Myofascial Trigger Points

Chiropractic Nimmo Receptor-Tonus Technique and McKenzie Self-Therapy Program in the Management of Adjacent Segment Disease: A Case Report

By Frank M. Painter|January 17, 2022|Adjacent Segment Disease, Case Studies, McKenzie, Myofascial Disorder, Myofascial Trigger Points|

Chiropractic Nimmo Receptor-Tonus Technique and McKenzie Self-Therapy Program in the Management of Adjacent Segment Disease: A Case Report

The Chiro.Org Blog

SOURCE: J Chiropractic Medicine 2020 (Dec); 19 (4): 249–259

Emsal Salik, MD PhD; Ali Donat, DC; Mustafa Hulisi Ağaoğlu, DC

Chiropractic Program,
Health Sciences Institute,
Bahcesehir University,
Besiktas, Istanbul, Turkey

Objective: The objective of the present study objective was to describe adjacent segment disease (ASD) from a chiropractic management prospective and subsequently to stimulate further research into the chiropractic therapeutic effects on such cases and to contribute to chiropractic literature.

Clinical features: A 44–year-old woman had a history of lumbar stabilization revision operation by pedicle screw fixation for spondylolisthesis. Her intractable back pain episodes, which were diagnosed as ASD, began shortly after this surgery. At presentation, she was taking pregabalin 75 mg 2 times a day for postoperative neuropathic pain without any pain relief. Clinical testing revealed myofascial tender points reproducing the pain.

Intervention and outcome: After taking the case history and performing a physical examination, the patient was managed with chiropractic Nimmo receptor-tonus technique in combination with McKenzie exercises. Nimmo was applied by manually pressing on clinically relevant points for 5 to 15 seconds in 11 visits over 3 weeks. The patient by herself did McKenzie exercises 5 to 10 times a day for 10 to 12 repetitions over 2 months. After 3 weeks of therapy, visual analog scale and Oswestry Disability Index scores were improved. Furthermore, because of the amelioration of the patient’s symptoms, her neurosurgeon successfully discontinued pregabalin 75 mg 2 times a day without negative consequences to care.

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Effect of Two Consecutive Spinal Manipulations in a Single Session on Myofascial Pain Pressure Sensitivity

By Frank M. Painter|July 26, 2016|Myofascial Trigger Points|

Effect of Two Consecutive Spinal Manipulations in a Single Session on Myofascial Pain Pressure Sensitivity: A Randomized Controlled Trial

The Chiro.Org Blog

SOURCE: J Can Chiropr Assoc. 2016 (Jun); 60 (2): 137–145

Michelle A. Laframboise, BKin (Hons), DC, FRCCSS(C),
Howard Vernon, BA, DC, PhD, and
John Srbely, BSc, DC, PhD

Canadian Memorial Chiropractic College,
6100 Leslie Street,
Toronto, Canada;
Division of Graduate Studies,
Sports Sciences,
Canadian Memorial Chiropractic College.

OBJECTIVE: To investigate the summative effect of two consecutive spinal manipulative therapy (SMT) interventions within the same session on the pain pressure sensitivity of neurosegmentally linked myofascial tissues.

METHODS: 26 participants were recruited and assessed for the presence of a clinically identifiable myofascial trigger point in the right infraspinatus muscle. Participants were randomly assigned to test or control group. Test group received two consecutive real cervical SMT interventions to C5-C6 segment while controls received one real SMT followed by one validated sham SMT intervention to C5-C6 segment. Participants received the two consecutive SMT interventions 30 minutes apart. Pain pressure threshold (PPT) readings were recorded at pre-SMT1 and 5, 10, 15, 20 and 25 minutes post-SMT1 and post-SMT2. PPT readings were normalized to pre-SMT1 values and averaged.

RESULTS: Repeated measures ANOVA demonstrated a significant main effect of SMT intervention [F(1,24)=8.60, p<0.05] but not group [F(1.24)=0.01] (p=0.91). Post-hoc comparisons demonstrated a statistically significant (p<0.05) increase in SMT2 versus SMT1 (18%) in the test group but not in controls (4%) (p=0.82).

