Whiplash- A Runner’s Approach to Diagnosis, Treatment and Prevention
Whiplash is one of the most common and painful disorder and is one part of the myofascial pain syndrome. It has cause many to visit the clinic more often . Myofascial pain syndrome has the ability to affect any skeletal muscle in the body. Approximately 50% of the body weight is made up of skeletal muscle and there is an approximately 400 muscles in the body. Most of the chronic musculoskeletal pain is caused by myofascial pain syndrome.
The syndrome has the ability to cause local or referred pain, tightness, tenderness, and limitation of movement. Suffering from the syndrome can be very painful in most cases. Fortunately, the pain can be treated and can be prevented. Although many experts do not know exactly the cause of the syndrome but there are some common signs and symptoms that are prevalent and it is going to discuss in this article. Read this article in order to get a complete information of what myofascial pain syndrome is, its symptoms, risk factors, the treatment options, and how to prevent future occurrence.
What is whiplash?
Whiplash pain is a kind of pain that occurs in the muscle region of the body. It can also be said to be a pain that occurs with the fascia. (Connective tissues). In a situation where this pain persists and get worsen, doctors call it myofascial pain syndrome. In case you are not familiar with myofascial pain syndrome, you need to know some few things in order to see if you may be suffering from it.
Myofascial pain syndrome is a chronic pain disorder and a presumed inflammation that affects the soft tissues or muscles of the body. It is seen as a painful condition that affects the fascia (the connective tissues covering the muscles).
Myofascial pain syndrome sometimes involve a single muscle and another time involve a group of muscle. Medical professionals believe that the actual site where the injury is located most times causes pain in other areas of the body. This situation is called referred pain. Meaning that a sharp pain can occur in any part of the body but the pain is originating from a trigger point within the muscle. While you are still suffering from the pain, it is possible to overlook the root-cause of the pain and might even be unable to decode that the cause of the pain is from a trigger point within the muscle.
Facts to Know
To be able to access the syndrome, is wise to first of all highlight some facts as it concern myofascial pain syndrome in a more objective and holistic way. Myofascial is the combination of two Latin words “myo” which means muscle and “fascia” which means connective tissues surrounding the muscle. This condition simply means that, the triggering of pain comes from the muscle but the pain is felt elsewhere in the body.
Taking a closer look, fascia is said to be a tough connective tissue which lies under the skin. It surrounds every muscle, bone, nerve and blood vessel in the body and it extends from the head to toe uninterruptedly. A trigger point is seen as the hypersensitive area that acts as a nodule within a tight band of the muscle. Trigger muscle is capable of causing pain, burning, weakness and loss in motion.
The syndrome is very prevalent among the general population than expected. Report shows that approximately 85% of the population can be affected with the syndrome at some point of their lives. Seeing how prevalent the syndrome is, it is advisable to be aware of the syndrome for future purpose. The syndrome is mostly prevalence among middle-age adult of 30-60 years. It happens that the syndrome is more common among women than men. It shows that 65%of women suffers from this issue and only 37%of men are affected with the syndrome. In general, it is in the elderly population that the syndrome is more common. 85% of the elderly population are susceptible to the syndrome due to the weakening of their muscles and the less active lifestyle most of them are living.
Majority of people that suffers the syndrome always overlook its symptoms and are not familiar with the consequences. Leaving the syndrome untreated can cause tightness, tenderness, popping and clicking and even loss of motion. This is dependent on the muscle the syndrome is affecting because every part of the body has a different reaction to the pain. The most common experience of the syndrome is that the pain is referred in nature. A referred pain is that kind of pain that arises in a particular trigger point but is felt at another point away from the active point. Due to this, they leave the syndrome untreated and this is not advisable. In any circumstances you suspect that you may be suffering from the syndrome, it is best to go your doctor for a professional advice.
Adding to the above explanation, the syndrome is mainly characterize by the following:
- Most times, the syndrome affect muscles at the asymmetric region of the body.
- The cause of the syndrome is unknown.
- It can easily lead to localized pain around the muscle tissue.
