Well my friends, though I am 60, my neck is 80. It seems in addition to severe arthritis, my discs have severely degenerated at all levels and it is "inoperable.”An implantable neurostimulator has been suggested by two doctors I respect. If you know anyone who has tried this, I would sure like to hear about it.
My history with neck problems.
My issues started after working in the ICU. A post anesthesia encephalopathy patient was on a tall air bed. He literally lifted me into the bed with him by my hair and tossed me about like a rag doll. It took several doctors and nurses to release his grasp. That was the beginning, only escalated by other accidents where I was expected to lift and assist patients that were too large for one person of any size. I have also had torn rotator cuffs of each shoulder and one complete reconstruction as a result of emergency nursing care. Anatomically, some of the muscles that support the shoulders also support the neck (cervical spine).
I have total respect for bedside nurses that care for us, they literally confront battle grounds every day. I have walked in their shoes.
Physical trauma can be a trigger to the onset of FM (discussed in the book), and I speak of this first hand.
Preventative Measures and Alternative Interventions.
I sleep with either a cervical collar or an ice pack. Because of the FM and chronic myofascial trigger points, I pay particular attention to stress on the muscles of the neck. Posture of course is a great aggravator and even with the best of intentions ones head starts to drift forward when in a stationary position. This adds greatly to the pain for those of us with these two co-existing conditions.
Thanks to a good friend here on FB, who brought up the importance of proper neck alignment and her use of a cervical pillow, I saw this as an important teaching opportunity. You obviously have cervical degeneration and stenosis or you wouldn’t be reading this discussion. Positioning is important. Of course, as we sleep, if we get it, which is rare for most of us, we are not in control of how our neck is positioned. Even if we do sleep, it is non-restorative, and we miss out on the healing phase. We definitely need help. If you have found a particular device that helps, please share. I think we are all up for hearing about it. We also know this won’t cure our degeneration, but anything that might retard further degeneration and help curb some of the pain is like a bright star.
I currently use a TENs unit, which helps divert the pain some.
I have tried the many FDA approved (and off label) medications for neuropathic pain and could not tolerate the side effects. I am fogged enough without being a zombie. Pain or not, I want to be present in my own life. I understand that it works for some, but many FMers have sensitivity to these meds. The goal of any medication or treatment is to improve function.
I am desperately trying to find a myofascial therapist, one that has been trained in Travell and Simons, here in the East KC area, but to no avail. I have had some help with active release therapy from a chiropractor and a physical therapist, but the effects are short lived. (See other discussions on myofascial trigger points).
So much has not been researched to my scientifically minded satisfaction, and I find anecdotal accounts of the utmost importance. Prolotherapy has also been mentioned. If anyone here has had it, or knows someone who has had it, I am all ears.
Harmony and Hope.
Sunday, September 12, 2010
Friday, September 3, 2010
Defining Myofascial Trigger Points (MTrPs)
Myofascial trigger points can mimic many things and cause pain, dysfunction, and shortening of the muscle affected by this knotted up muscle fiber in a taut band of muscle. Such things as paresthesias (numbness and tingling), burning, or a needles and pins sensation if the TrP is entrapping the a nerve, circulation/temp changes (if located next to a blood vessel) and swelling (if located next to a blood or lymph vessel) may also be present. (Helpful treatment links following).
The following ook excerpts, protected by copyright, you must ask permission from Healing Arts Press to reuse this content
Myofascial Trigger Point ©
A myofascial trigger point (TrP) is a self-sustaining, irritable area in the muscle that can be felt as a nodule in a taut band. This irritated spot causes the muscle to gradually shorten, interfering with the motion function of the muscle and causing weakness and pain. Trigger points differ from tender points in that generally they refer pain to other parts of the body and can usually be felt with the hand (palpated) unless the muscle is too rigid from intense muscle involvement, or the trigger point is in a deep muscle or under bone. The tender points of FM or myalgias associated with CFID do not restrict motion or cause localized muscle weakness. If they do, the patient should also be evaluated for the presence of CMP. Trigger points in CMP are well defined and often radiating—the pain radiates out to other parts of the body.
