Trigger Points, Referred Pain, and Release Therapies: Questions

Discussion in 'Fibromyalgia Main Forum' started by dhcpolwnk, Jan 7, 2003.

  1. dhcpolwnk

    dhcpolwnk New Member

    I have several questions.

    1. I saw my primary care doctor yesterday, and he said I have a lot of trigger points, but I don't have the ropy bands or knots. Maybe he's using the term in a way that's different from the CMP usage, but he said it's not necessary to have the ropy bands or knots to have tigger points. He's *not* a fibro or CMP specialist. In fact, I really think I know more about it than he does. But he's very nice and usually willing to give me whatever referrals or meds I request. So I'm not eager to get another primary doctor. I belong to Kaiser, so my referral choices are limited to Kaiser docs, unless I pay out of pocket, which I'm already doing for far too much stuff! (My plan doesn't even pay for prescription drugs.) Anyway, I'd really appreciate some clarification from the experts on this board about whether you can have trigger points without the ropy bands or knots.

    2. I've received suggestions about "trigger-point release therapy" and "active release therapy." Are those different names for the same thing? Or are they different treatments? If they're different, how are they different?

    Thanks to all who have answered my questions in the past, as well as to any who can help me with these questions.

    --Laura R.M.
  2. klutzo

    klutzo New Member

    Please remove the URL from your post by clicking on "edit" before a Moderator comes along, as you can be banned for posting them here. I see you are pretty new here. Welcome. For your info, please read the "message board rules". I watched this happen to someone because of this recently, and would hate to see you be next! Even though it is a Dr.'s website, there is no discrimination....all URL's are not to be posted here. Just letting you know,
    Klutzo
  3. dhcpolwnk

    dhcpolwnk New Member

    I've already been diagnosed with fibro. In fact, three different doctors gave me the same diagnosis within one week. I never asked about CMP. But I've been reading so much about trigger points, and my pain seems to occur in areas the seem to correspond to areas of referred pain involving trigger points, that I started to wonder. And then when my doctor started using the term "trigger points," I asked him about the "ropy bands" to make sure he was distinguishing trigger points from tender points. I'm still not sure that he was. Which is why I posted my question.

    I don't know whether it's possible to have CMP referred pain if you *don't* have the ropy bands/knots.

    --Laura R.M.
  4. wineToU2

    wineToU2 New Member

    I thought FMS and CMP feed off each other and a person can have both together. I have been getting trigger point therapy injections and I thought I had both FMS and CMP. I also thought this was very common to have both together?
  5. starstella

    starstella New Member

    tender points are used as one of the means to diagnose fm. if you do a search on your computer you will undoubtedly find a picture which shows typically identfied fm tender points. they do not all have to be tender at the same time. you may also have more than those shown. Body wide achiness, not always from the same source) is a primary symptom.

    The trigger points are very painful sore points -on some of them you can actually feel a lump- which are part of myofacial pain syndrome. by definition, they are called trigger points because with pressure on he spot, they can refer pain to other parts of the body.
    Therefore, you can have trigger points in your calves that are actually causing pain in your feet. The taunt, ropy bands are actually formed from a collection of trigger points in a specfic area. If you have those, there is more pain and difficulty with movement because the nerves can become entrapped.
    Also, with a collection of trigger points in the same area, satellite trigger points will form in other parts of the body. You can have both FM and MFP. and, i suppose, CFS also, but in my understanding, CFS is a whole other demon which thankfully I'm not dealing with.

    Myofacial release therapy focuses on a gentle pulling and stretching of the myofacia, which in my opinion, is probably most effective when you have the ropy bands, but can be helpful as a means of dealing with trigger points. I have had personal experience with this which I find helpful.

    I've read about the active release therapy, haven't received this, but my understanding is the therapist puts a lot of pressure on the trigger point to break it down. Hurts at the time, but is also supposed to have good results.

    So, with your insurance, you should do some searching around to see if you can find a physical therapist who has had specific training to work with myofacial pain syndrome. Do not let a therapist tell you to weight lift while you have trigger points as a way to get rid of them.
    Good luck
  6. teach6

    teach6 New Member

    Active Release Techniques is when the therapist does manual manipulation while you participate by moving a part of your body to release some of the knots and ultimately the pain. Depending upon where you live there may be many therapists available to you or none at all.

    I have found a wonderful chiropractor who I was able to get treatment with for a fairly reasonable fee until Dec. 31. Now my ever "improving" insurance company has decided to put all their "alternative therapies" under one network, anad didn't bother to tell the practitioners about it!

