Re: myofacial therapy
Hey CB and Kathy, What he's describing is triggerpoint therapy. Applying pressure to a trigger point drives the blood of out a muscle spasm or TP and causes it to release. It's something that can be helpful just like trigger point injections or using Botox on muscles that are constantly in spasm may provide longer lasting relief.
What your likely going to run into with PT when your no longer improving is the insurer will say you have reached max medical benefit from any further treatment. If you were using your own insurance or comercial insurance, you would have used up all your PT benefits long before 6 months of 3 days a week. I would love to get a massage 3 days a week for the rest of my life and have unlimited chiro benefits to adjust the problems having my entie lumbar spine fused created in the thoracic area and SI joints , but Once you max med benefit you need to find a better longer lasting way to achieve the same relief.
We also have to do our part and take advantage of the relief we get from any modality, whetther it's a nerve blocks, chiro, Botox or anything that eases pain and allows us to take over and start strengthening, stretching and rebuild what we loose while injured and living a sedentayry life to limit the amount of pain we experience.
I would expect your PT and insurance to discontinue a therapy that isn't providing measurable gains, otherwise everytone would use their insurance to get a massage 3 days a week simply because it feels good.
The latest in trigger point therapies is actual surgical release, it's new and experimental but the docs doing it are reporting great success in whiplash patients and patients with cervicle turtocolis.
TP pressure is something you spouse can learn to apply and do daily, they make specific tools to ease the stress on her thumbs wih large plastic jacks that have different szize balls on theend of each arm of the Jack, they also make hand help devices to give your partners hand a beak but they need tolearn to identify them and the patient needs to stretch and excercise in between feel good treatments. After 6 monhs of no improvement, you simply can't expect feel good therapy to continue indefintiely so it's a must to take advanatage of any relief your geting and do your part to improve your condition.
You're also more lkely to continue to show measurable improvement if your doing your part excercising, stretching, using heat, or ice or going to the gym to work out and use a pool or jacuzzi or simply walk daily. Treatment will continue longer since comp doesn't have a specific limit on the number of visits it takes to return someone to work, but without measurable improvement it will come to an end at some point.
There are stronger methods like TP injections and botox that last longer and may be time better spent if those allow you to work on your strength and felxability in between apts.
There are also alternatves like intrathecal baclofen because you simply can't take enough oral baclofen to stop the spacticity that many MS patients have. Where intrathecal delivery allows enough to be delivered to truly make a difference on severe spasticity or spasm.
Trigger point therapy or acupressure isn't anything new, many Chiros use it along with spinal manipulations, Physiatrists and Osteopaths have been using the same technique since before my first surgery in 93. Unfortunately it's not a cure, it's just a feel good modality like massage, heat or E-stim and the rest is up to the patient to participate in a comprehensive physical rehab program.
This is particularly important because it doesn't apear your beng hindered by a spnal injnury and the problem is purely muscular. Acupuncture may be worh tryng, TENS, TINS, and most important, rebuilding the muscle strength and flexability you have lost because pain limits willingness to participate in anything that causes more pain.
If your simply resting between treatments your loose more and more strength, flexability and range of motion as you become more and more tolerant to the meds used to facilitate participation in a rehab program.
Good luck, Dave
Last edited by Shoreline; 05-29-2006 at 09:56 AM.