Myofascial Pain Syndrome Support Group
Myofascial Pain Syndrome (or MPS) is a term used to describe one of the conditions characterized by chronic pain. It is associated with and caused by "trigger points" (TrPs), sensitive and painful areas between the muscle and fascia. The symptoms can range from referred pain through myofascial trigger points to specific pains in other areas of the body. It may be related...
I have a problem with my PT. I started physical therapy at the end of April after being referred by my physiatrist. Mind you that when he mentioned PT, I told him that I had not had good luck with PTs, but he assured me that this one was different. He even capitalized on his instructions to her that she should proceed in a GENTLE & SLOW manner. Things were going well and she was spending extra time working on my TrPs, stretching, and some resistance bodywork. I was given a home program and told to go at my own pace. It took me time to be able to complete the program once a day without developing TrPs or pain. My legs were feeling good and I was happy with my progress and feeling slightly stronger.
Two weeks ago it all changed and she decided that I should progress faster, so she asked me to do typical PT stuff like step-ups. We had to make some compromises as to the amount, but after doing these on a Tues., and Fri., I developed TrPs in my hamstrings and my legs were quite sore and tight. Last week when I saw her on Tues., I told her that I needed to talk to her before she started working on me. I told her that the new exercises were too much and since I had TrPs, that I couldn't do anything until she deactivated them. She said that she felt that I could do it and that "fear" was holding me back. I explained to her that people with myofascial pain can't do repetitive exercises and that my program needed to adapted to my needs and that I had to proceed SLOWLY. I could see in her face that she didn't buy it, but after she worked on me, she didn't ask me to do anything. Saw her again last Friday and my legs hurt because on Thurs. I had to walk into my internist's office for my physical. That short walk really set me into a flare. Again on Fri., I attempted to explain how I reacted to overuse of my muscles and that I could not do the current program. This time she stated, "Well, you know that many doctors give the diagnosis of myofascial pain, because they don't know what is wrong with you." (RED FLAG!, I realized that she doesn't believe that myofascial pain is a true condition.) I know some doctors do give that diagnosis because they don't know what is wrong, but I've been living with this for 12 years and I know I have myofascial pain. My physiatrist didn't write it on the referral. He wrote hyperlaxity syndrome. I see my doctor again on July 29, so we agreed to leave it up to him to decide how we should proceed. This disagreement with her has been quite upsetting, because I need to be rehabilitated but it has to be done correctly. Maybe he will need to refer me to someone else, but I know he thinks she is a great PT, so I am nervous about my appointment with him. I know this is a looong entry, but it was time for me to vent my frustrations. To all who have read this far, thank you for listening. Kat
Two weeks ago it all changed and she decided that I should progress faster, so she asked me to do typical PT stuff like step-ups. We had to make some compromises as to the amount, but after doing these on a Tues., and Fri., I developed TrPs in my hamstrings and my legs were quite sore and tight. Last week when I saw her on Tues., I told her that I needed to talk to her before she started working on me. I told her that the new exercises were too much and since I had TrPs, that I couldn't do anything until she deactivated them. She said that she felt that I could do it and that "fear" was holding me back. I explained to her that people with myofascial pain can't do repetitive exercises and that my program needed to adapted to my needs and that I had to proceed SLOWLY. I could see in her face that she didn't buy it, but after she worked on me, she didn't ask me to do anything. Saw her again last Friday and my legs hurt because on Thurs. I had to walk into my internist's office for my physical. That short walk really set me into a flare. Again on Fri., I attempted to explain how I reacted to overuse of my muscles and that I could not do the current program. This time she stated, "Well, you know that many doctors give the diagnosis of myofascial pain, because they don't know what is wrong with you." (RED FLAG!, I realized that she doesn't believe that myofascial pain is a true condition.) I know some doctors do give that diagnosis because they don't know what is wrong, but I've been living with this for 12 years and I know I have myofascial pain. My physiatrist didn't write it on the referral. He wrote hyperlaxity syndrome. I see my doctor again on July 29, so we agreed to leave it up to him to decide how we should proceed. This disagreement with her has been quite upsetting, because I need to be rehabilitated but it has to be done correctly. Maybe he will need to refer me to someone else, but I know he thinks she is a great PT, so I am nervous about my appointment with him. I know this is a looong entry, but it was time for me to vent my frustrations. To all who have read this far, thank you for listening. Kat
#1. the dr i saw before pT diagnosed me with ankle tendonitis or FHL tendonitis ( which is what ballerinas get, well I am NOT a ballerina) why I didnt question then is beyond me!
#2. She took that diagnosis and gave the standard cookie cutter PT program for tendonitis of the ankle. I did theraband stretches which called for eccentric exercises strengthening the muscles around then ankle (Ahem..the gastroc, tibialis posterior, hamstrings). Step Up 2 sets of 20 every day . I did these for 2-3 months!! Travell calls it repetitive Strain Injury!!!