- Stiffness, fatigue and poor sleep is commonly associated with the syndrome.
- The best prognosis to patients happens when only one physician is in charge of the different multifaceted treatment approach and also monitors the different response to the therapies.
Generally speaking, the pain in the muscle can be steadily painful and deep. But this depends on the location and the intensity of the pain. Some can be mild and discomforting while others can be really excruciating.
The signs and symptoms of myofascial pain syndrome includes the following.
- Persistent pain
- A soft knot in the muscle
- Deep and aching pain in the muscle
- Difficulty sleeping because of the pain.
In addition to the above, people with the syndrome can also suffer
- Behavioral disturbances
Causes and Risk Factors
The precise cause of the syndrome is unknown but there are strong evidence that stress in the body is the major cause of the pain, especially the muscles that are contracting frequently. People that subject themselves to extreme exercise or people that work manually on a continual and long-term basis stands the risk of suffering from the syndrome.
Myofascial pain can develop from a particular muscle injury or it can develop from an excessive application of force to a particular muscle or group of muscle, ligament or tendon.
Most times, the syndrome occurs in a situation where you are using a muscle that you have not used in a long while. It could be that after having a stroke, breaking a bone, or waking up from coma. The pain can also originate from muscle that are seen to be contracted, and the contraction has been repetitive. It is the people who are doing strenuous work and the work involves a high level of repetitive motion. Again, people that engage in a demanding physical hobbies that are prone to the syndrome. Stress that is related to the muscle tension can also be the cause of the syndrome.
It should be known that, muscle pain is a common pain and it should not be mistaken to be the syndrome without doctor’s pronouncement. What distinguishes the syndrome from other pains is the discomfort from experienced and the persistence of the pain over a long period of time.
The summary of the causes of the the syndrome include the following.
- Injury to the muscle fibers
- Repetitive motions
- Lack of activity. Example, subtending a broken arm in a swing.
- Fatigue in general
- Medical situations like stomach upsets, heart attack.
- Poor posture
- Emotional disturbance can also be the cause.
Myofascial pain syndrome is caused by a stimulus like, pressure which eventually sets up a trigger points in the muscle. Some of the factors that may possibly increase the risk of muscle trigger points are:
- Muscle injury: Muscle injury that is acute in nature or a repetitive muscle stress can result in the development of trigger points. Example, a spot near a strained muscle can become a trigger point over the course of time. Also, repetitive motions and poor posture can increase the risk.
- Stress and Anxiety: People that frequently experience anxiety and stress in most of their activities stands a greater risk of developing a trigger point within the muscle. A theory holds that these set of people in most cases clench their muscles. This is a form of repeated force on the muscle which leaves the muscle susceptible to trigger points.
There are some complications that is associated with the syndrome and it includes the following.
- Sleep problems: Signs and symptoms of myofascial pain syndrome can possibly cause difficulty sleeping at night. The patient may have trouble finding a comfortable sleeping position at night.
- Fibromyalgia: Some research make suggestions that myofascial pain syndrome may develop into fibromyalgia in some people. Fibromyalgia is a situation that comes with a widespread pain. It is also believed that the brain of people suffering from fibromyalgia becomes more sensitive to pain and it has been affirmed that the syndrome may contribute hugely to this complication.
When can I see a doctor?
If you have a muscle pain that doesn’t go away, is advisable to make appointment with the doctor. Nearly everyone at one particular time or the other experiences muscle pain. But in a situation where the muscle pain persist despite rest, massage and other self-care measures, make an appointment with your doctor.
What specialties of doctors treat myofascial pain syndrome?
In most cases, myofascial pain syndrome is treated by primary-care physician also, family medicine doctors, general practitioners, and internist can also treat. Some other physicians who treat myofascial pain syndrome include physiatrists, orthopaedists and rheumatologists.
Preparing for your doctor’s appointment.
The signs and symptoms of the syndrome is very similar to other disorders. It is possible that you will see several doctors before receiving a diagnosis.
What you can do.
