CMP: An Introduction Using an Analogy
Chronic Myofascial Pain (CMP) can best be described by using the following analogy, otherwise the explanation can get too technical and bogged down in details to make much sense. Picture a piece of raw chicken breast. The actual chicken breast itself is your muscle, but the thin clear stuff on the surface is what is referred to as the myofascia. The myofascia line all of our organs, separating them from the bone but holding them in place. It often has a stretchy nature to it as the muscle must have some mobility in order to stretch and contract as it should. In CMP what happens is that the myofascia becomes stuck between the muscle and the bone, creating tension and eventually effecting the range of motion that that particular muscle will experience. You have no doubt heard of people talking about having a knot in their muscle, which is actually the formation of a taut band of myofascia that has developed a contraction knot, or what is technically known as a trigger point.
The Link Between Trigger Points and Endometriosis
Some research suggests that trigger points develop easier in damaged tissues. Women with endometriosis tend to have tissue damage in the pelvic/abdominal areas, especially as the disease causes the tissues to become inflamed and the cells to start bleeding. When we curl up in the fetal position due to the pain, we are also putting pressure on certain muscle groups. This type of overuse can also lead towards the development of trigger points.
Trigger Points: A Pain in the $!$
Once the myofascia has developed a trigger point, the muscle may become stuck and then have a limited range of motion. The trigger point may cause the muscle to be locked in a state of contraction or expansion, limiting the range of mobility that the muscle has. The surrounding muscles then try to compensate, but with the extra pressure on them to do the work of the initial muscle, it too may eventually start to develop a trigger point. In this manner, the pain may cascade down throughout the body as each muscle group slowly becomes effected. I often have trigger points develop in my shoulders and neck, which can be a trigger for my migraines. It can also trigger me to have lower back pain. The trigger points throughout my pelvic and abdomen also create a lot of pain in that area and send pain signals through my lower back and down through my legs.
CMP is NOT Fibromyalgia
While CMP often goes along with those who have fibromyalgia, they are not part of the same condition. With fibromyalgia a person develops tender spots; spots that when touched even sometimes with the lightest amount of pressure can send abnormal amounts of pain rocketing through the body. However, the pain tends to stay localized to that particular point. Fibro pain also tends to be widespread throughout the body, affecting both sides.
With CMP, activation of the trigger point often sends shooting pain throughout the body's muscle groups. You might have trigger points only in one part of your body, even though the corresponding muscle groups might be affected by the radiated pain. However, this is not the same as with fibromyalgia.
How do they Treat CMP?
Relief of the trigger points can be achieved in a few different ways. Massage therapy, although it might be painful as the muscle groups learn to relax again, can help to reduce and relieve the trigger point contractions. There are a number of Self-Help Trigger Point manuals available at the bookstore which can show you how to do self massage techniques on your trigger points. Afterwards, the use of moist heat can allow the muscle to relax. It is vital not to overwork the affected muscle group. Some doctor's also believe that physical therapy might help with trigger points, especially pelvic floor therapy. Gentle stretching exercises are also generally recommended in between treatment sessions.
I go for trigger point injections, which is one of the quicker ways to escape the misery that trigger points can cause. My pain specialist uses a muscle relaxant along with a freezing medication, to inject directly into the trigger points. As he inserts the needle, I can often feel the knot actually jump, which is an odd sensation. I can honestly say that this has helped me immensely, especially with my migraines. I've had a few of the "less deep" trigger points in my abdomen and pelvic area also injected which has brought relief from some of the pelvic and abdominal pain.
If you find yourself in quite a bit of pain, it might be worthwhile to investigate whether the pain is being amplified by CMP. There are estimates out there that over 80% of individuals with a chronic pain illness will also have CMP.