Chronic Pain Relief in Maryland, DC & Northern Virginia:

Chronic Pain

is a symptom that is treated every day in a clinical setting.  The majority of patients recover from a painful condition in a relatively short period of time (usually in 6-8 weeks for most adults).  A small percentage of patients, 5-15%, continue to suffer from persistent pain after physical therapy.  This persistent pain can last for months and even years without any pain relief, leaving the patient frustrated and often times at an emotional limit.

In the medical community, the concept of pain is based on tissue injury causing a localized inflammatory response stimulating the local pain receptors which convey signals to the pain centers in the central nervous system. In the absence of localized tissue damage, a medical diagnosis is difficult to obtain resulting in ineffective treatments from both a medical and therapeutic perspective.

Myofascial pain (chronic soft tissue or muscle pain) is the most commonly overlooked diagnosis in chronic pain patients. Myofascial pain is due to the development of taut bands (contracted muscle fibers) called trigger points which results in both local and referred pain. Trigger points can be classified as either active or latent. Active trigger points tend to be painful when compressed, stretched or even contracted and can affect muscle function and refer pain. Latent trigger points are thought of as dormant points that are not necessarily painful, but may still have a negative effect on muscle function. This can result in further injury to the muscle and the development of chronic pain.

Myofascial pain is thought to be caused by various factors. One such cause is Neuropathy, which is based on the work of Dr. Chan Gunn. The underlying theory of the neuropathic model is derived from Cannon's and Rosenbleuth's Law of Denervation. Cannon's Law States:

"When a unit is destroyed in a series of efferent neurons, an increased irritability to chemical agents develops in the isolated structure or structures, the effect being maximal in the part directly innervated." Essentially, when the nerve supply to a particular part of the body fails that part of the body becomes highly irritable and extremely excitable. Non- painful stimuli become painful and painful stimuli become extremely painful.

In the neuropathic model, myofasical pain occurs due to shortened spinal muscles causing peripheral nerve compression, irritability and super sensitivity. This change in nerve function results in altered muscle function and sensitivity, and eventually the development of myofasical pain.

Other possible causes of myofascial pain are acute overuse, trauma (whiplash), persistent low level muscular contractions (poor posture), vertebral joint dysfunction and various systemic metabolic syndromes.

If you think you may have myofascial or neuropathic pain and are located in Maryland, Washington, DC or Northern Virginia, contact AppliedOrtho Physical Therapy today. It's time to get relief!