Myofascial pain syndrome is a condition that originates in the fascia of muscle tissues. The term myofascial stands muscle tissue (myo) and the connective tissue that surrounds it (fascia). Fascia is made up of thin sheets of tissue that surround and separate muscles and muscle fibers, enabling them to function independently from neighboring tissue. In the trunk and limbs, deep fascia contains and separates groups of muscles into well-defined spaces called compartments. Deep fascia is made of dense sheets of connective tissue with large numbers of collagen fibers.
Sometimes, due to injury or overuse, small areas of fascia can cramp or spasm, creating a tight painful knot that can often be seen beneath the skin’s surface. Those knots, referred to as myofascial trigger points, often appear in areas where connective tissue meets bones, nerves and muscle, often on the limbs and back.
In addition to injury and overuse, other potential causes of trigger point formation include:
Trigger points can be painful when pressure is applied, causing muscle fibers to shorten. They can also cause referred pain, meaning a trigger point in one muscle can create pain in another area of the body. Trigger points can reduce muscle function, causing pain, stiffness and tension, and interfering with physical performance.
Trigger point therapy is aimed at releasing taut myofascial tissue, thereby relieving local muscle pain and referred pain. Trigger point therapy has been proven effective in treating a number of conditions, including:
Trigger point massage therapy is the most common approach to releasing trigger points. A trigger point massage therapist is trained to locate and identify trigger points, and apply appropriate massage techniques.
The myofascial pain specialists at NYDNRehab embrace new technologies and innovative therapies to treat muscle pain.
Some of our treatment methods include:
Unlike acupuncture which seeks to restore energy balance in the body, dry needling is aimed specifically at trigger points, inducing a local twitch response that causes tissue spasms to release and relax.
Cupping creates negative pressure, the opposite of massage, to improve circulation, relieve pain and relax tense muscles.
This non-invasive treatment uses sonic waves to break up scar tissue and stimulate cell metabolism. Shock wave therapy has been proven effective in treating myofascial trigger points.
A massage therapist specially trained in trigger point pressure release technique can successfully help relieve trigger point pain.
At NYDNR, our goal is to relieve pain and restore function, so you can enjoy the very best quality of life.
and a faulty diagnosis can make treatment a total waste of time.
Failure to accurately diagnose a condition in its early stages can lead
to chronic problems and sometimes devastating results.
Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.Successful Treatment
A bad physical therapy experience is one of the primary causes of unnecessary surgery.
We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.
Most importantly, we are the only facility in the US where structural medical diagnosis is reflected in functional treatment, and vice versa.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris
with large hematoma (blood)
Separation of muscle ends due to tear elicited
on dynamic sonography examination
