Treating MPS

Myofascial Trigger Point Syndrome Massage Therapy NYC

Doctor Lev Kalika offers and innovative approach to myofascial pain syndrome treatment – trigger point therapy. This method is completely non-traumatic and exceptionally effective in pain management and treatment. Myofascial pain syndrome is a disorder within muscle and skeletal system of human body that is able to prompt local and referred types of pain.

This type of pain syndrome is likely to have a palpable taut band. Upon palpation this concentrated stiffness causes unpleasant sensation and pain. The syndrome of myofascial pain can be a primary disorder. Or an obvious symptom resulting from another condition. This syndrome is usually characterized by a chronic or acute condition. The problem behind the condition is concentrated around an actual painful point in a muscle tissue. Myofascial pain has to be treated with a holistic approach, addressing a range of factors:

– patient’s posture;
– ergonomics;
– metabolism;
– deviations in musculoskeletal system.

It is a widely-known approach – to treat a variety of MPS by compressing the painful spot and releasing it, rushing the blood flow into the stiffened tissue. This way it reduces inflammation by increasing the “tissue metabolism” around the spot. As shockwave technology moves ahead, myofascial pain syndrome is getting easier and faster to treat, more accessible too. It has been my personal experience and that one of my European colleagues that various muscle spots react differently to multiple treatment methods. Specific exercise that acts as if a remedy along with shockwave application therapy brings forth an outstanding healing result with long term benefits.

Shockwaves are sonic waves that induce physiological reactions diminishing impact of local muscle pain upon penetration of a muscle tissue.

SUCH IMPACTS MAY BE DUE TO VARIETY OF MECHANISMS:

– separation of actin-myosin fillaments (structural units of muscle fiber)
– destruction of damaged muscle fibers
– muscle oscillation
– improvement of local blood circulation
– pain modulation through release of substance P
– pain modulation through release of nitric oxide
– biological mechanotrunsduction

Based on our experience and experience of our European colleagues shockwave therapy offers better diagnostic accuracy and higher therapeutic effectiveness then classic trigger point treatments.

Combining technology and manual therapy we successfully treat muscle pain and MPS. Each of the modalities, including acupuncture adds to the efficacy of our skilled manual therapies. A EPAT machine and focused electromagnetic shockwave machines are the two that we’ve been using for years now.

It became obvious to our team that certain methods work much better with particular muscle groups (shockwave vs acupuncture).

SO HOW DOES EACH TYPE
OF SHOCK WAVES WORK

Focused shockwaves (FSW)

Repeated shock waves cause microtrauma in the chosen spot, forcing it to stimulate healing process. Moreover, the oscillations and pressure of EPAT waves increase blood circulation and facilitate lymphatic drainage. The trigger points occurring at the tenoperiosteal junction (bone-tendon interphase) as well as taut bands and scar tissue may be successfully eliminated by cross movement swiping of the EPAT waves to the direction of the tendon.The effectiveness of EPAT waves on the myofascial chains as described by Karel Lewit MD (the pioneer of manual and needling treatment of myofascial pain) and later by Thomas Myers in his Myofascial trains research, can be shown through the use of EPAT smoothing in the direction of muscle fiber or in the direction of connections between muscles. Once the particular patterns of these myofascial chains are recognized and their connections are understood, EPAT smoothing application can address these muscular crosslinks. The application of EPAT has also shown to have effect in improving local circulation (reactive hyperemia) and reduce the quantity of vasoneuro-active substances within the generalized treatment area.

TREATMENT PROCESS AND DIAGNOSIS

For proper understanding and decoding of the study results it is important to determine whether the object trigger points are active or not. Dormant myofascial trigger points are characterized by areas of tension in the muscles, not accompanied by painful manifestations.

Researchers divide MBS into two types: Primary MAB, in which the main complaint is a specific – muscle trigger pain and the absence of another musculoskeletal pathology; and secondary MBS, which is more common, and is characterized by muscular pain and the presence of another underlying disease of the musculoskeletal system (rheumatoid arthritis, stenosis of the spinal canal, disc herniation, spondylolisthesis, vertebral fractures).

Active myofascial trigger points are accompanied by pain syndrome, which is clearly reproduced by clicking on these points. Studies on the incidence of myofascial pain syndromes in rheumatological diseases have not been conducted. But some authors believe that they are often not diagnosed and treated, but are present as a pain component in systemic rheumatological diseases (SLE, rheumatoid arthritis, osteoarthritis). Currently myofascial pain syndrome (MPS) means any regional manifestations with reflected pain that appears from soft tissues (muscles, ligaments, tendons).

Regardless of the interpretation of MBS, the trigger points differ from the painful sites in fibromyalgia in that the patient experiences only local soreness, without reflected pain.

MBS is often an exception diagnosis, meaning that other diseases are excluded. The name myofascial means that the main source of pain is a specific skeletal muscle. To diagnose this syndrome, a physical examination and palpatory determination of the muscular densities (nodes), called trigger points in the location of ligaments of skeletal muscles, is necessary.

Patients at our clinic have a much higher success frequency with application of the combined treatment strategy. Using manual and automated methods apart was not as fruitful.