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A trigger point is often in the centre of a taut band of | French surgeon Leriche performed the first nerve block muscle. It may feel like a little, hard rubber band. It may _ into the stellate ganglion and alleviated intractable arm commonly be termed a muscle knot. Pressing into the pain. That same year, the German brothers Drs centre of it may yield its pain syndrome region— __ Ferdinand and Walter Huneke cured their sister's sometimes containing the TrP, and sometimes quite distant migraines with an intravenous (IV) injection of procaine. from it. Lightly running a finger across the taut band in n 1940, Ferdinand Huneke cured a patient's shoulder pain perpendicular fashion may cause the muscle to twitch. — and limited range of motion by injecting into a scar in one of Always remember that in a distant region, pain, _ her legs. Neural therapy has been relatively commonplace numbness, swelling or possibly all or none of these may in Germany since then, and is far more prevalent in be emanating from a distant TrP. Books, wall charts and Europe and South America than elsewhere. websites depict known TrPs and their projected pain Before having injections in the ganglia, it might be wise regions. Of course, my main purpose here is to detail © see first if the adjacent vertebrae can be beneficially hat serious organ dysfunction and inflammatory disease reated via chiropractic or osteopathic adjustments. may be intertwined with some TrPs, and to facilitate your © Shiatsu, acupuncture, deep tissue work or yoga elbowing earning how to find and correct the most crucial of these — might also loosen up these areas adjacent to the spine. TrPs. This can save your life, if and when the time comes, In the USA, the "mother" of musculoskeletal trigger or help with chronic problems now. point therapy is considered to be Janet Travell, MD. Circa Trigger point therapy has its own jargon concerning the 1940, she began her clinical work with and research into interactions of different TrPs. An active trigger point is one —-TrP therapy. She would publish many papers detailing hat refers pain either locally or various TrPs and_ their oa more distant region, along a associated pain scenarios. She . A latent tri int i G Q that does not refer pain activeh, | Advanced kinesiology president Kennedy's White but may do so when pressure or techniques can be House physician. Kennedy first strain is applied to the muscle met Dr Travell in 1955. The containing the trigger point. A employed to ask the body young, emaciated, — sickly key trigger point has a pain referral to indicate which TrPs ennedy hobbled in on crutches pattern along a nerve pathway an was in much _ pain. that activates, or creates, a should be worked on ennedy's medical history latent trigger point on that first—the key TrPs. included football injuries (back pathway. A satellite trigger point is pain), wartime injuries, and near activated by a key trigger point. death from adrenal failure Correcting the key trigger point Addison's disease). It is said will often correct the satellite Tre. A primary trigger point hat his life was saved by his taking the newly created can activate a secondary trigger point in another muscle. cortisone drug, back in the early 1950s. After several Treating the primary trigger point does not treat the reatments of anaesthetic injection into his TrPs, secondary trigger point. ennedy no longer needed the crutches and was soon in it does not take long to learn to gauge the presence of — robust health. Indeed, it is possible that his severe trigger points in those taut bands of muscle or to learn — pain—and/or the associated trigger points—caused his how to correct some of them. However, some TrPs may _ adrenal failure, as he only fully regained his health after be in deep tissue or otherwise may be inaccessible (such seeing Dr Travell. She also designed his famous White as in “private parts") and thus are not easy to correct, House rocking chair. Travell's two-volume set of books except perhaps by medical means. Advanced kinesiology on TrP therapy, written with David G. Simons, MD, and techniques can be employed to ask the body to indicate Lois S. Simons,' is considered the masterpiece of this which TrPs should be worked on first—the key TrPs. ield, although English-speaking people may not know of he great works in German. A Brief History of Trigger Point and Neural Therapies ['rP injection therapy involves the following. A small First let me go over a distinction. Trigger point therapy | amount of an anaesthetic may be injected just under the involves injection into skeletal muscle tissue. Neural — skin, above a TrP. After a short interval for its numbing therapy can include this, but also entails injection into action to take effect, a larger amount of anaesthetic is scars and ganglia, which are nerve masses. injected deeper into the muscle TrP. Procaine is often Injections of local anaesthetic go back to the late 19th used. Some physicians may use lidocaine, some may century, when both Pavlov and Freud used cocaine for use anaesthetic with a corticosteroid added, and others this purpose. In 1906, the German surgeon Spiess found may use botulinum toxin. The injectables may have that wounds and inflammatory processes healed more __ allergenic preservatives such as sodium metabisulphite. quickly after local injections of procaine. Unlike cocaine, | Sulphites are known to cause asthma, anaphylaxis or procaine is not supposed to be addictive. In 1925, the other reactions. Likewise, corticosteroids can also cause techniques can be employed to ask the body to indicate which TrPs A Brief History of Trigger Point and Neural Therapies First let me go over a distinction. Trigger point therapy involves injection into skeletal muscle tissue. Neural therapy can include this, but also entails injection into scars and ganglia, which are nerve masses. Injections of local anaesthetic go back to the late 19th century, when both Pavlov and Freud used cocaine for this purpose. In 1906, the German surgeon Spiess found that wounds and inflammatory processes healed more quickly after local injections of procaine. Unlike cocaine, procaine is not supposed to be addictive. In 1925, the 26 * NEXUS Advanced kinesiology should be worked on first—the key TrPs. AUGUST - SEPTEMBER 2012 www.nexusmagazine.com