Friday, September 3, 2010

Neck Pain, Migraines, and Myofascial Trigger Points

This question came up in the discussion at our Integrative Therapies page on Facebook, so I thought I would share it here.

It is important to understand that latent trigger points (those that you can feel and hurt when you touch or manipulate them, but don't cause pain otherwise) for some reason in the FM patient can be activated just by a chill. Of course paying close attention to aggravating postures and activity is important too. I talk about the do's and don'ts of exercise in the book. If you have a copy, you might check that part out again, as it is important not to exercise a muscle with TrPs (trigger points) until they have been treated, otherwise you will activate latent ones or cause rebound of active ones.

Remember, anywhere there is muscle (and attachment of muscle to bone) there can be a trigger point. Each trigger point has a specific pain/symptom referral pattern that does not change between patients. The neck is a big issue for many of us and I suspect that is why so many researchers initially thought FM could be cured with neck surgery, yes this is true. It is however, a direct avenue, so to speak, to the central nervous system and is part of the spine that is more subject to injury as there are very few supporting structures other than muscle, and it has to hold up our heavy cranium.

Each bone of the spine has tiny little muscles that connect each vertebra. Even these minute little muscles called intervertebrals, meaning between vertebrae, can develop trigger points. You can feel them as tiny bands when you move your finger across them. Normally you would not feel this taut little band unless it has a TrP.

I use a tennis ball in a knee high hose and treat these every night and several times a day when I can.

Definitely this can be the source of a migraine, it certainly is mine. It is also important that you not miss any TrPs on your face, the temporal area, forehead all of it. I believe this is why so many with FM have migraines. We also have sinus problems which is an aggravator to facial TrPs and the whole cascade of events is off and running.

Sometimes the muscle with the TrP is well away from the pain area. Very basically put TrPs in any of the neck and head muscles, including the trapezius can contribute to migraine.

Often we develop satellite TrPs (TrPs in the referral area of the primary TrP) If you are treating only the satellite TrP and not the primary TrP, it will seem your therapy is not working when in fact, you have not treated the causative TrP. Also, the primary TrP could be latent (dormant), but still there. That is why it is so important to make sure you are treating all of your TrPs not just the ones that are screaming out at the time.

On 11/14/2010 I received word that the FDA has approved botox for treatment of migraine. This makes sense, because many times one can find TrPs at the temples, and I read that serotonin release abnormalities may play a part in migraine like it does in FM. It it always good to have options. In my own personal experience, I had botox for TrPs in my neck (I have severe diffuse degenerative disc disease and stenosis). What happened was it paralysed the muscle involved, which put all the work load of the other muscles to keep my head erect. This resulted in activation of many latent TrPs in many layers of muscles in my neck and upper back, resulting in excrutiating pain and self treatment was minimally effective because of the continued stess on the muscles and no way to relieve the work load. I had to wait for the Botox to wear off, which seemed like an eternity. Having injections in the face would most likely not have this effect and is something to consider with caution.


Clair Davies The Trigger Point Therapy Workbook - The illustrations are wonderful and he shows the referral patterns well. Sometimes the ONLY way you can locate a TrP is by tracing it back to by its referral pattern.

Valerie DeLaune's Trigger Point Therapy for Headaches and Migraineby , if you JUST want to look at myofascial TrPs in the head and neck and migraine.

Myofascial therapist that specializes Travell and Simons trigger point therapy. There is a listing of therapists that might be in your area.

Harmony and Hope, Celeste


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Celeste Cooper said...

Wonderful. If you learned from this article, you might also be interested in this one for June awareness. And thank you so much for the positive feedback.

Scream “4,”Cervicogenic Migraine and Myofascial Trigger points: June Awareness

Celeste's Website

Celeste's Website
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