Are you suffering from neck pain or back pain and unable to identify it’s root cause?

In my daily practice, being a Consultant Pain physician, I come across a good number of patients who suffer from pain on a daily basis.

Identification of the pain generators is the most important task in the hands of a Pain physician. Trigger points are such entities which are often missed by the physicians.

Myofascial Trigger points or Muscle knots are the hyper-irritable spots in the taut muscle fibres. These spots are painful on compression and can produce pain, motor and sensory dysfunctions and in some patients even autonomic phenomena. 

Even though scientific evidence is lacking, many researchers agree that Acute trauma or repetitive microtrauma can be the culprits leading to these trigger points. Muscle trauma releases acetylcholine which potentiates development of taut bands while hypoxia and decreased blood flow in the muscles produces the pain.

Lack of exercise, prolonged poor posture, vitamin deficiencies, sleep disturbances, joint problems, Occupational or recreational activities that produce repetitive stress on a specific muscle or muscle group commonly cause chronic stress in muscle fibres, leading to trigger points. The most common example is locking mobile between the ear and shoulder to free arms or sitting in chairs with poor back support.

Here are some tips that you can use to identify this condition on your own.

1. Persistent pain in the neck, upper back, shoulder or lower back which has affected your range of motion over a period of time

2. Pain, usually associated with particular muscle activity. If chronic, patients can have a constant dull kind of pain

3. You are able to reproduce this pain with the same movement

4. Pain never follows a nerve distribution, however, referred pain is very often seen

5. You may feel a very painful tender nodule in the muscle fibre at the site of pain.

6. Jump sign and a Twitch response on palpation are pathognomonic of a trigger point.

1. Lifestyle modification and Ergonomic correction: Identify the activities responsible for the development of micro-traumas in the muscles and try to modify or avoid them. This can be as simple as using a Chair with a lumbar curve support or using a Laptop table or study table to prevent undue stress on your back and neck.

2. Regular exercises: Doing exercises of the muscles of the problematic areas plays a very important role in getting rid of these Trigger points.

3. Nutrition: Many studies have proven that if you incorporate foods having anti-oxidant and anti-inflammatory properties in your diet, you are less prone to develop chronic pain issues.

4. Spray- stretch technique: This involves passively stretching the target muscle with trigger points while simultaneously applying ethyl chloride spray locally over the skin. This spray produces cooling effect and local anaesthesia which decreases the pain sensation and allows the passive stretching of the muscle towards normal length, which then helps to inactivate trigger points, relieve muscle spasm, and reduce referred pain.

5. Deep tissue massaging with Percussion Massage guns: Regular Trigger point release with use of Massage guns is a very effective method that can be done at home and can save you from repetitive visits to physiotherapists or doctors.

Dry needling is a procedure done by Pain physicians to release the tense bands in the muscles with the help of solid filiform hollow-core hypodermic needles.

This improves the local blood circulation providing nutrition and oxygen to the muscles and also washes away the accumulated acidic products. The response that is seen is the twitch response while puncturing the bands.

Use of Ultrasound technology for accurate identification of the taut bands and dry needling further improves the success rate of this procedure.

JEEVISHA Pain Management Center is the only centre in Pune, Maharashtra to offer Ultrasound guided Dry needling with successful results.