Overcoming Chronic Myofascial Pain

Wellness Concept

Overcoming Chronic Myofascial Pain

From the Healing Bridge Physical Therapy

November 2008 Wellness Notes

By Allison Suran PT, GCFP


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.