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Healing through Trigger Point Therapy: A Guide to Fibromyalgia, Myofascial Pain and Dysfunction Paperback – August 27, 2013
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“The hallmark of this book is the ‘Gallery’ which contains detailed discussions of selected muscles throughout the body. The reader will find detailed medical information about the function of each muscle complete with medical illustrations of the highest quality. … [This book] not only serves as a textbook and valuable reference, but also an eye-opener for those who have struggled with chronic pain and other symptoms that have until now eluded diagnosis and effective treatment!”
“The book is written in a way that is approachable to patients and those who do not have a background in health care. Detailed illustrations help to facilitate a deeper understanding of complex patterns of pain referral and also demonstrate location of muscles. …. This text is a great resource for patients with trigger points, fibromyalgia, and chronic myofascial pain, and can be a great tool for making the patient an active participant in their care. In addition to being a resource for patients, this book would be a great addition to any student’s or clinician’s library and would go a long way toward facilitating more successful outcomes with patients in this population.”
—Journal of Orthopaedic & Sports Physical Therapy
About the Author
DEVIN J. STARLANYL has published over 100 articles on fibromyalgia and myofascial pain in national and international medical journals and is the coauthor of Fibromyalgia and Chronic Myofascial Pain and author of The Fibromyalgia Advocate. JOHN SHARKEY, MSc, is a physiologist, anatomist, neuromuscular therapist, and the author of The Concise Book of Neuromuscular Therapy. The author lives in West Chesterfield, NH/Dublin, Ireland.
Top customer reviews
An important part of it is getting you focused on what to do next. If all your muscles have numerous triggerpoints and you have FM amplifying the pain and dyesthesias from TPs gone wild you can't just 'treat all of them', you have to focus on the most important problems and do the 4 most effective things each day. Devin helps you figure out what those are and guides you to treat them in an orderly manner.
I've barely gone deep into the book on a few muscle groups, but this is the primary TP resource for me today. Clair Davies book was transformative to the newbie in treating TPs, but this book will take you to the next level in sorting out your complex CMP patterns.
Devin Starlanyl GETS IT! because she is a patient and knows all the crap we have to deal with just to be taken seriously. A major leap from the last book and much more useful. Somethings are not fully explained- but there is more than enough to satisfy all.
The incompetence of medical research professionals is a disgrace, when they have assumed that because there are central nervous system abnormalities present in sufferers of a condition, then that is all there is to it. But surely it is "Neurology 101" that chronic physiological pain can precede and be the cause of, CNS dysfunction? For example, victims of evil regimes around the world, who have been incarcerated and tortured over prolonged periods, have CNS dysfunctions, do they not? Does that mean the CNS dysfunction is all there is to their history of pain?
Devin Starlanyl has the most credible hypothesis out there, backed up with evidence, for the sequence in which much chronic pain conditions develop. Unfortunately, there is a lot of confusion among practitioners about the various symptoms and conditions which overlap each other, and if you are patient and read Starlanyl carefully, everything will be clarified.
Here are what I regard to be highly important take-away points. Unfortunately Starlanyl, following in others steps, has utilised the term "Trigger Point" for what are actually "contraction nodules" in muscle tissue. Starlanyl does use the term "contraction nodule" in one place in the book, and I like this term. The problem is that "Trigger Point" is a term long since in common use among many kinds of therapist, to describe known points around the body that affect some other part of the body when they are pressed, needled, or treated in some way. This is nothing to do with dysfunctions at the locations of the Trigger Points, it is just part of existing treatments and understandings of body neurological pathways. Therefore, many practitioners first response to this whole new hypothesis involving contraction nodules, termed "Trigger Points", is to be confused and skeptical. The contraction nodules DO indeed act like Trigger Points as commonly understood, in affecting other parts of the muscle and the whole body, but they are much more than that. Unlike Trigger Points as understood by most practitioners, these nodules are highly dysfunctional, toxic little spots that ARE themselves the problem needing treatment.
