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- $Unique_ID{BRK01961}
- $Pretitle{}
- $Title{What can be Done for Trigger Points?}
- $Subject{Trigger point Points muscle muscles bursitis tendonitis Fibromyalgia
- rheumatism cause causes causing ache aching pain painful trapezius backside
- back hip greater trochanter elbow lateral epicondyle knee disease diseases
- symptom symptoms headache headaches irritable bowel syndrome syndromes bladder
- sleep disturbance disturbances chronic fatigue treat treatment treatments
- exercise exercises fitness environment Environmental emotions emotional stress
- stresses nonsteroidal anti-inflammatory drug drugs NSAIDs narcotic analgesic
- analgesics corticosteroid corticosteroids tricyclic medication medications
- amitriptyline cyclobenzaprine therapy therapies anesthetic}
- $Volume{}
- $Log{
- Diagnosis of Irritable Bowel Syndrome*0008402.scf
- Exercise has Overall Benefits*0003209.scf
- Exercise Helps Strength and Flexibility*0003204.scf
- Exercise Stimulates the Brain*0003201.scf}
-
- Copyright (c) 1993 Tribune Media Services, Inc.
-
-
- What can be Done for Trigger Points?
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-
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-
- QUESTION: Please write an article in your column about trigger points on the
- muscles. I have been diagnosed as having lots of these all over my body. My
- doctor always called it either bursitis or tendonitis, but a licensed massage
- therapist diagnosed these as trigger points. They are tremendously painful,
- and has become so bad that I am limited in some of my house work. What does
- this all come from, and what can I do?
-
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-
- ANSWER: While your therapist has recognized an important symptom, trigger
- points are really only one of the many problems that accompany a mystifying
- syndrome called "fibromyalgia". Fibromyalgia is a form of rheumatism that
- affects muscles, causing both diffuse aching as well as well defined painful
- spots. These tender points (also known as trigger points) can be spread all
- over the body, but are most common in the middle of the back (trapezius), in
- the backside (gluteal), hip (greater trochanter) as well as the elbow (lateral
- epicondyle) and knee. In fact there are 18 defined sites, and pain must be
- present on palpation in at least 11 of these for the diagnosis of fibromyalgia
- to be made.
- Fibromyalgia is a curious disease; in fact, there was some doubt for a
- long time that it really could be diagnosed as a legitimate medical entity.
- However, as more research became available it was more easily defined, and is
- now considered to be a disease that is certainly real, if not life
- threatening. Experts estimate that it may affect between 3 and 6 million
- Americans, though it is often misdiagnosed, and so the numbers could be
- higher. Women are 4 times more likely to be the patient than men, and while
- it may occur at any age, it most often appears in the late 40's and after.
- Many symptoms can be present, including headache, irritable bowel
- syndrome, irritable bladder, and varying symptoms in response to weather
- changes. A careful history almost always reveals patterns of sleep
- disturbances and chronic fatigue. Many other maladies often present with
- these same symptoms and complaints and so the diagnosis of fibromyalgia is a
- difficult one to make. And if diagnosis is difficult, then treatment is even
- more so. The chances of a complete cure are at best only moderate, and
- changes in life style are an important part of the treatment plan. A program
- of gradually increasing aerobic exercise can improve muscle fitness, reduce
- pain and improve a sense of well being. Environmental and emotional stress
- must be reduced to a minimum, and any other illnesses that can contribute to
- the pain should be cared for.
- When pain persists, a trial of the oral analgesics is in order. Aspirin,
- acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs) are all
- possible choices. However narcotic analgesics are not recommended, nor the
- use of oral corticosteroids. However, tricyclic medications (such as
- amitriptyline) is helpful and may also help promote a more restful sleep
- pattern. The muscle relaxant cyclobenzaprine has also been shown to reduce
- symptoms, including point tenderness.
- Physical therapy as well as massage, acupressure and the use of heat can
- provide relief. When all else fails, injecting the trigger point with a local
- anesthetic, sometimes mixed with a small amount of corticosteroid, can produce
- an immediate reduction of pain, that may last for a short period of time, or
- over an extended time in some luckier patients.
-
- ----------------
-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-