The most likely place to start with is your primary care doctor. He may then refer you to a doctor that specializes in diagnosing and also treat muscle and joint conditions (rheumatologist). To get more from your appointment, do the following.
- Try as much as possible to be aware of the pre – appointment restrictions. The moment you make an appointment, be sure that you ask if there is anything to do in advance in order to prepare you for your evaluation.
- Writ down any symptoms you are experiencing. Also include those things that seems unrelated to the reason you scheduled the appointment.
- Create a list that your key medical information are included. Also include other conditions for which you are being treated. Try to mention the names of any medications or supplement that you have been taking.
- Think and write down all the possible questions you will like to ask your doctor. In addition to it, go along with your notepad and a pen so as to write down some vital information given by your doctor as he tries to address your questions.
Some basic questions to ask your doctor.
- What are the possible causes of my symptoms?
- Is it a temporary condition?
- Does it require treatment?
- What are the different kinds of treatment that is available?
- Is there any printed materials that will be of help and I can possibly go with?
What to expect from your doctor.
There are some possible questions that will be ask by your doctor or health care provider. The ability to answer those questions will help you reserve quality time for questions that will require more explanation and illustration. The following are the possible questions your doctor might ask.
- What are the symptoms that you are experiencing?
- Which area of your body do you feel severe pain?
- For how long have you been experiencing these symptoms?
- Is there any symptoms that persist to go?
- Is there anything you do that makes the symptoms better?
- Is there anything possible that makes the symptoms worse?
- Have you been performing any task repetitively?
- Is there any injury that is recent in your body?
- Has the pain limit your activities?
There are many ways that a professional can use in diagnosing the syndrome. While suffering from the syndrome, there might not be any changes in appearance such as lack of redness, warmth or swelling. But there ways to determine if you are suffering from the syndrome through description and evaluation.
Myofascial pain syndrome can be diagnose base on the areas of complaints during physical examination. To recognize this syndrome, it will require a precise understanding of the trigger points in the body. To identify the trigger points, it requires the application of pressure to the particular area of the body the patient complained about. The pain experienced will determine where the trigger point is located. During diagnosis, the doctor may choose to apply a gentle finger pressure to the painful area especially the tense areas. At the point of attaching pressure to the painful areas, some specific responses will be shown. Example, it might be possible to experience muscle twitch.
In diagnosing the syndrome, there are four trigger points that can be distinguished.
- Active trigger point: This is an area of extreme tenderness and it is usually located within the skeletal muscle and it is associated with a local or regional pain.
- Latent trigger point: It is a dormant area and has the potential to act like a trigger point.
- The point at which the muscle region is highly sensitive and has the ability to become active because of the existence of the main point of pain but the pain is more severe in a different muscle. This form of pain is seen to be a secondary point of pain
- Satellite point: This is a highly irritable spot in a muscle and it can become inactive due to the fact that the muscle is in the region of another trigger point.
There are several ways and methods of treating the syndrome and this includes, medication, injection at the trigger point, physical therapy. There is no conclusive evidence that supports the use of one therapy method over another. Discussing your options and treatment choice with your doctor is advisable and you may need to try more than one therapy method in order to find pain relief.
Physical therapy methods is said to be the best method of treatment for the pain . The physical therapist can decide to build up a plan that will help relieve your pain depending on your signs and symptoms. There following physical therapy will help relieve myofascial pain syndrome.
- Stretching: The therapist will be leading you through some gentle stretching exercises that will help reduce the pain in the affected muscle.
- Low-impact aerobic training: This particular workout will try as much as possible to rev up your heart beat while taking it easy with your joints. Example, you might be using a stationary bike to warm up or try walking fast instead of running. This will happen before you begin your strengthening exercise.
- Strengthening exercise: You might be using machines like resistance band to begin this type of exercise. You can decide to work on your core muscles like belly, gluts, back, and any other part of your body.
- Massage: Physical therapist may massage the part of your muscle that is affected in order to relieve your pain. Hand strokes along your muscle can be used by the therapist or the application of pressure on the affected area to release tension.