Active Trigger Point ©
An active TrP is a myofascial trigger point that causes pain at rest. It is always tender, causes shortening of the muscle, weakens the muscle, and causes patient complaints of referred pain on direct compression. An active trigger point can elicit a visible local twitch response when adequately stimulated by compression or needle insertion. It can produce referred motor and autonomic phenomena, generally occurring in the TrP referral zone. An active TrP can also cause the referral zone to become tender.
Secondary Trigger Point ©
A secondary TrP is one that develops in a second compensating muscle. A compensating muscle is one that is trying to make up for the malfunction of the muscle affected by primary trigger points. In other words, when a primary trigger point causes muscle dysfunction, the opposing muscles become stressed. These opposing muscles become overloaded because they are attempting to carry the entire load of the muscle work needed to perform a task. When staring at a computer screen your head starts to drift forward after a while, particularly if you spend hours there. You may have primary TrPs in muscles on the front of your neck, which may or may not be making their presence known. As your head starts drifting forward, putting less stress on the primary TrPs because of the slackening, the muscles on the backside of your neck are being stretched and stressed in an effort to keep your face from falling onto your keyboard. The sustained overstretching of these muscles causes secondary trigger points to develop in the muscles on the back of your neck. (This is an important reason to pay attention to posture as an
aggravating factor, to be discussed in chapter 4.)
Satellite Trigger Point ©
A satellite trigger point is a type of secondary TrP that develops in a muscle
of the primary trigger point’s referred pain area.
Latent Trigger Point ©
This type of trigger point is painful only when there is pressure on it. A latent TrP can restrict muscle movement and cause stiffness and weakness that persist for years after apparent recovery. Unless restricted motion or weakness causes you to start rubbing around to find the source, a latent TrP may go unnoticed. When you stumble upon a sore, hypersensitive nodule in a muscle that does not refer pain anywhere, you have found a latent trigger point. Now you have discovered the source of your restricted motion and weakness. Dormant latent TrPs can be reactivated by overstretching, overuse, or injury. Treat TrPs when you discover them, because some seemingly minor event, such as chilling, can cause a latent TrP to transition to an active trigger point. Once the TrP transitions from latent to active it will be painful all the time and can cause referred pain. Treatment is discussed in chapter 4.
End Notes:
Chronic myofascial pain (CMP) from myofascial trigger points is a peripheral nerve to muscle problem. Fibromyalgia, CFID/ME, migraine, IBS, irritable bladder and several other common co-existing conditions have a strong central nervous system component. When any of these co-exist with chronic myofascial pain (CMP) from myofascial trigger points (TrPs), the peripheral message of painful trigger points to the brain keeps the brain in a hypersensitive state," causing a “wind up” phenomenon at the HPA-axis (dysfunctional in FM and thought to be dysfunction in CFID) is off an running.
The good news is there are specialized myofascial physical therapists and chiropractors trained in techniques specifically designed for treatment of the myofascia. They can do a proper assessment and offer treatments such as myofascial release and active release therapy (ART) and active release therapy (ART). There are also specially trained myofascial massage therapist trained specifically in the work of Travell and Simmons.
Myofascial Release
http://www.myofascialrelease.com/fascia_massage/public/default.asp
Active Release Therapy (ART):
http://www.qfac.com/pain_management/active_release_therapy.html
National Association of Myofascial Trigger Point Therapists
http://www.myofascialtherapy.org/
Think adversity?-See opportunity!
