the high rate frequency daily reduced the development of mechanical allodynia in CCI rats and low rate frequency reduced the development of thermal allodynia, but only when the TENS was delivered on the left side.”(Somers & Clemente) 2 “Indications showed that TENS delivered contralateral to a nerve injury best reduces allodynia development.”(Somers & Clemente) 2 “Comprehensive reduction of allodynia development would need to be a combination of high and low frequency TENS intervention.”(Somers & Clemente) 2