Muscles and Pain

Muscles and Pain: Knee Pain, Backaches, Headaches, Even Carpal Tunnel Syndrome.
By C.M. Shifflett.

Many common pains, from knee pain and back pain (including some forms of arthritis and other joint problems) to head and neck pain, can be traced to muscles and fascia.

Myofascial pain is pain originating in muscle or fascia (rather than pain from disease or inflammation, such as kidney stones or a swollen appendix).

Fascia ("FASH-uh") is the connective tissue that surrounds every structure of the body like a shrink-wrap leotard. In general it has a tensile strength of around 2,000 psi (pounds per square inch) rising to 4,000 psi in the scalp and head. It is the organic equivalent of the steel belting in radial tires. It is piezoelectric, meaning that it produces electrical charge under pressure, a property thought to be involved in its ability to refer pain over long distances. For example, the Soleus muscle of the calf has no muscular or neurological connection to the upper body, yet can send pain to the lower back and to the side of the face.

Muscles make up the largest organ system of the body, variously estimated at around 50-70% of body weight. In medicine, muscles have been largely ignored. Yet individual muscles produce remarkably individual pain patterns, commonly sending pain to other areas of the body ("referred pain") far from the actual point of origin. Over 80% of the time, the point where you hurt is not the source of the pain.

Together, muscle and fascia can misalign bones and produce mechanical and postural distortions, compartment syndromes, adhesions, nerve entrapments with baffling neurological symptoms, pain, and eventually joint damage.

Nerves and blood vessels also come into play when muscles are tight. A contracted muscle shortens and thickens. We tend to think of "pinched nerves" as nerves caught between two bones. That is far less common than their being caught -- strangled -- between a thickened muscle and its bony surroundings or within the tight muscle itself. Entrapment is common and it disrupts nerve messages and reduces blood supply producing numbness and tingling.

For example, the leading cause of the symptoms of carpal tunnel syndrome is nerve entrapment by muscles, especially the Scalenes of the neck (the Brachial Plexus, the upstream electrical supply for the arm winds through these muscles), the Pectoralis Minor muscle of the chest (the nerve and blood supply must slip between muscle and ribs), and the Pronator Teres of the elbow (where the median nerve travels through the muscle itself). Actual nerve entrapment by the carpal tunnel itself is rare.

However, muscles aren't everything. Numbness and tingling are also symptoms of stroke or nerve damage. Always have such symptoms checked by a physician.

Trigger Points are areas of shortened, hyper-sensitive muscle fibers named for their ability to "trigger" pain elsewhere. They are observed to form at the motor end plates of nerves, a junction between nerves and muscles. Trigger Points in one part of the muscle strain and overstretch the rest of the muscle. They are rather like tangles and snarls in a 20 ft. phone cord that still needs to stretch the whole 20 feet.

Trigger points form in muscle due to

• Direct trauma (such as blows, lacerations, surgery),
• Chilling (whether from inactivity, air conditioners, or wind whipping around a motorcycle helmet)
• Overstraining (whether lifting weights at the gym or children at home),
• Overstretching (which fires off the muscle's automatic protective shortening response),
• Chronic shortening (such as holding a phone with neck and shoulder, or typing with head held turned),
• Repetitive motions (or repetitive lack of motion),
• Metabolic problems (such as thyroid or adrenal problems or a head injury which can precipitate such problems),
• Dehydration (too little water, too much caffeine or alcohol), and Inadequate or unbalanced nutrition (especially electrolytes and B vitamin complex).

Once pain has developed in one area, limping or "compensating" for the injured part can strain the muscles recruited to aid the original injured ones -- laying down new injuries and new trigger points.
It just gets worse. And what did you expect at your age, anyway? (I've heard that one since I was 24!)

But there is good news, since muscles are the source of so many mysterious aches and pains, many surgeries, drugs and long recovery times can be avoided by treating the muscles directly.

Myofascial Trigger Point Therapy or Myotherapy goes to the source of the pain: the contracted muscles themselves. It uses pressure, specialized stretches, and/or precision massage to eliminate the Trigger Point and return the muscle to its full resting length. It is non-invasive and can return mobility to people who have been severely limited by pain.

Although a trained therapist is the best help, you can treat many aches and pains yourself or with help from a friend. One caveat: Always check aches and pains with a physician first, to eliminate any possibility of a serious or life-threatening condition.The above article was written by C.M. Shifflett. Read more on Head and Neck Pain by this author.

About the Author:

C. M. Shifflett is a Certified Myofascial Trigger Point Therapist.
She is a former research geologist and a technical writer who writes on martial arts, science and medical topics.