The following ook excerpts, protected by copyright, you must ask permission from Healing Arts Press to reuse this content
Common Abbreviations ©
MPS: myofascial pain syndrome
CMP: chronic myofascial pain
MTP: myofascial trigger point
TrP: trigger point
Myofascial Trigger Point ©
A myofascial trigger point (TrP) is a self-sustaining, irritable area in the muscle that can be felt as a nodule in a taut band. This irritated spot causes the muscle to gradually shorten, interfering with the motion function of the muscle and causing weakness and pain. Trigger points differ from tender points in that generally they refer pain to other parts of the body and can usually be felt with the hand (palpated) unless the muscle is too rigid from intense muscle involvement, or the trigger point is in a deep muscle or under bone. The tender points of FM or myalgias associated with CFID do not restrict motion or cause localized muscle weakness. If they do, the patient should also be evaluated for the presence of CMP. Trigger points in CMP are well defined and often radiating—the pain radiates out to other parts of the body.
Active Trigger Point ©
An active TrP is a myofascial trigger point that causes pain at rest. It is always tender, causes shortening of the muscle, weakens the muscle, and causes patient complaints of referred pain on direct compression. An active trigger point can elicit a visible local twitch response when adequately stimulated by compression or needle insertion. It can produce referred motor and autonomic phenomena, generally occurring in the TrP referral zone. An active TrP can also cause the referral zone to become tender.
Secondary Trigger Point ©
A secondary TrP is one that develops in a second compensating muscle. A compensating muscle is one that is trying to make up for the malfunction of the muscle affected by primary trigger points. In other words, when a primary trigger point causes muscle dysfunction, the opposing muscles become stressed. These opposing muscles become overloaded because they are attempting to carry the entire load of the muscle work needed to perform a task. When staring at a computer screen your head starts to drift forward after a while, particularly if you spend hours there. You may have primary TrPs in muscles on the front of your neck, which may or may not be making their presence known. As your head starts drifting forward, putting less stress on the primary TrPs because of the slackening, the muscles on the backside of your neck are being stretched and stressed in an effort to keep your face from falling onto your keyboard. The sustained overstretching of these muscles causes secondary trigger points to develop in the muscles on the back of your neck. (This is an important reason to pay attention to posture as an
aggravating factor, to be discussed in chapter 4.)
Satellite Trigger Point ©
A satellite trigger point is a type of secondary TrP that develops in a muscle
of the primary trigger point’s referred pain area.
Latent Trigger Point ©
This type of trigger point is painful only when there is pressure on it. A latent TrP can restrict muscle movement and cause stiffness and weakness that persist for years after apparent recovery. Unless restricted motion or weakness causes you to start rubbing around to find the source, a latent TrP may go unnoticed. When you stumble upon a sore, hypersensitive nodule in a muscle that does not refer pain anywhere, you have found a latent trigger point. Now you have discovered the source of your restricted motion and weakness. Dormant latent TrPs can be reactivated by overstretching, overuse, or injury. Treat TrPs when you discover them, because some seemingly minor event, such as chilling, can cause a latent TrP to transition to an active trigger point. Once the TrP transitions from latent to active it will be painful all the time and can cause referred pain. Treatment is discussed in chapter 4.
End Notes:
Chronic myofascial pain (CMP) from myofascial trigger points is a peripheral nerve to muscle problem. Fibromyalgia, CFID/ME, migraine, IBS, irritable bladder and several other common co-existing conditions have a strong central nervous system component. When any of these co-exist with chronic myofascial pain (CMP) from myofascial trigger points (TrPs), the peripheral message of painful trigger points to the brain keeps the brain in a hypersensitive state," causing a “wind up” phenomenon at the HPA-axis (dysfunctional in FM and thought to be dysfunction in CFID) is off an running.
The good news is there are specialized myofascial physical therapists and chiropractors trained in techniques specifically designed for treatment of the myofascia. They can do a proper assessment and offer treatments such as myofascial release and active release therapy (ART) and active release therapy (ART). There are also specially trained myofascial massage therapist trained specifically in the work of Travell and Simmons.
Myofascial Release
http://www.myofascialrelease.com/fascia_massage/public/default.asp
Active Release Therapy (ART):
http://www.qfac.com/pain_management/active_release_therapy.html
National Association of Myofascial Trigger Point Therapists
http://www.myofascialtherapy.org/
(Signature line appended, March 2018)
In healing,
Celeste Cooper, RN / Author, Freelancer, Advocate
Think adversity?-See opportunity!