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Manual Treatment For Cervicogenic Headache And Active Trigger Point In The Sternocleidomastoid Muscle: A Pilot Randomized Clinical Trial

By Frank M. Painter|August 30, 2013|Cervicogenic, Headache, Myofascial Trigger Points|

Manual Treatment For Cervicogenic Headache And Active Trigger Point In The Sternocleidomastoid Muscle: A Pilot Randomized Clinical Trial

The Chiro.Org Blog

J Manipulative Physiol Ther. 2013 (Sep); 36 (7): 403—411

Gema Bodes-Pardo, PT, MSc, Daniel Pecos-Martín, PT, PhD, Tomás Gallego-Izquierdo, PT, PhD, Jaime Salom-Moreno, PT, MSc, César Fernández-de-las-Peñas, PT, PhD, Ricardo Ortega-Santiago, PT, PhD

Clínica Fisioterapia Santiago Vila,
San Fernando de Henares, Spain.

OBJECTIVE: The purpose of this preliminary study was to determine feasibility of a clinical trial to measure the effects of manual therapy on sternocleidomastoid active trigger points (TrPs) in patients with cervicogenic headache (CeH).

METHODS: Twenty patients, 7 males and 13 females (mean ± SD age, 39 ± 13 years), with a clinical diagnosis of CeH and active TrPs in the sternocleidomastoid muscle were randomly divided into 2 groups. One group received TrP therapy (manual pressure applied to taut bands and passive stretching), and the other group received simulated TrP therapy (after TrP localization no additional pressure was added, and inclusion of longitudinal stroking but no additional stretching). The primary outcome was headache intensity (numeric pain scale) based on the headaches experienced in the preceding week. Secondary outcomes included neck pain intensity, cervical range of motion (CROM), pressure pain thresholds (PPT) over the upper cervical spine joints and deep cervical flexors motor performance. Outcomes were captured at baseline and 1 week after the treatment.

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Conservative Chiropractic Management of Urinary Incontinence Using Applied Kinesiology: A Retrospective Case-series Report

By Frank M. Painter|September 12, 2012|Myofascial Disorder, Myofascial Trigger Points, Spinal Manipulation, Urinary Incontinence|

Conservative Chiropractic Management of Urinary Incontinence Using Applied Kinesiology: A Retrospective Case-series Report

The Chiro.Org Blog

SOURCE: J Chiropr Med. 2012 (Mar); 11 (1): 49–57 ~ FULL TEXT

Scott C. Cuthbert and Anthony L. Rosner

Chief Clinician, Chiropractic Health Center, PC, Pueblo, CO 81004

OBJECTIVE: The purpose of this case series is to describe the chiropractic management of 21 patients with daily stress and occasional total urinary incontinence (UI).

CLINICAL FEATURES: Twenty-one case files of patients 13 to 90 years of age with UI from a chiropractic clinic were reviewed. The patients had a 4-month to 49-year history of UI and associated muscle dysfunction and low back and/or pelvic pain. Eighteen wore an incontinence pad throughout the day and night at the time of their appointments because of unpredictable UI.

INTERVENTION AND OUTCOME: Patients were evaluated for muscle impairments in the lumbar spine, pelvis, and pelvic floor and low back and/or hip pain. Positive manual muscle test results of the pelvis, lumbar spine muscles, and pelvic floor muscles were the most common findings. Lumbosacral dysfunction was found in 13 of the cases with pain provocation tests (applied kinesiology sensorimotor challenge); in 8 cases, this sensorimotor challenge was absent. Chiropractic manipulative therapy and soft tissue treatment addressed the soft tissue and articular dysfunctions. Chiropractic manipulative therapy involved high-velocity, low-amplitude manipulation; Cox flexion distraction manipulation; and/or use of a percussion instrument for the treatment of myofascial trigger points. Urinary incontinence symptoms resolved in 10 patients, considerably improved in 7 cases, and slightly improved in 4 cases. Periodic follow-up examinations for the past 6 years, and no less than 2 years, indicate that for each participant in this case-series report, the improvements of UI remained stable.

CONCLUSION: The patients reported in this retrospective case series showed improvement in UI symptoms that persisted over time.

From the Full-Text Article:

Introduction

Urinary incontinence (UI) occurs when there is leakage of urine involuntarily, most commonly in older patients. [1] Fantl et al [2] state that incontinence affects 4 of 10 women and 1 of 10 men during their lifetime, and about 17% of children younger than 15 years. A large postpartum study of the prevalence of UI found that 45% of women experienced UI at 7 years postpartum. Thirty-one percent who were initially continent in the postpartum period became incontinent in the future. [3] (more…)

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