Myofascial/Trigger Point Release

Discussion in 'Fibromyalgia Main Forum' started by Bren2135, Sep 1, 2006.

  1. Bren2135

    Bren2135 New Member

    Hi Everyone..

    I've been reading bunches of past posts (newbie here!), and enjoy your sassy, funny, inspiring quips. (Oh, and the advice is good too!!) Here's my question:

    Has anyone been successful in getting their insurance to cover regular care for myofascial and/or trigger point release? I was lucky a few years ago, to have a physical therapist sneak this in for me, and it was so VERY effective -- until the insurance company called it "maintenance" and denied care...

    (Umm, if I were diabetic, would my insulin be denied, considered "maintenance"????)

    Any word around town of a good myofascial therapist? I'm in Canton, Ohio..

    Thanks, lookin forward to your advice..


  2. Mikie

    Mikie Moderator

    The insurance company may be confusing the trigger point release with tender point massage. If they are billing with a diagnosis of FMS, it is understandable. Trigger point release for MPS is not maintenance. In fact, if the knots in the facia are not released, referred pain can increase and, as a result, increase the total cost of treatment. Be sure the physical therapist is billing the ins. co. with a diagnosis of MPS. If there has been an injury, trauma should also be used as a diagnosis.

    I had to have this treatment following an auto accident. It takes more than one treatment session but it isn't maintenance. Trauma can cause knots in the facia.

    If the ins. co. won't pay, find out how to file a grievance. You sometimes have to be persistant. Your doc may have to write a letter. If all else fails, call them, speak to a supervisor and tell him or her you are filing a complaint with the state insurance comissioner's office. That often brings results. Good luck.

    Love, Mikie
  3. bandwoman

    bandwoman New Member

    I am in the Chicago area. I have a wonderful myotherapist who specializes in trigger point therapy. She bills throught my chiropractor and my insurance pays 100%. I have seen her for over 12 years. I know I am extremely fortunate to have excellent coverage. I wish you all the best because I know how she keeps me functioning all these years.

  4. Bren2135

    Bren2135 New Member

    Ah, well that explains a lot, thanks...

    (Hadta go looking for what MPS meant!) Haven't been diagnosed, but that seems to be what's going on, hmmm..

  5. Bren2135

    Bren2135 New Member

    ...I do some trigger point release myself, with a Theracane. However, there are some very deep tissues that I can't reach or stretch out, and a PT who isn't afraid to dig deep enough to cause bruises could very well become my new best friend!!

    (It hurts, something awful... I have to do that "Natural childbirth" breathing, in order to get through it. (And btw, who was the guy who coined THAT phrase????!!)

    Umm, sorry, I digress...

    I'll check out that book you mentioned..!!

  6. Mikie

    Mikie Moderator

    The facia is like a knitted sweater which holds the body together. Like a sweater, it can get knotted up like when you snag a sweater. If you pull a string on a sweater, it puckers all down the line. The facia is like that too and where it knots, it can cause referred pain somewhere else in the body. Until the knots are worked out, the pain persists.

    Hope this helps; it helped me to understand.

    Love, Mikie
  7. IntuneJune

    IntuneJune New Member

    My insurance paid for awhile.

    But since I needed ongoing treatments and the treatments were not a permanent fix, the company stopped paying.

    I called them.

    "You will cover the medications my rheumatologist once had me on...the daily muscle relaxers, pain medications, and sleeping pills, which all damage my liver; and by the way, not only did NOT "fix" my problem, but rendered me into a more zombie-like state resulting in deteriorating daily function; but you will not cover treatments which noninvasively help me deal with the pain, improve muscle tone, and keep me connected to professionals who can advise me on methods to continually help myself."

    The company, "yes, that is correct."

    Me, "How much is my damaged liver going to cost you in a few years?"

    My rheumatologist had me on many different types of pain meds, they made me care less about the pain, but did not really address the pain. After that experience, I often wondered with all these different medications floating around in my body, surely my responses were affected. I probably was not as responsive a driver than without the meds. Wonder how many car accidents might be occurring..... sorry, I digress.

    My therapists cut me a deal, so I could continue.... wonderful guys, but I don't go as often as I should.

    Fondly, June

  8. suz45

    suz45 New Member

    I see a chiroparator 1x a week a present time, even though I have a sub acute back problem . The MPS interferes with the decreasing the back problem. Therefore my chiro uses manipulation for the back, however prior to manipulating my spine he uses eelectro therapy, moist towels and trigger point compression and stretching to release the points in my back.

    So far he has billed under low back/ thoracic back treatment for multiple sublaxations.

    My copay is half of the tx. Therefore if the insurance company were to stop paying I would simple manage as best I would pay out of pocket, as to me it is less then the meds and I will have to pay a copay of about the same to see any other specialist and only slightly less for my pcp.

    I find the chiro work so far to have the best reults. As the MPS only affects both the low back pain and the mild case of FMS as well.

  9. wentworth228

    wentworth228 New Member

    Bandwoman or nancy:
    I live in Chicago area. Looking for a good therapist.

    Thanks, nancy (too) Reply to