Myofascial dysfunction can be a primary source of chronic pain, and it can perpetuate pain in other diseases that involve chronic pain. When muscles are overused, stagnant, or injured, the fascia and/or other connective tissue become restrictive, muscles become weak, and attachments become inflamed (tendonitis, bursitis, etc.). Other issues include joints that don’t function properly, scar tissue that pulls against other tissue, trigger points that develop, and nerves, blood, and lymph vessels that become entrapped.
I know the frustration that results from numerous failed treatments for this chronic pain. But I want you to know that there are hands-on treatments that help restore muscle function and manage associated pain.
Myofascial trigger point compression
There is a relationship between myofascial trigger points and pain, and there is specific treatment. When done correctly by a specially trained therapist, trigger point compression returns the muscle(s) involved to their normal functional length. What’s a trigger point (TrP)? It’s a knotted muscle fiber in a taut band of muscle. It restricts motion, causes weakness, and refers pain in a consistent pattern directly related to TrP location.
It’s important to know what perpetuates the pain. For instance, if I have been at the computer too long, TrPs activate, my neck muscles become taut, radiating pain ensues, and — for me — the risk of developing a migraine increases. I have learned to set an alarm so I remember to get up, stretch, move, hydrate, and give stagnant muscles a break.
Chronic myofascial pain co-exists with many painful disorders, i.e. fibromyalgia, migraine, spinal degeneration, irritable bladder, arthritis, joint hypermobility, and more. The good news — it is treatable. And, with a guidebook that focuses on the work of doctors Travell and Simons, you can learn to self-treat. When writing a book on integrative therapies for fibromyalgia, chronic fatigue syndrome, and myofascial pain, I found many valuable resources.
Myofascial release approach (MFR)
The myofascia is like chicken skin. It’s attached to the muscle, but it still moves freely, unrestricted. The fascia surrounds each muscle and gathers on each end of the pocket to form a tendon. Tendons attach muscle to bone. So, when the myofascia adheres to muscle, the movement of other muscles and the joint involved is impaired and causes pain. I once had so many restrictions that my back twitched like fireworks in response to the physical therapist’s treatment. That was definitely an awakening moment.
Developed by physical therapist John F. Barnes, myofascial release is a manual therapy performed by a skilled therapist. I recommend checking credentials beforehand.
The goal of MFR is to improve movement and promote wellness by releasing myofascial restrictions.
Neuromuscular therapy and reprogramming (NMR)
Founded by body-worker Jocelyn Olivier, Neuromuscular Therapy and Reprogramming, like other myotherapies, treats soft-tissue restrictions, relaxes muscles, rebuilds strength, improves flexibility, restores venous and lymph flow, and relieves the underlying cause of pain. However, the specific goal of NMR is to balance the central nervous system and musculoskeletal system by engaging the motor center of the brain. NMR includes assessment of blood flow, myofascial TrPs, nerve compression, problems with gait, posture and body alignment, and perpetuating factors.
There are hundreds of myotherapies but some dominate, such as spray and stretch, Bonnie Prudden Myotherapy, Jones Institute Strain Counterstrain Technique, and deep tissue bodywork, such as Rolfing and Active Release Technique.
Regardless if restrictions are in connective tissue or muscle, regardless if restrictions are the result of disease, injury, surgery, or neglect, dysfunction contributes to our pain and mobility. So managing chronic pain also means managing our myofascia. We can identify perpetuating factors, employ myotherapies we find helpful, be perpetually aware, and practice preventive strategies like stretching and strengthening to maintain muscle health, stamina, and general overall wellness.
Talk with your doctor regarding the potential benefits of myotherapy, and do some homework on what approach might be best for you. Sports medicine physicians and physical therapists are often a good resource for more information on pain management.