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Question:
"I have been diagnosed with a chronic myofascial pain in
my hips and thighs. How is this treated and can it be cured?"
Simply
stated, myofascial pain is a form of chronic pain in the muscles
and tissues known as the fascia. It is often characterized by
"trigger point" areas of pain which are areas in the
muscles that are extra sensitive to touch. Unlike a typical muscle
strain or injury, myofascial pain lingers long after physiological
"healing" of the tissues has taken place.
There
can be as many approaches to curing or managing this type of pain,
as there are practitioners. Physicians will typically address
the issue through medication management and trigger point injections.
Naturopaths, acupuncturists, nutritionists, chiropractors and
massage therapists will likely have different approaches, many
of which work for some people and do not work for others.
Many
myofascial pain syndromes are exacerbated by a nervous system
that becomes "hypersensitive." This then begins a downward
spiral of activity which leads to increased pain, which leads
to less activity, which leads to increased hypersensitivity, and
so on.
Paradoxically,
movement is exactly what nerves need to decrease their hypersensitive
state. But for folks who have chronic painful conditions,
finding the right amount and level of movement or exercise can
be challenging. Your physical therapist can guide and support
you into finding the right level and intensity of movement that
can help gradually desensitize the nerves in your muscles and
help you manage your symptoms. Simultaneously, a physical therapist
can use a variety of techniques to treat and manage the painful
symptoms in the muscles and tissues.
A
physical therapist will also evaluate contributing factors to
the experience of pain. Postural and skeletal alignment and imbalances
will be addressed through education, specific stretches and exercises
designed for the individual. There is no one "recipe"
of exercises because each person has a lifelong history of movement
patterns that can contribute to painful conditions. Your physical
therapist can also help with specific region massage, other pain
management techniques and an individualized exercise program and
a strong emphasis on education.
My
specialty is the Feldenkrais Method®: A unique method which
helps change how the brain and nervous system control fundamental
movement patterns that are contributing to the on-going experience
of pain. The Feldenkrais Method uses specific movement sequences
performed by the practitioner, or in an instructional setting
(either in a class or done to an audio CD at home) to teach the
nervous system how to direct movement with significantly less
effort and strain. It empowers the patient to become more aware
of their own movements, and learn to change these basic, often
life-long patterns through becoming more curious in their own
movement and postural discoveries. This level of mindfulness also
promotes relaxation and a significant change in the brain's attitude
towards the body, movement and pain. This, in turn, alters the
fight-or-fight stress response which is often chronically triggered
by the experience of on-going pain and limitation.
So,
is there a cure for myofascial pain syndrome? Yes and no. Many
folks have been down the path of chronic pain and found healing
in a variety of places. I have personally seen dramatic shifts
in a person's quality of life through improved pain management
and coping strategies. At Healing Bridge Physical Therapy, we
have several therapists that specialize in working with patients
struggling with chronic pain conditions.
I
would encourage anyone experiencing chronic pain to never give
up, never give in, and always have hope. Most importantly, approach
your condition as though it has something to teach you. Learning
to change your relationship with your pain from victim to manager
can be the most empowering, life changing, gift you could receive.
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