Referred or Myofascial Pain

Referred pain is a very common type of muscle pain and can happen with any muscle in the body. It is most common to occur in the head and neck.

Janet Travell MD and David Simon MD wrote the most important book in this area of study, and it is to these two physicians that we owe our gratitude.

Their text concerns the pain and dysfunction of myofascial tissue (muscles and the fascia that surrounds muscle).

Referred pain is not a new subject to any of us. When someone is having a heart attack, they often complain about pain in the left arm. This is a type of referred pain which we all are familiar with.

In the video concerning TMD disorders Dr. Ney discusses myofascial pain with respect to the neck, head and jaws.

Myofascial Pain, however can occur in any muscle in the body. It is also common occurrence in back pain.

The pictures below show trigger points marked with an X and pain marked with red dots. The pain from pressing on a trigger point is sharp pain.

Illustrations of Trigger Points

The above pictures are just a sample of trigger points and referred pain but offer a general idea about trigger point pain.

The pain referred to another area by the trigger point is described as dull with a feeling of pressure and slight numbness. Sometimes it throbs, although very very slowly, not like pain which beats with your heart. It can vary from a feeling of pressure to severe pain. We know from experience that we have to manage the pain but also the pressure.

Trigger points are aggravated by the following:

• Cold air blowing on the trigger point
• An incorrect bite (the way your teeth come together... See our video for more information)
• Improper posture
• Sleep disorder, trouble getting to sleep, staying asleep, or lying in bed after you awaken in the morning
• Stress which makes you tighten up your muscles
• Trauma such as a motor vehicle accident
• Strenuous use of a tired muscle
• Stretching a tired muscle into pain
• Placing a muscle in a shortened position too long
• Cold damp weather

Trigger point pain is decreased by:

• The muscle is kept warm night or day
• By slowly stretching a muscle especially in warm water
• By short periods of movement to stretch the muscle to its full working length
• Physical Therapy by a physical therapist who is schooled in myofascial pain
• Massage Therapy by a professional massage therapist schooled in myofascial pain
• By learning to use a Theracane which allows you to help the trigger points yourself
• By wearing a mouth splint which corrects your bite
• By an ergonomically correct work station…especially computer desk, or factory station which causes you to overuse or work in an awkward position
• Relaxation or meditation
• By medication which allows you to sleep

At the Center for Rehabilitation and Pain Management, we believe that it is our job to educate you and give you the tools to manage myofascial pain yourself. It takes all of us and you... we, together, are the team.