- Heat: The application of heat which might be from either a hot pack or a hot shower can help in relieving the muscle tension and reduces the pain.
- Ultrasound: This particular therapy has to with the use of sound waves to increase the circulation of blood and warmth which may promote the healing of the affected muscle.
Trigger point injection
Trigger point injection (TPI) in some cases, becomes an option for the treatment of the pain in some patients. It is a procedure where a pain- relieving is injected into the affected muscle. It is another method that can be used to treat the pain. The injection of numbing agent into the trigger point can help in relieving the pain. In some people, the act of inserting only the needle into the trigger point helps in breaking up the muscle tension. This method is called dry needling. It is the process of inserting a needle into different places in and around the trigger point.
Medications that can be used for myofascial pain syndrome include:
- Pain relievers: There are some few over-the-counter pain relievers like Ibuprofen (Advil, Motrin IB, others) that can help relief the pain. But it is advisable to get a prescribed pain reliever from your doctor. Some might be in patches where you have to place on your skin.
- Antidepressants: There are many antidepressants that can help relieve pain. For some people, using amitriptyline appears to be very effective in reducing the pain and also improve sleep.
- Sedatives: Sedatives like Clonazepam (Klonopin) can help in relaxing the affected muscles. Carefulness must be exercise because it causes sleepiness and can be addictive.
Lifestyle and home remedies.
There are many home remedies that is available in case you have developed the syndrome and you are looking for some simple solution to add to what your doctor gave you. There are many simple ways and methods that can be applied in order to keep your body and muscle relax and also to maximize your recovery. Try to take care of yourself. Self-care measures will help to keep your body healthy and it will make it easier for you to be able to cope with the pain. While at home try the following.
- Exercise: Trying to exercise gently will help you cope better with the pain. Ask your therapist about the best form of exercise be carried out.
- Hot shower: One of the home remedies is to take a long hot shower. The heat from the shower will help in loosening the muscles and help in reducing the pain. It is also advisable to do additional stretching while still in the shower as the muscle is dilated and can be stretch more while under direct heat. Another source of heat is a heated pad. You can put the heating pad on the trigger point in order to reduce the tension in the muscle. Jacuzzis and spas is also another source of heat. All these sources of heat brings you an opportunity to submerge your body in hot water which will eventually loosen all the muscle and relax them.
- Abstinence from tobacco, caffeine, and alcohol: Staying away from stimulant like tobacco and caffeine will effectively help you recover from the syndrome. Also, alcohol should be avoided because it dries up the muscles and may contribute to your health problems.
- Relax: Being stressed and tensed will only cause you to experience more pain. Try as much as possible to relax. Sitting out with friends or writing is a good way to relax.
- Take care of your body: Eat healthy diet most importantly, let the diet include much of fruits and vegetables. Try to get enough sleep. By doing this, you will be able to pull your energy towards coping with the pain.
A couple of measures has been outlined so as to help in preventing the syndrome. however, it is a difficult task to prevent the syndrome. Most times the syndrome is developed after a serious physical trauma like car accidents which makes it hard to be prevented. Ultimately, it is important to be taking care of your environment and try as much as possible to be involve in a stressful and much physical labor that has the possibility of causing the pain.
Most times, our hobbies which seems to be enjoyable are the culprit to the cause of the syndrome and it is a hard thing to stop what we enjoy doing. The best option to this is to be aware of your posture and always try to be consistent in maintaining good posture. Ensure that you engage in light exercises and stretching daily most especially if you have been involving in strenuous physical labor. In the process of exercising, ensure that you are positioning yourself in the correct manner just to avoid unnecessary strain to your body and muscle.
Stretch the muscle daily to ensure that there are in a relaxed state and also avoid cramps. Other ways to avoid the syndrome is to avoid re-injury if you might have had a serious injury in the past because it makes you susceptible to the syndrome. It is important to take a break and stretch the muscle no matter how small the motion is. It will help to prevent the syndrome
It is important that you maximize your optimal sleep pattern in order to keep your muscle and your body rested and relaxed. Engaging yoga is also beneficial to the body. All these preventive measures is to help ward of the syndrome, but it does not stop from these preventive measures. You can also reduce the risk if you are able to put a check on your body weight and you eat healthy food. Try to gain vitamin D in almost every diet you eat, this will keep your muscle healthy.
