Myofascial Pain Integrated Self-care Treatment
By Jeannie Hill
Olivia lived with severe pain in the jaw, neck and shoulders that was accompanied by severe headaches over 19 months. Daily coping with pain while working zapped all of Olivia energy and willpower. She would go home after each workday and lay in bed with a heating pad over her jaw and neck. Weekend activities ground nearly to a halt. “I was always exhausted with pain,” says Olivia, assuming this was generated by severe sinus pain.
Olivia went from doctor to doctor trying to find out what was wrong. Where is relief from such chronic and consistent pain? Doctors found little wrong and her sinuses were clear. On the scale of 1 to 10 commonly used to measure pain, Olivia’s pain was usually up to 7 or 8.
Like many individuals suffering from chronic pain, she lived with it for many months. Then, Olivia found Dr. James Fricton, a pain specialist at the Minnesota Head and Neck Pain Clinic. A clear diagnose of myofascial pain in the jaw, head, and neck followed. A pain patient’s sense of relief is enormous when the unknown is dispelled. So we started out explaining what it is and answering questions.
What is Myofascial Pain Syndrome?
Myofascial pain (MP) is the most common cause of chronic pain. It is a chronic hurting condition that impacts the fascia, which is the connective tissue that covers the muscles. Myofascial pain syndrome typically triggers pain in either a single muscle or a muscle group. At times, the area where a person experiences the pain might not be where the myofascial pain is generated from.
It not only involves the muscles, but also the connective tissue that holds the muscles together. Myofascial pain patients experience sensitive trigger points in tight bands of muscles. These commonly occur in muscles that hold tension such as the jaw, neck, shoulders, and back.
What Triggers Myofascial Pain?
Myofascial pain often begins with:
- Trauma or injury such as whiplash
- 3rd molar extractions
- It is sustained by repetitive muscle strain and muscle tension from either daily habits or a reaction to daily stressors.
- The joint can also be strained leading to tenderness and inflammation of the jaw and neck joints, called arthralgia.
What does Myofascial Pain Treatment Involve?
Myofascial Pain Treatment includes addressing the root cause of the person’s pain. This treatment at Minnesota Head and Neck Pain Clinic involves both treating the muscles and joints while also reducing contributing factors that cause the muscle strain and tenderness.
To treat her condition, physical therapy was recommended to relieve her sore muscles, review exercises and improve range of motion of the muscles and joints affected. Olivia started using a mouth guard to reduce the strain of clenching or grinding of the teeth while sleeping.
“I improved some, but my pain was still constant, and around a 4 or 5,” says Olivia. When the pain was unbearable, Olivia took ibuprofen to help reduce the pain and inflammation. Using stronger painkillers, like opioids, was not recommended since they can increase pain over time.
How is Myofascial Pain Syndrome Diagnosed?
Diagnostics starts with a physical exam to look for myofascial trigger points. Your doctor will look for tender nodules in the taut bands of your muscles. By pressing, a pain response is located. When pressing a trigger point, your doctor will feel for a twitch in the muscle; also known as a jump sign. Patients are asked about their symptoms and health history.
Once diagnosed, your doctor may introduce you to trigger point therapy, neuromuscular, or structural integrative therapy. Olivia asked key question to avoid pain induced depressino and to understand what a Myofascial trigger point was, among others.
Effective Self-management of Myofascial Dysfunction
Chronic pain is the primary reason why most people seek a physician
A pain condition like Olivia’s is the #1 reason. To summarize, chronic pain is typically the reason why:
- People go to the doctor
- Cause of work loss
- Cause of disability and addiction
- The primary driver of escalating healthcare costs
Medical treatment of chronic pain symptoms tallies to more than cancer, heart disease, and diabetes. When pain such as headaches, jaw pain, neck and back pain lasts more than three to six months after an injury, it’s considered chronic. Unfortunately, more than half of the persons seeking care for pain conditions at 1 month still have pain 5 years later despite treatment. It’s usually due to many patient-centered risk factors that lead to delayed recovery and persistence of pain. Or the real issue of myofascial pain syndrome has been missed. As both pain specialists and researchers, MNHNPC finds that all patients have risk factors that may perpetuate the pain causing chronic pain, addiction, and disability.
Transformative Care: Self-Care Training & Treatment Reverse Pain Cycles
A transformative care approach integrates self-care with treatment. MHNPC facilitates the integration of training with treatment to relieve pain conditions long-term. It demands a whole person, integrative approach combining self-care with conventional treatment to reverse pain cycles. It begins by creating a healthy pain-free cycle. This helps patient identify the pain cycles that drive pain and the simple steps needed to create a pain-free cycle.
Chronic pain patients’ benefit by our training:
- Gain an understanding of their specific pain condition and identify its root causes
- Receive on-line training on simple steps to change these root causes with a health-oriented protective action plan
- Provided Telehealth coaching and support while making life changes
Olivia quickly learned that simply avoiding the use of strong pain medications isn’t the answer. Gaining transformative pain management strategies is what actually worked for her.
“I was really excited about the clinic’s self-care training program. I’m interested in the holistic approach to healthcare. I knew if I could avoid being prescribing long-term medications and treatment, that was the route I wanted to go.” – Olivia
What is an Action Plan for Myofascial Pain Relief?
With Minnesota Head & Neck Pain’s help, patients develop an action plan for each module in the training program. It focuses on healthy habits, daily mindful pauses and calming practice. People who are healthiest and happiest execute action plan items every day. A nationally certified health coach reviews the assessments and provides telehealth support. This helps patients set goals, stay motivated, understand the program, and succeed in completing it. Healing the pain often requires a long-haul dedicated focus and commitment.