Clarifying what Fibromyalgia is and where it overlaps with "Myofascial Pain Syndrome", and where both overlap with "Contraction Nodules" (I hate the term "Trigger Point") is a really helpful part of this book. Contraction Nodules / "Trigger Points" are common in a lot of people; often being the cause of some prolonged pain or dysfunction at one particular location, eg the ankle. Often this is the reason that an injury seemed to "never heal". Contraction Nodules / "Trigger Points" are simply sarcomeres (muscle fibre strands) or larger assemblies of muscle tissue, surrounded by "myofascia" (the fine "wrap" around the muscle tissue) that has lost its normal lubricated, easy-sliding property, with the result that a clump - a nodule - of "stuck" muscle tissue has formed. Someone with a single one causing a problem somewhere, can be easily treated by an understanding practitioner.
"Fibromyalgia" on the other hand, is simply a diagnosis of widespread chronic pain in which most of a number (18?) of recognised points on the body are tender and painful; and the Central Nervous System is in a heightened state. MOST people with FM do actually have "Myofascial Pain Syndrome", Starlanyl correctly states, along with the fact that a small proportion of people with the tender points and the heightened CNS do not have MPS, but some other cause (Graves Disease, Ehlers-Danlos Syndrome, etc) of their FM. It is totally wrong that medical professionals dismiss so many patients with the diagnosis of FM, without moving on to what the underlying cause is, whether MPS or one of the rarer causes.
I think it would be fair to say that everyone with MPS either has FM or is going to get it. The catalyst for the dysfunction in the myofascia is most likely body-wide - dehydration, energy-byproduct toxins not being metabolised out of the system, contamination with external toxins, etc. I recognise in my own history, the gradual spread and increase of pain and tension through more and more muscles of my body, and believe that contraction nodules / "trigger points" were multiplying in number through the years.
Starlanyl's book is an exhaustive guide to identifying and working out some kind of order of approach to treatment of these numerous contraction nodules / "trigger points". It does not, unfortunately, dwell very much on the angle that the underlying condition responsible for the formation of the contraction nodules / "trigger points" could be perennial, and hence as fast as they are treated, by whatever means (acupressure, needling, cortisone injection, etc) they can simply recur. In my own long experience, experimentation with self-help / self-treatment, and eventual successful multi-disciplinary rehabilitation (not a "cure", but regaining many lost functions), I regard it as very important to have de-toxed as much as possible, dieted (paleo, low carb), and got plenty of the right kind and intensity of exercise and "movements". Supplementing intelligently with the aid of Hair Mineral Analysis tests is essential for detoxing and achieving the right mineral balance - elevated calcium and depleted magnesium is an ever-present phenomenon with these conditions, but many other elements go in and out of balance as one is self-treating. I suspect that getting these things right, allows the contraction nodules / "trigger points" to release in response to therapy of many kinds including basic massage and stretching. The body becomes more and more responsive to hands-on therapies and less and less prone to relapse.
Every massage therapist, physiotherapist, etc are really quite used to contraction nodules / "trigger points", they are probably the lumps and bumps in muscles that are routinely treated, successfully in myriads of cases day after day. It is people with MPS and FM who are the "hard cases", with dozens of spots all over their bodies, that do not respond like normal people's muscle tissue does to basic therapy. Practitioners may find that "Trigger Point Therapy" such as acupressure, needling, cortisone injection, etc may "work" but only temporarily. And in my experience, acupressure was no more effective than massage (including many different types of massage) back when I was in the full grip of FM, and still doing all the wrong things that contribute to the myofascia stickiness, formation of contraction nodules, etc. For example, (hypothesizing here) exercising at an intensity that creates lactate that the FM victim's metabolism is ineffective at clearing post-exertion; an energy metabolism dependent on sugars (fat being stored by a contrary metabolism and not burned for energy); being subjected to unreasonable stress in daily life; unaddressed sleep disorders; etc. Starlanyl does touch on these things in this book, but this book is more focused on "treating the trigger points" (contraction nodules) and hence readers may not get the importance of a wholistic approach. "Trigger Point Therapy" is a useful tool but I believe that it must be part of a multi-disciplinary protocol if it is to have a net balance of "results over pain endured in therapy"!