Trigger Point
Fibromyalgia syndrome is differentiated from other musculoskeletal disorders as the former involves multiple pressure and trigger points that are characterized as discrete, focal, and hyperirritable spots in a tight band of skeletal muscle. These areas are painful when compressed. They can produce localized pain, referred tenderness, referred pain, motor dysfunction and autonomic phenomena.
The causative factor of this syndrome is thought to be stress developed on muscle fibers secondary to acute trauma or repetitive microtrauma. Muscles usually involved are those used to uphold body posture, such as neck muscles, shoulder muscles, and pelvic muscles. When these muscles are affected, patients experience persistent pain and may suffer from decreased range of movement.
In contrast to pressure or tender points, trigger points have an important characteristic that is referred pain. The pain on palpation is described as radiating at a site that is remote from the origin. The pain that spreads from other sites has pattern that is similar to the patient’s chief complaint. Another difference is its production of local twitch response and jump sign upon application of firm pressure in a snapping fashion perpendicular to the muscle.
Fibromyalgia trigger points can be classified as active or latent. In the former, pain is actively referred either locally or to another area along the nerve pathways while in the latter, localized pain but not referred pain exists. However, referred pain in the latent type can be elicited by applying strain or pressure to the spot in a taut band of myoskeletal structure.
Another classification is either key or satellite. The former classification promotes a “pain referral pattern” along a certain nerve pathway that activates a dormant type on the pathway while the latter is set into motion by the key type. Therefore, successful treatment of the key type will resolve the satellite type.
Another classification is either primary or secondary. The former biochemically activates the latter in another structure. However, treatment of the former does not necessarily resolve the latter.
Diagnosis is through examination of signs, symptoms, pain patterns and manual palpation. The site is usually a taut band in muscles in which a hard nodule can be felt. Another important feature is the presence of twitch response that activates the "all or nothing" response in a muscle resulting to contraction.
There are pharmacologic and non-pharmacologic modalities for the treatment and management of this disorder. These include analgesics, antidepressants, non-steroidal anti inflammatory drugs (NSAIDs), acupuncture and acupressure, massage therapy, ultrasonography, heat or ice application, diathermy, electrical nerve stimulation of skin, spray and stretch technique, dry needling, and local anesthetic, saline, or steroid injections.
Injections offer a faster relief and can be second line choice when patient did not respond to other methods. However, decision to use this treatment depends strongly on the training and skill of the physician. It is important to note that just like any other modalities, injections may have possible complications such as vasovagal syncope, skin infection, pneumothorax, needle breakage, and hematoma formation.
The treatment is considered successful if pain on the area is eliminated and deactivated, elongating the structures affected and allowing the natural range of movement of the affected body part.
About the Author:
Jessie Mcknight is an expert in
fibromyalgia treatment. Learn how to eliminate the symptoms of fibromyalgia
from your life today by visiting
http://www.banishfibromyalgia.com
Article Source: ArticlesBase.com - Trigger Points Differentiate Fibromyalgia
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