Each training module starts with a self-assessment of the pain condition, its root causes, readiness to change, and self-efficacy. The program presents short video lessons on each risk factor personalized to the patient based on the results of the assessment.
Real change is hard work. Education and information alone do not change human behavior. Coaching at MHNPC is about empowering patients and providing them with resources, support, and a plan. Health coaches are key change agents who can help shift the U.S. healthcare system from one that is focused on reacting to disease and injury into one that also supports prevention and health promotion and fosters health and wellbeing.
Empowering, Engaging and Training Patients Suffering from Myofascial Pain
Minnesota Head and Neck Pain Clinic helps patients like Olivia understand the important role they play in managing their pain. Self-management strategies empower, engage and train patients to reduce the causes of their chronic pain in all realms of their lives. Orofacial pain is now recognized as a new dental speciality.
What is Myofascial Chronic Pain Transformative Care?
By combining conventional pain treatment with self-management, patients can achieve more optimal healing and health. Eighty percent of relief of pain conditions comes from daily self-care. Self-care makes the efficacy of treatments such as physical therapy, splints, and medication more effective. The Institute of Medicine, the National Pain Strategy, the Institute for Clinical System Integration, and other health care leaders all recommend integrating self-management with conventional treatment for chronic pain. This constitutes a transformative care approach.
Supporting Self-Management of Pain with Evidence
The research behind the importance of self-care is available as a University of Minnesota on-line course. It is called Preventing Chronic Pain: A Human Systems. Today, health professionals better understand the power of self-care. Data from 771 participants with pain who participated in this form of self-care shows that:
- 93% of the participants changed their life to improve their pain
- 85% changed their care plan to include self-management
These studies funded by the National Institutes of Health (NIH) reveal that patients who complete self-care training have less pain, better function, and less pain interference duing daily routines. Funding from the University of Minnesota and the International MYOPAIN Society, are behind the Patient-Centered Transformative Care to Prevent Chronic Pain and Addiction training program.
“Our studies and systematic reviews show how integrating self-care with evidence-based conventional treatment are the most effective pain management strategies for pain conditions.” – Dr. Fricton.
Building Self-Awareness, Overcoming Barriers
“I realized I have a lot of habits that contribute to my pain,” says Olivia. Topping the list were forward head posture, tensing the jaw, hunched shoulders, and sitting too much at work. As a catastrophe risk analyst for an insurance company, Olivia spends most of her day sitting in front of a computer. Olivia found the training easy to use and talked to every Wednesday by telephone with Dr. Fricton. Smaller stepping stones reduced the feeling of being overwhelming.
“We talked through things that were coming up in my life and my coach helped me set reasonable goals and provided accountability for reaching those goals. I tend to be an overachiever and set the bar too high. It was nice to have someone to talk with about what’s actually attainable. The health coaching is personalized to the needs of each person. It’s focused on where you are now, where you want to go, and what’s important to you.” – Olivia
Next was figuring out which habits she needed to focus her energy on changing. Her diet was already healthy, for example, but she needed more exercise. “After a long time of feeling I needed to lay down a lot due to the pain, it was hard to get back into exercise,” she says.
Olivia is trying to do more power walking and biking. On days that she can’t fit in a longer workout, she does at least 20 minutes of brisk walking. Sometimes she takes the stairs up to her office, which is on the 11th floor. Many patients are hesitant to move when dealing with chronic pain. However, physical movement is precisely what’s needed.
Overcoming Myofascial Pain with the “HEALS” Strategy
- Heat: and then ice, and massage
- Exercise: gentle stretching and posture alignment
- Analgesics: ibuprofen and/or acetaminophen
- Lifestyle: having good sleep routines, diet, and stress reduced skills following an injury.
We find that for most injuries, active recovery is better. By letting the person’s pain be their guide, they can carefully move as much as their bodies allow.
During the workday, Olivia sets alarms on her computer to avoid sitting too long and to relieve stress. When the alarm goes off, Olivia pauses to check her posture and think positive thoughts. She may also walk to the farthest water fountain to get more water, or do some of the strengthening and stretching exercises for her shoulder and neck that she learned through the self-care program. It is best to do these exercises throughout the day whenever feeling uncomfortable.
Practicing brief relaxation and mindfulness is also part of Olivia’s day. She uses the CALM practice technique in the morning and takes mindful PAUSEs many times during the day to simply pay attention. Changing some of her bad habits was difficult for Olivia. “The self-care program made me take a really hard look at my life and my habits. It was difficult to change expectations to fit a realistic pace. Since Olivia completed her self-care, her pain has gone down to 1 or 2 (on the 1-10 pain scale). Occasionally, the pain flares up, but Olivia knows how to manage it now.
“I have more awareness that I was really stressed out and not keeping up with my good habits,” she says.
Within a few days of going back to her good habits, Olivia feels better again and can sleep well. Key benefits of self-care are developing self-awareness of what triggers a person’s pain and getting tools to control or head off pain before it gets big. “Self-care does take work, but my quality of life has improved drastically,” says Olivia. “I feel positive that I’m going to continue to get better.”
Patients and Providers Turn to MHNPC for Myofascial Pain Services
“Every health professional wants their patients to get better,” saysDr. Fricton. “Our clinic provides a simple solution to integrate self-management and telemedicine coaching with their treatment to improve long-term outcomes for patients with pain disorders.”
Our MHNPC staff help people with many pain conditions. The same risk factors drive various chronic illnesses. Our approach of combining education, empowerment and health coaching can lead to your success in beating your myofascial pain syndrome.
Call (763) 577-2484 today or Contact Us For Your Consultation
Jeannie Hill is a Twin Cities digital marketing consultant who specializes healthcare digital marketing.