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  1. #1
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    Re: cervical examination for myofacial pain

    Quote Originally Posted by thomas bibu View Post
    hi sagar,

    well, I really had problems the other day to format the text into three divisions
    eg. C/features******Fibromyalgia*******MPS.

    what I really meant is tenderness & not tender points. perhaps the reason why I made that mistake is because of the cut and paste technique, please excuse!

    retrospectively with tenderness what I mean is not local but diffuse tenderness of the muscle (FM), unlike only on certain points or in other words trigger points (MPS).

    hope it is clear now.

    cheers,

    thomas

    Thanks for clarifying.

    I got confused because both Tenderness and Trigger Points were mentioned.

    Still I think explanation for tenderness and trigger points in not too convincing.

    As you have mentioned trigger points and tenderness are both same. When tenderness is local it is called trigger points. {This is what I interprete from your lines marked in red above.}

    Both are different terms and can't be used interchangeably.

    Definition of Trigger Point - Trigger points are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers. (Wikipedia)

    Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response.

    Definition of Tenderness - Pain or discomfort when an affected area is touched. (Wikipedia)

    You might wanted to say same thing but the sentence reads to me the other way. So just wanted to make sure.

    Cheers for PHYSICAL THERAPY,

    Sagar Naik
    [URL="http://www.physio4all.webs.com"]http://www.physio4all.webs.com[/URL]
    [URL="http://www.therapyprotocols.com"]http://www.therapyprotocols.com[/URL]

  2. #2
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    Re: cervical examination for myofacial pain

    dear sagar,

    thank you for defining trigger point and tenderness .

    let me copy your definition and ask for your explanation on hyperirritable spots.

    Definition of Trigger Point - Trigger points are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers (Wikipedia).

    well my question is how would you describe the hyperirritable spots??? please dont mention about the palpable nodules / taut bands - which I am sure as practicing PTs we are all aware of as associated signs, but only on "hyperirritable" spots,

    preferably without using similar words like pain/tenderness/ache/soreness/twinge/hurt/sting/smarting/throbbing/pricking/burning/stinging/thorny/spiky etc.

    looking forward to your reply.

    cheers,

    thomas



  3. #3
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    Re: cervical examination for myofacial pain

    Quote Originally Posted by thomas bibu View Post
    dear sagar,

    thank you for defining trigger point and tenderness .

    let me copy your definition and ask for your explanation on hyperirritable spots.

    Definition of Trigger Point - Trigger points are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers (Wikipedia).

    well my question is how would you describe the hyperirritable spots??? please dont mention about the palpable nodules / taut bands - which I am sure as practicing PTs we are all aware of as associated signs, but only on "hyperirritable" spots,

    preferably without using similar words like pain/tenderness/ache/soreness/twinge/hurt/sting/smarting/throbbing/pricking/burning/stinging/thorny/spiky etc.

    looking forward to your reply.

    cheers,

    thomas
    Let me put the classic difference between Trigger Point and Tender Point defined by American Academy of Family Physicians.

    Active Trigger Point is tender to palpation with a referred pain pattern that is similar to the patient’s pain complaint. This referred pain is felt not at the site of the trigger-point origin, but remote from it. The pain is often described as spreading or radiating. Referred pain is an important characteristic of a trigger point. It differentiates a trigger point from a tender point, which is associated with pain at the site of palpation only.

    For complete reading please find the attached article. I have highlighted difference for you so that it would be easy.

    Waiting for your views.

    cervical examination for myofacial pain Attached Files
    Sagar Naik
    [URL="http://www.physio4all.webs.com"]http://www.physio4all.webs.com[/URL]
    [URL="http://www.therapyprotocols.com"]http://www.therapyprotocols.com[/URL]

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    Re: cervical examination for myofacial pain

    trigger point is it fact or fantacy.
    We treat "it".
    Sure, maybe its a placebo effect. But if the outcome is a patient that feels better and functions better, and the risks of hurting the patient are minimal, why not continue well-established therapies and also continue to discover their physiologic basis.
    But my original question is how to we EXAMINE the neck to gather enough info to make an educated , calculated diagnosis on what to base our treatment.
    Is there a standard protocol anyone is using?
    Can one do a cervical exam without including shoulder or upper back?
    How can one rule out referred cervical pain?
    With regard ro the trigger point my gut feeling is that the answer is chemical and Nano technology is the answer,
    david



 
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