Tuesday, June 20, 2017

Muscles That Mimic

Easily-treatable Myofascial Pain Can Scare the Pants Off You

Ow! I think I have sciatica!

It is important to note that myofascial pain patterns commonly mimic those of other conditions and illnesses. High on the list of muscles that mimic other problems is the gluteus minimus, in the hip. Sitting for a long time in a chair or car seat with inadequate thigh support, or taking a fall can create trigger points in this muscle. These refer pain into the buttocks, and down through the thigh and calf, as in illustration A. When this particular pain occurs, lay people and healthcare professionals alike often reasonably presume this pattern to be a symptom of sciatica.

OMG!  I'm having chest pain!

Trigger points in the pectoralis major will cause pain in the chest and down into the arm, as in illustration B, mimicking a heart attack. Of course, a patient should immediately have this checked out by a physician, but when the appropriate tests for heart problems come back negative, the doctor may next refer the patient for myofascial trigger point therapy, having ruled out a more serious diagnosis.

Oh no, pelvic pain!  That has to be bad, right?!

There are numerous cases in which appendixes have been removed and found to be disease free. In these cases, the culprit might have been trigger points in the lower rectus abdominis, which, as you can see from the pain pattern in illustration C, cause pain in the lower abdominal area, mimicking appendicitis. These trigger points can be activated when a person is tired, worried or premenstrual. Trigger points in the other lower abdominals can cause diarrhea and symptoms mimicking diverticulitis or gynecological disease.

Ugh, these migraines are ruining my life!

With the ever increasing pace of today’s hectic lifestyle more and more people are suffering from migraine headaches on a monthly, weekly, or daily basis. Trigger points in the posterior cervical muscles (the back of the neck) are nearly always involved in severe headaches such as migraines, tension headaches, and post-traumatic headaches. When trigger points in the upper trapezius are activated, they mimic migraines (illustration D) and cause severe head and neck pain. These muscles can contract strongly, or cramp, compressing and entrapping the greater occipital nerve, causing not only muscle pain, but nerve pain, as well.

These are just a few examples of the tricks muscles can play on us if we are not aware of this common but sneaky type of pain. There are many more of these patterns, but even once correctly recognized, there are also key concepts to be aware of in order to treat this kind of pain effectively.

This is an excerpt of an article I wrote for Pathways, and contains material used with the permission of my excellent colleague, Vicki MacGown.

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