"Adversity
is only an obstacle if we fail to see opportunity."
~ • ~ • ~ • ~ • ~ • ~
Learn more about
Celeste’s books here. Subscribe
to posts by using the information in the upper right hand corner or use the
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All blogs and comments are based on the author's opinions and are
not meant to replace medical advice.
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. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm229782.htm 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.
Resources:
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.
http://www.myofascialtherapy.org/
Harmony and Hope, Celeste
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. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm229782.htm 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.
Resources:
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.
http://www.myofascialtherapy.org/
Harmony and Hope, Celeste
Wednesday, September 1, 2010
September is Pain Awareness Month-My Letter for the "March on Pain"
In honor of pain awareness month, September, the American Pain Foundation is planning a virtual "march on pain" to Washington.
Following is my contribution letter:
I have fibromyalgia; chronic fatigue syndrome and chronic myofascial pain (CMP) from myofascial trigger points and have written a book as a way of personal coping and reaching out to help others that are ready and willing.
I do not abuse drugs, yet I find it difficult to find a doctor not terrified to treat my pain. It seems chronic pain patients are accused of overusing medical care, yet it is this same system that puts us in that position. Why should we endure painful procedures that do not help? Why should we be prescribed anything but a pain medication to treat pain? Other alternative medications have many life threatening side effects and interactions with medications that opioids do not.
Having my pain managed should be a basic human right, it should not be decided by others who do not walk in my shoes, nor should I be treated as a criminal. With proper education programs for patients regarding the risks, pain can be controlled and improve quality of life. Should we become addicted, not pseudo addiction, abusers, for which there is a predisposition in some individuals, THEN you can get us the proper help. Please do not assume that we will abuse our pain medications. In fact approximately 70% to 90% of us will have improved mobility without risk of abusing our medications.
Sincerely, Celeste Cooper, author
"Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection" (co-author, Jeff Miller, PhD)
Risk Evaluation Mitigation Strategies (REMS), the FDA and pain medications, what it means and the American Pain Foundation plan for using your voice.
http://www.painfoundation.org/take-action/natl-efforts/rems/
Following is my contribution letter:
I have fibromyalgia; chronic fatigue syndrome and chronic myofascial pain (CMP) from myofascial trigger points and have written a book as a way of personal coping and reaching out to help others that are ready and willing.
I do not abuse drugs, yet I find it difficult to find a doctor not terrified to treat my pain. It seems chronic pain patients are accused of overusing medical care, yet it is this same system that puts us in that position. Why should we endure painful procedures that do not help? Why should we be prescribed anything but a pain medication to treat pain? Other alternative medications have many life threatening side effects and interactions with medications that opioids do not.
Having my pain managed should be a basic human right, it should not be decided by others who do not walk in my shoes, nor should I be treated as a criminal. With proper education programs for patients regarding the risks, pain can be controlled and improve quality of life. Should we become addicted, not pseudo addiction, abusers, for which there is a predisposition in some individuals, THEN you can get us the proper help. Please do not assume that we will abuse our pain medications. In fact approximately 70% to 90% of us will have improved mobility without risk of abusing our medications.
Sincerely, Celeste Cooper, author
"Integrative Therapies for Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain: The Mind-Body Connection" (co-author, Jeff Miller, PhD)
Risk Evaluation Mitigation Strategies (REMS), the FDA and pain medications, what it means and the American Pain Foundation plan for using your voice.
http://www.painfoundation.org/take-action/natl-efforts/rems/
Sunday, August 29, 2010
Response to Karen Richards Health Central Expert-Proposed FM Criteria
Karen Richards is the fibromyalgia expert at Healthcentral.com, and co-founder of the National Fibromyalgia Association. Following is the link to her post on the proposed criteria for diagnosing FM.
http://www.healthcentral.com/chronic-pain/c/5949/115093/fibromyalgia/2
Thank you for posting Karen, this proposed criteria are long overdue.
