Myofascial Pain Syndromes

Publication Title: 
Journal of Manipulative and Physiological Therapeutics

The interaction of the body and mind in stress syndromes; the input from the mind which influences the neurological functions regulating physiological responses; and the metabolic changes that result are discussed. Treatment direction is based on clinical experience and previously published theories. The synergistic effect of psychological and physiological treatment in stress syndromes is mandatory for permanent reduction of the negative feedback loop. Coordination of treatment by the physician and therapist is optimum.

Author(s): 
Sandman, K. B.
Backstrom, C. J.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Two cases of low back pain from quadratus lumborum myofascial trigger points are presented. One of the patients suffered from an acute episode while the other had a chronic condition. This condition may be more common than previously believed. The quadratus lumborum should be examined in patients presenting with flank pain as well as low back, buttock and lateral hip pain. Thoracolumbar joint dysfunction may often coexist with quadratus lumborum myofascitis and must be treated for optimal results.

Author(s): 
de Franca, G. G.
Levine, L. J.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: The purpose of this study was to evaluate the pain/pressure threshold of selected myofascial points in subjects with chronic mechanical back pain after a single manipulation or mobilization. DESIGN: The study design was a randomized control trial. SETTING: Chiropractic College outpatient clinic. PARTICIPANTS: Thirty subjects aged 18-50 yr (mean age 31 yr, SD = 7 yr) with chronic mechanical low back pain (mean duration of pain 74 months, SD = 83 months) were randomized into two groups. One group received a manipulation and the other received a mobilization.

Author(s): 
Côté, P.
Mior, S. A.
Vernon, H.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: This study reviews the clinical distinctions between fibromyalgia (FM) and myofascial pain syndrome (MPS), which represent two separate and distinct soft-tissue syndromes. The major aim of this article is to clarify the terminology associated with these syndromes and clearly define the parameters of differential diagnosis and treatment. DATA SOURCES: Pertinent articles in the chiropractic and medical literature are reviewed with an emphasis on the literature published from 1985-1994.

Author(s): 
Schneider, M. J.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

INTRODUCTION: Most studies on sensory changes after manual therapies have focused on pain sensitivity. This ignores the wider range of sensory alternations that may be important in assessing patient functioning and neglects the issue of bias, which is inherent in most methods of pain assessment employing threshold methodology. Signal detection theory (SDT) addresses the issue of bias and provides a measurement of intramuscular discrimination--the ability to discriminate between two stimuli--which can be assessed over the full range of sensation.

Author(s): 
Murphy, B. A.
Dawson, N. J.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

Dr. Raymond L. Nimmo (1904-86) was the definitive chiropractic pioneer in the now widely accepted field of soft tissue and trigger point therapy. This article explores how Nimmo was able to make the radical conceptual leap from moving bones to working with muscles that move the bones. Also discussed are the neurophysiological explanations that Nimmo evolved in the 1950s for the trigger point phenomenon, formulations that are still regarded as highly sophisticated half a century later.

Author(s): 
Cohen, J. H.
Gibbons, R. W.
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: We discuss how altering the cycling technique of a cyclist receiving periodic chiropractic care helped in the management of gluteus medius syndrome. CLINICAL FEATURES: A 24-year-old male amateur cyclist had numbness and tingling localized to a small region on the superior portion of the right buttock. The area involved demonstrated paresthesia to light touch sensory evaluation. The cyclist had received chiropractic adjustments 2 days before the onset of the symptoms. One week earlier, the patient began riding a new bicycle with different gearing than his previous one.

Author(s): 
Green, B. N.
Johnson, C. D.
Maloney, A.
Publication Title: 
Archives of Physical Medicine and Rehabilitation

OBJECTIVES: To determine the interexaminer reliability of palpation of three characteristics of trigger points (taut band, local twitch response, and referred pain) in patients with subacute low back pain, to determine whether training in palpation would improve reliability, and whether there was a difference between the physiatric and chiropractic physicians. DESIGN: Reliability study. SETTING: Whittier Health Campus, Los Angeles College of Chiropractic. PARTICIPANTS: Twenty-six nonsymptomatic individuals and 26 individuals with subacute low back pain.

Author(s): 
Hsieh, C. Y.
Hong, C. Z.
Adams, A. H.
Platt, K. J.
Danielson, C. D.
Hoehler, F. K.
Tobis, J. S.
Publication Title: 
Spine

STUDY DESIGN: A randomized, assessor-blinded clinical trial was conducted. OBJECTIVE: To investigate the relative effectiveness of three manual treatments and back school for patients with subacute low back pain. SUMMARY OF BACKGROUND DATA: Literature comparing the relative effectiveness of specific therapies for low back pain is limited.

Author(s): 
Hsieh, Chang-Yu J.
Adams, Alan H.
Tobis, Jerome
Hong, Chang-Zern
Danielson, Clark
Platt, Katherine
Hoehler, Fred
Reinsch, Sibylle
Rubel, Arthur
Publication Title: 
Journal of Manipulative and Physiological Therapeutics

OBJECTIVE: To discuss the management of upper crossed syndrome and cervicogenic headache with chiropractic care, myofascial release, and exercise. CLINICAL FEATURES: A 56-year-old male writer had been having constant 1-sided headaches radiating into the right eye twice weekly for the past 5 years. Tenderness to palpation was elicited from the occiput to T4 bilaterally. Trigger points were palpated in the pectoralis major, levator scapulae, upper trapezius, and supraspinatus muscles bilaterally. Range of motion in the cervical region was decreased in all ranges and was painful.

Author(s): 
Moore, Michele K.

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