    Instead they sent out a magazine in mid-December which I'm betting most people didn't even look at and suggested the patients could tell their practitioners about the change. When I mentioned this to my chiro she had heard nothing about it and told me she wasn't planning to join any more plans. I tried, without success, to explain that all her patients under this type of Blue Cross Blue Shield will no longer be covered, but I don't think she really comprehended what I was saying. I'm hoping that the impact will be so big on her practice that she will relent and join the network.

    Now that I've gotten way off track, if you want to know more about active release techniques you can type that in and add a dot com and you will get the official website which has a search for providers in your area.

    Good luck!
    Barbara
  7. jolly

    jolly New Member

    Lucky you if you haven't reached the point of ropy bands. I have them in the upper back/shoulder/neck region and whoever said they were a collection of trps is probably right. This has been the hardest area for me to clear up. I just take a hard rubber ball in a sock and run it across this area all the time. It's gradually, and I do mean gradually, improving. Although the ability to turn my head again came about pretty quickly.

    I've wondered, too, if the ART that Mel talks about is the same thing as trp therapy. It sounds the same. You've bought the book haven't you? Seems like you did if I remember and remember can be a relative thing on many days!

    I also had the ropy bands in my neck, but that is much improved. Jo Ellen
  8. dhcpolwnk

    dhcpolwnk New Member

    Yes, I have the Starlanyl book, but it's the first edition. I bought it the day before I found out there was a second edition! It's been very helpful, but I'm still not quite sure what I'm dealing with, and my doctors seem to know less about it than I do. (I've been giving/sending them copies of the special reports for health-care providers that are posted at Devin Starlanyl's web site.)

    As I think I said in another post/thread, my doctor said he thinks I have rotator cuff tendinitis, but after researching that a bit on the Net, I'm not so sure. To me, it seems more like what's described as "frozen shoulder," though I *can* move my shoulder. On the other hand, this could all be referred pain from trigger points. Which brings me back to the original question.

    Anyway, I just got back from the endodontist and have confirmed that now I need a root-canal job. Preparing for that is kind of taking priority right now, but the arm pain really is becoming harder to deal with.

    Thanks for writing.

    --Laura R.M.
  9. VickyB

    VickyB New Member

    My husband bought me a device from "RELAX THE BACK STORE" for trigger point or tender points. It is in the shape of a big S with a wooden ball on each end. You put it over your shoulder and position it anywhere you have pain. You also can put as much pressure on the spot as you need. I like it because I can do it myself and reach anywhere on my back. Check it out, they have a store online, if there is not one in your city.
    Vicky
  10. healing

    healing New Member

    I too have a Backnobber, the S-shaped device referred to above. You can just enter the name of the device into Google and the manufacturer's site will pop up. I highly recommend it, have used mine for a couple of years now. It's about $25, I think.

    I also get myofacial release therapy weekly and have for many years now. My first therapist did deep tissue massage with hard, direct pressure on the trigger points. My current therapist works more obliquely, coming at the trigger points from an angle and saving me much discomfort. Heat packs after treatment can make a big difference because trigger point releases will leave you very, very sore. This therapy is the single best thing I do to keep myself functional and movng.

    Good luck in your treatment.
  11. jolly

    jolly New Member

    Devin has some trigger point diagrams in her book,the second one is the only one I have, but Clair Davies has the whole caboodle...very explicit and easy to follow. Devin recommended the book is how I bought it. It's called "The Trigger Point Therapy Workbook" $18 delivered off amazon.
    He actually wrote the book after figuring out how to fix his frozen shoulder. Jo Ellen
  12. BethM

    BethM New Member

    It's my understanding that if Kaiser doesn't offer a needed treatment, they are obligated to pay for a provider who does. My cousin and my sister both got Kaiser to pay for acupuncture that way. Just my 2 cents!

    Beth.
  13. dhcpolwnk

    dhcpolwnk New Member

    Thanks for the suggestion about Kaiser. I suspect, though, that Kaiser will pay for the therapy outside of Kaiser only if the benefit is included in your Kaiser coverage. So far, it seems that everything I've checked on is something I *don't* have Kaiser coverage for: prescription drugs, durable medical equipment, orthotics, chiropractic, etc. I do have some limited coverage for physical therapy, but as long as Kaiser has licensed physical therapists, I don't believe it is obligated to pay for therapists who specialize in things like myofascial/trigger point release. But I can give that a try--that is, if my Kaiser PT doesn't do that sort of therapy or isn't available in a reasonably timely manner.

    Thanks again for the suggestion.

    --Laura R.M.