As you state the 18 tender point exam was never intended as a diagnostic exam. Speaking with many FM patients, most of us have tenderness everywhere. I am a bit disappointed however, that the myofascial trigger points (not tender points) that are present in so many FM patients is not being addressed in this proposed diagnostic criteria. These knotted up pieces of muscle fiber that shorten the taut band of muscle involved, cause dysfunction and could explain the symptoms of numbness and tingling and referred pain. They are easily felt by the examiner (unless under bone or other larger muscles) and have a specific pain and symptom pattern. This is an objective assessment for those trained to identify them.
Have you seen the studies that suggest the presence of chronic myofascial pain from myofascial trigger points may be present in all FM patients? I question, why are we missing this peripheral issue that keeps the FM brain in constant wind-up? As you know I have discussed this exhaustively as a patient and author. Why are those that study us missing this most important piece of objective information, when the research has been done? We have been yearning for objective, measurable, visible criterion, here it is staring us in the face. (See the citings below)
Harmony and Hope, Celeste
From PubMed Abstracts:
Ge Hy. Prevalence of Myofascial Trigger Points in Fibromyalgia: The Overlap of Two Common Problems. Curr Pain Headache Rep. 2010 Jul 6 [EPub ahead of print]
http://www.ncbi.nlm.nih.gov/pubmed/20607459
Ge HY, Wang Y, Danneskiold-Samoe B, Graven-Nielsen T, Arendt-Nielsen L. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points. J Pain, 2010, Jul:11(7):644-51.
http://www.ncbi.nlm.nih.gov/pubmed/19914876
Ge HY, Nie H, Madeleine P, Danneskiold-Samxoe B, Graven-Nielsen T, Arendt-Nielsen L. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome. Pain 2009 Dec 15;147(1-3):233-40.
http://www.ncbi.nlm.nih.gov/pubmed/19819074
Kuncewicz E. Samborski W. Tender points and trigger points--differences and similarities. Chir Narzadow Ruchu Ortop Pol. 2009 Nov-Dec; 74(6): 367-71. [In Polish]
http://www.ncbi.nlm.nih.gov/pubmed/20201336
http://www.healthcentral.com/chronic-pain/c/5949/115093/fibromyalgia/2
Thank you for posting Karen, this proposed criteria are long overdue.
As you state the 18 tender point exam was never intended as a diagnostic exam. Speaking with many FM patients, most of us have tenderness everywhere. I am a bit disappointed however, that the myofascial trigger points (not tender points) that are present in so many FM patients is not being addressed in this proposed diagnostic criteria. These knotted up pieces of muscle fiber that shorten the taut band of muscle involved, cause dysfunction and could explain the symptoms of numbness and tingling and referred pain. They are easily felt by the examiner (unless under bone or other larger muscles) and have a specific pain and symptom pattern. This is an objective assessment for those trained to identify them.
Have you seen the studies that suggest the presence of chronic myofascial pain from myofascial trigger points may be present in all FM patients? I question, why are we missing this peripheral issue that keeps the FM brain in constant wind-up? As you know I have discussed this exhaustively as a patient and author. Why are those that study us missing this most important piece of objective information, when the research has been done? We have been yearning for objective, measurable, visible criterion, here it is staring us in the face. (See the citings below)
Harmony and Hope, Celeste
From PubMed Abstracts:
Ge Hy. Prevalence of Myofascial Trigger Points in Fibromyalgia: The Overlap of Two Common Problems. Curr Pain Headache Rep. 2010 Jul 6 [EPub ahead of print]
http://www.ncbi.nlm.nih.gov/pubmed/20607459
Ge HY, Wang Y, Danneskiold-Samoe B, Graven-Nielsen T, Arendt-Nielsen L. The predetermined sites of examination for tender points in fibromyalgia syndrome are frequently associated with myofascial trigger points. J Pain, 2010, Jul:11(7):644-51.