By using the vary muscles that had trps I was causing more breakdowns or microtears in the muscle, more trps to tighten those muscles. I D ONT believe it is a conicidence that the muscles she had me strengthen through the standard protocol are the problem areas i have today, racked with Trigger POints!!
My opinion is run, run fast...ok.. walk walk fast and get out outhere. For one, I see 2 problems. Your doctor did not write Myofascial Pain Syndrome as one of your diagnosis beside Hyperlaxity??
Second your PT c an not seem to break out of her little box and does not beleive in MPS, and also seems to do the same standard thing that they all do.. strengthen stregthen strengthen. That is why myotherapists ( trp specialists) are not fond of the work of traditional PTs is there mind is stuck in one direction, and we are not all cookie cutter cases! The fact that she does not beleive in myofascial pain, would have me walkingt... walking fast out of there.
I would see your dr and ask why did he not put on the script the diagnosis for MPS? Also consider going to see a trp therapist or myotherapist. I am to the point of beyond skepticism with the mainstream PTs as far as this condition is concerned . I am sorry Carole, but beleive me, you were mucth smarter than I to listen to the warning signs and possibly get out, than me sitting there like a dumb a ** doing the stregthening exercises and causing more damage, I account her for probably a good portion of the damage i am in with my legs.
So advice, find a myotherapist, get out of PT and ask Dr why he did not list it as your diagnosis.
UGH! this makes me angry! I want the best for you too!
I am so sorry that you had confidence and hopes with this PT and now you're disappointed.
I'll write more but my *first* reaction is to ask the PT to confer with your doctor to explain that in she views CMP as an imaginary illness. I do believe that your doctor will see your issues.
I hope this can get straightened out for you
In your situation, I would ask for a therapist experienced with CMS, who understands it as a medical condition, who is willing to make regular adaptions based on your pain level and who doesn't label any of your limitations with emotionally charged words such as "fear". I can't think of how to articulate that professionally right now but I would assume that kind of tone with your doctor.
I'll be thinking of you and I hope you'll keep us up to date. Hugs.
I agree with the doctor that I do need rehabilitation where my muscles are retrained so that they don't react by developing TrPs and contracting. The doctor told me that retraining muscles is a very slow process and that I needed to be patient. (Well, the PT needs to be patient too!) But he also told me that he felt that fear was holding me back and that is why he recommended that I read the book Managing Pain Before it Manages You. I really like my physiatrist and he SEEMS open minded and that he isn't ego driven like other doctors. He is very dedicated to his patients even staying after hours to do the taping of my hamstrings or give Trp injections, etc... Before the PT got the Kinesio tape, I had called his nurse to get in to be taped. She said that he could see me at 7:00 p.m. (His hours end at 5:30 and the facility locks their doors at 6:00) She told me that I would have to come before 6:00 and wait, but that he would see me. (I didn't need to do that because the PT called and said that she had the tape and could do it.) But this shows the type of doctor he is. So I'm praying that he will be supportive of me and refer me to someone who believes that myofascial pain truly exists and has to be treated differently. I will also ask him if he could rewrite the referral to indicate myofascial pain as well as the hyperlaxity syndrome. His feeling was that the source of my myofascial pain was the hyperlaxity or hypermobile syndrome as some call it.
My pain started 12 years ago, but I didn't get a diagnosis until I ended up at an osteopath who found all my structural problems. While I was seeing him for manual work, he was giving me TrP injections. At the same time I was going to myofascial release twice a week. I went to him once a week for about 3 years until he moved, but continued another year with myofascial release. Still not feeling that I had found the source of my pain, I moved on to seeing an Atlas Orthogonal Chiropractor who was the only one to put my Atlas and C2 in place. That stopped the muscle spasms in my back. I still see him to keep in alignment. Meanwhile I saw a Myotherapist for 3 months last summer, which didn't solve my problem, so I moved on to Active Release, which didn't solve the problem. Next, I started prolotherapy to strenghten my ligaments to hold my bones in place. I went every month for 6 months. Finally, I ended up in April, 2010 at the physiatrist and the PT. All these therapies have helped me and I have reduced my pain level from a constant 7 to usually a 2 and sometimes a 3 -5 using the pain scale in the book.
The one thing that has been missing is movement and as the years progressed, regardless of the therapy, I got weaker and weaker. That is the reason that I believe that I must be rehabilitateded , but it MUST be done correctly. If I don't find the proper way to rehab myself, then I will be confined to my wheelchair, which I currently have to use when I go to the medical clinic to see my doctors or anywhere that requires walking more than a short block.
I've been working on my hamstrings all weekend and they aren't painful today, but I do have an appointment with my Myotherapist tomorrow. Again, guys, thanks for listening to my story and for all your support. I am so glad I found this group. HUGS to you all.
I am sure if you talk to your Dr and tell him about the pain the increased activity is causing he will support you. He is the one who who ordered gentle and slow. I would make sure you get MPS on your script so there is no discrepency! They always find the small stuff!!
I am glad your hamstrings are feeling a little bit better, but I hope you get more relief today at your myotherapist!