CHRONIC NECK PAIN
In other words, Trigger Points are hard (pea or marble-sized) nodules of tissue that cause pain, but have no specifically known causes or findings that can be determined from X-rays, MRI, or neurological examinations. Not only this but they tend to refer pain along very specific patterns. And although not as common, they can involve a "Twitch Response" (if you run your fingers along a Trigger Point perpendicular to the direction of the muscle fibers themselves, it can cause the "triggered" portion of the muscle to fire or 'twitch'). Although Trigger Points can be found anywhere in the body, by far the most common place people get them is in the upper trapezius (shoulder muscle). There are not only all sorts of theories as to how Trigger Points start, there are a wide variety of methods used to treat them as well. The three methods described by Dr. Travell include,
Other methods of dealing with Trigger Points include, modalities such as Electric Stimulation, Ultrasound, COLD LASER THERAPY, various forms of VIBRATION, a wide variety of massage and body-work methods, CHIROPRACTIC ADJUSTMENTS, Dry Needling (using a heavy gauge needle to repeatedly poke / puncture a MTrP, acupuncture (very different than dry needling), and numerous others, including our SCAR TISSUE REMODELING (a popular online encyclopedia states that, "Fascia surrounding muscles should also be treated, possibly with myofascial release, to elongate and resolve strain patterns, otherwise muscles will simply be returned to positions where trigger points are likely to re-develop"). This would make sense as I believe that FASCIA is often times a missing link in helping people struggling with various CHRONIC PAIN SYNDROMES.
I have found to effectively deal with the Trigger Points that occur so frequently in the trapezius muscle, one must address the Structural / Functional model. No one would argue that structure and function are intimately related. However, because so few people have a proper LORDOTIC CURVE in their cervical spine (neck), most physicians consider this loss of curve a "normal" finding. This is absolutely not true. Even the medical community is starting to admit this. As a primary example, we can look at last August's study (Cervical Spine Alignment, Sagittal Deformity, and Clinical Implications: A Review) from the Journal Neurosurgery, Spine. I am going to cherry-pick some sentences from this study ---- a study that was written by surgeons, for surgeons, about people they believe need surgery.
What is dumbfounding when reading this article is that the authors --- spinal neurosurgeons --- almost sound like chiropractors. They say things like, any amount of FORWARD HEAD POSTURE causes "an increase in cantilever loads...". Furthermore, they unequivocally tell us that the worse the Forward Head Posture, the worse the quality of life (HRQOL). But here is where the rubber meets the road. According to these surgeons, the various regions of the spine (cervical, thoracic, lumbar and pelvic areas) are not independent from each other. The alignment of one affects the alignment of the others. To top it all off, they admit that alignment affects function; and loss of function causes pain and degeneration (ASD). The bottom line is that things like alignment and posture matter (the next thing you know they will be telling us that these problems could actually lead to sickness and disease --- HERE). Interestingly enough, loss of normal cervical (neck) curve can not only be measured, but it can effect the cord itself and lead to DJD and severe neurological problems. I bring all this up because of the work of Dr. Donald Harrison.
It's almost comical to watch the medical community make these huge "breakthroughs" ---- particularly when the chiropractic profession has been saying these very things for decades. Although he passed away in 2011 leaving his son Deed and others to carry on his work, the elder Harrison's accomplishments cannot be overlooked. Dr. Harrison received a doctorate in Applied Mathematics and a master's degree in mechanical engineering after becoming a chiropractor. He eventually founded Chiropractic Bio-Physics (CBP), which, over the past two-plus decades, has published approximately 150 peer-reviewed papers in scientific / medical journals on this very topic.
I have found that simply adding "EXTENSION THERAPY" to my clinical protocols (I personally like the Dakota Traction device from Dr. Mark Payne) can not only dramatically improve outcomes, it seems to help many people who struggle with hardcore Trigger Points of their upper traps. But, in order for Cervical Extension Retraining Devices to be effective, range of motion in the cervical spine must be dealt with on both a sectional basis (Tissue Remodeling) and a segmental basis (Chiropractic Adjustments). Trying to create cervical extension (put your head back as far as you can to see what I mean) without addressing both the sectional and segmental motion abnormalities (SUBLUXATION and FASCIAL ADHESIONS) can cause real problems as well as pain (WARNING: Do not try Cervical Extension at home without a trained individual first determining if you are a good candidate, and then receiving instruction on how to proceed).
COLD LASER THERAPY AND TRIGGER POINTS
One of the things we have used it for is Trigger Points. TRIGGER POINTS are small knots of muscles that, although they can occur anywhere, usually occur in the trapezius muscle (where the back meets the neck and shoulder). Although our tissue work helps some of these folks, unfortunately these are, much of the time, not simply FASCIAL ADHESIONS.
What does the scientific peer-reviewed literature have to say about COLD LASER THERAPY for Trigger Points? Let's go back a few years and take a look. in the January 2009 edition of JMPT (The Journal of Manipulative and Physiological Therapeutics), a study was published called, "Chiropractic Management of Myofascial Trigger Points and Myofascial Pain Syndrome: A Systemic Review of the Literature" . 112 relevant studies were reviewed, and various forms of Trigger Point treatments were looked at. Here are the results of this study.
- Chiropractic Adjustments (Moderately Strong evidence for short term relief --- Limited Evidence for long term relief.)
- Electric Stimulation --- all kinds (Limited Evidence)
- TENS (Moderate Evidence)
- Acupuncture (Moderate Evidence)
- Magnet Therapy (Moderate Evidence)
- Ultrasound (Weak Evidence)
- Low Level Laser Therapy (Strong Evidence)
Did you catch that? The evidence for Low Level Laser Therapy (Cold Laser Therapy) is strong for dealing with myofascial pain issues --- particularly Trigger Points. To learn how it works, click the link above. Because Trigger Points can be so difficult to completely get rid of, I would suggest the inexpensive TheraCane or Back-Buddy for dealing with these at home and in the office. I would also suggest asking your Chiropractor about using a DAKOTA TRACTION DEVICE. Not sure what I'm talking about? Read my posts on EXTENSION THERAPY and DRY NEEDLING.
Dr. Schierling completed four years of Kansas State University's five-year Nutrition / Exercise Physiology Program before deciding on a career in Chiropractic. He graduated from Logan Chiropractic College in 1991, and has run a busy clinic in Mountain View, Missouri ever since. He and his wife Amy have four children (three daughters and a son).
Brain Based Therapy
Can You Help
Cardio Or Strength
Cold Laser Therapy
Death By Medicine
Degenerative Joint Disease
D's Of Chronic Pain
Evidence Based Medicine
Gluten Cross Reactivity
Ice Or Heat
Jacks Fork River
Leaky Gut Syndrome
Number One Health Problem
Platelet Rich Therapy
Post Surgical Scarring
Re Invent Yourself
Rib And Chest Pain
Scar Tissue Removal
Sleeping Pills Kill
Stay Or Go
Stretching Post Treatment
Tensegrity And Fascia
The Big Four
Thoracic Outlet Syndrome
Whole Body Vibration