Many critical and serious diseases like obesity, congestive heart failure as well as renal failure do have their recommended diet. Considering this facts, scientific information together with clinical observation in recent years has observed that chronic pain like myofascial pain syndrome also need recommended diet. Although, till date myofascial pain syndrome has not officially gotten a recommended diet but there are some classes of diet that has been proven to be helpful in the treatment of the syndrome. The following are the recommended kinds of diet.
- Protein: The important type of kind of food patient with myofascial pain syndrome must be taking are food that is high in protein. Patients with the pain has been advised to be eating food rich in protein and also avoid food or drink that has high carbohydrate content because carbohydrate induces episodes of hypoglycemia and weight gain. Protein diet is intended to help in promoting the patient’s strength, movement, energy and mental function.
Why protein is critical
There are four major theories that states why a patient with myofascial pain syndrome should take high-protein diet.
- Protein produces endogenous pain relievers: In the intestine, protein is broken down into its different component which comprises of dozens of different amino acids. It is important to note that, there are eight essential amino acids that the body cannot produce and this must be supplied through our diet. Apart from these eight amino acids, the body can produce other amino acids if there is adequate nutrition. Amino acid goes through the blood from the intestine and then moves to the different parts of the liver, glands and the brain. Most especially where there are building blocks for compound that is responsible for pain relief. The general complain from patients about pains may have many causes but out of these causes, lack of protein must definitely be one of them. Although it is unknown how much protein that is to be taken by patient in order to provide enough amino acid need for the production of pain-controlling compounds.
- Muscle-cartilage is built by protein: Much amino acids are required in order to build up the muscle. Amino acid is one major building block of the body and is needed for the development of cartilage and intervertebral discs.
- Protein decreases inflammation: Food with protein content such as fish and green vegetable has anti-inflammatory agents.
Most patients that are treated for myofascial pain syndrome have some form of vitamin inadequacy which has a drastic effect on the lasting relief from pain. Vitamin inadequacy has been seen to have increase irritability myofascial trigger points. Therefore, in order to achieve a good result while treating the syndrome, vitamin inadequacy must be addressed. Myofascial pain relief is associated with several key vitamins and minerals. Vitamins like vitamin A, B1, B3, B5, B6, B12, C, D, E, K and others. The inadequacy of vitamin B12 and folic acid are the major vitamin related to the syndrome than others. Also, the insufficiency of vitamin B12 and folic acid reduces the production of blood cell and it is the blood cell that carries oxygen to the muscles and also play a role in every metabolism. When there is an energy crisis, sensitizing substances are released which gets to interact with local pain receptors and it will eventually lead to pain at the myofascial trigger point.
Taking proper time to read through this article will be helpful. It will adequately inform you on the different symptoms, the causes and the possible treatment of myofascial pain syndrome. It will be benefitting to always refer back to this article in order to refresh your memory on this condition. I believe the information that is provided in this article will help you if you are suffering from myofascial pain syndrome. If stress is reduce, you keep good posture and you stretch regularly and also adhere to good diet, your chances of developing the syndrome will continually reduce. Keeping this method in mind will ensure that your future health is guaranteed. These preventive methods are within our reach and there is no reason for us not to engage in them just to take precaution. Also, if there is any symptoms of the syndrome that you are experiencing, consulting a medical professional is a very helpful step toward the treatment process.
Some of the sources that was used while conducting our research.
The primary objective of this article is to inform. Everything that is written here is gotten from a painstaking scientific research from several sources. Although this information is wisely search upon, it does not take the place of a professional medical advice. I strongly advice that if you are suffering from myofascial pain syndrome or you are experiencing some signs and symptoms you should go talk to your doctor. Do not make the content of this article your professional adviser.
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