http://www.ncbi.nlm.nih.gov/pubmed/19914876
Ge HY, Nie H, Madeleine P, Danneskiold-Samxoe B, Graven-Nielsen T, Arendt-Nielsen L. Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome. Pain 2009 Dec 15;147(1-3):233-40.
http://www.ncbi.nlm.nih.gov/pubmed/19819074
Kuncewicz E. Samborski W. Tender points and trigger points--differences and similarities. Chir Narzadow Ruchu Ortop Pol. 2009 Nov-Dec; 74(6): 367-71. [In Polish]
http://www.ncbi.nlm.nih.gov/pubmed/20201336
Tuesday, July 27, 2010
Upset with the CDC and misappropriation of funds, yet again?
Upset with the CDC, misappropriation of research funds, neglect in providing a replication study to the WPI and XMRV, and the oops we published this invalid study before the NIH study results (which does confirm the WPI and XMRV association with CFS/ME)? Advocates are now soliciting help from Erin Brockovich. Empowering! We will not be slam dunked again by the CDC.
I encourage everyone to PLEASE see the blog "Sample Advocacy Letter" posted in April.
There you will find and I hope you will contribute links for contacting government officials, worldwide.
"Though our bodies are weak our determination is unbreakable, standing tall, standing strong, standing united, committing to a cure."
Add this one to the list
http://www.brockovich.com/workcontact.html
I encourage everyone to PLEASE see the blog "Sample Advocacy Letter" posted in April.
There you will find and I hope you will contribute links for contacting government officials, worldwide.
"Though our bodies are weak our determination is unbreakable, standing tall, standing strong, standing united, committing to a cure."
Add this one to the list
http://www.brockovich.com/workcontact.html
Poem - "A Fall Homecoming at Horseshoe Park"
A Fall Homecoming at Horseshoe Park ©
Elk promenade streets of Estes Park,
They nibble quivering aspen’s tenderness.
On runway’s modeling racks to behold,
Blind to danger this wilderness dweller.
Though leery of man, in family tradition,
Fall’s decent from where trees greet tundra.
The magnificent graze in meadows of silk,
Swaying to their own reunion at Horseshoe Park.
Pure and sturdy, keeping a skeptical eye,
Dusk’s misty dew hazes as harems gather.
Buck’s circling females, bugling their mates,
And gold aspens give backdrop, scene one.
The novice youth lingers, as a matter of course,
But the senior, the voyeur, waits to pull rank.
The dance of defense won’t calm either stud,
But the sagest male’s patience claims victory.
The mating rehearsal, giving way to the play,
Strumming meadows provide a Broadway stage.
We lurk, crowded roadways, binoculars in hand,
How long, we ask, will the third act last?
Elks homecoming here at Horseshoe Park,
Applause in silence broken only by calls,
The bugling males harmonizing in the dark.
The curious watch, and the curtain falls.
The wonders of ritual at Horseshoe Park.
Written by Celeste Cooper, author
Elk promenade streets of Estes Park,
They nibble quivering aspen’s tenderness.
On runway’s modeling racks to behold,
Blind to danger this wilderness dweller.
Though leery of man, in family tradition,
Fall’s decent from where trees greet tundra.
The magnificent graze in meadows of silk,
Swaying to their own reunion at Horseshoe Park.
Pure and sturdy, keeping a skeptical eye,
Dusk’s misty dew hazes as harems gather.
Buck’s circling females, bugling their mates,
And gold aspens give backdrop, scene one.
The novice youth lingers, as a matter of course,
But the senior, the voyeur, waits to pull rank.
The dance of defense won’t calm either stud,
But the sagest male’s patience claims victory.
The mating rehearsal, giving way to the play,
Strumming meadows provide a Broadway stage.
We lurk, crowded roadways, binoculars in hand,
How long, we ask, will the third act last?
Elks homecoming here at Horseshoe Park,
Applause in silence broken only by calls,
The bugling males harmonizing in the dark.
The curious watch, and the curtain falls.
The wonders of ritual at Horseshoe Park.
Written by Celeste Cooper, author
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