|
A
Matter of Urgency
By
Victoria L. Magown, CMTPT, LMT and George S. Pellegrino, LMT, CMTPT
Anita, a
44 year old teacher, was referred to MyoRehab by her chiropractor for
Myofascial Trigger Point Therapy of the buttocks and hip muscles. Two
years ago, while setting a box on an upper shelf, Anita stepped
backwards, tripped and landed hard on her right buttocks.
Although
successfully treated by her chiropractor for low back pain resulting
from her fall, she continued to suffer from the buttocks and hip pain.
She also experienced urgency to urinate, as well as, a pressure pain in
the pelvic area. These symptoms began just weeks after her fall.
Anita
was unaware that the symptoms of a Urinary Tract Infection (UTI) were
related to her fall. After several lab tests proved negative for a UTI,
Anita was at her wits end. A biological cause for her symptoms could
not be found. Also, antibiotics did not help.
It
wasn’t until the third treatment of her Myofascial Pain that Anita
commented on her UTI dilemma. When questioned further, it was learned
that Anita experienced temporary relief of her UTI symptoms following
pelvic mobilization by her chiropractor.
Trigger
Points shorten muscles which in turn can maintain joint misalignment. A
Trigger Point is a hypersensitive spot in a muscle that when stimulated,
produces pain that is referred in a predictable pattern usually away
from the Trigger Point. In Anita’s case, the referred pain was to the
buttocks and hips.
Unfortunately, her UTI symptoms would return coincidentally with her
buttocks and hip pain. The relief of her pain with chiropractic
adjustments lasted no more than two or three days. It was obvious to us
and to her chiropractor that muscles were responsible for causing the
continued pelvic and hip misalignment and the return of the symptoms.
As you
might suspect, Myofascial Trigger Points in the gluteus maximus were
contributing to the buttocks and hip pain. However, the primary culprit
was the piriformis which lies deep underneath the gluteus maximus.
(Illustration A) Since it is attached to both the sacrum and the top of
the thigh bone, Trigger Points in the piriformis can cause misalignment
of the sacrum.
When the
sacrum is misaligned, other parts of the pelvis can also be out of
alignment. This can cause the two halves of the pubic bone to be out of
level. When this occurs, patients often report UTI symptoms. These
include pressure pain, urgency to urinate and urinary leakage
(incontinence) with sneezing or laughter.
If this
misalignment persists, an actual UTI can occur. his happens when the
two halves of the pubic bone are not level and complete emptying of the
bladder is not always possible. In this case, antibiotics will
successfully treat the infection. When UTI symptoms frequently reoccur,
with or without infection, muscle and joint dysfunction should be
addressed.
Myofascial Trigger Points can mimic many common pain syndromes.
Likewise, many serious pain syndromes can mimic Myofascial pain. Having
an evaluation for both Myofascial Trigger Points and the possibility of
a serious pain producing pathology should be considered.
Treating
the muscles of the pelvis and chiropractic adjustments of the hips
relieved the buttocks and hip pain and most of the UTI symptoms. Anita,
however, continued to suffer with pelvic floor pain. When asked, Anita
told us that walking up stairs or hiking uphill increased the pain.
Our
suspicions were correct. Although several muscles can cause pelvic
floor pain, the adductor magnus is active when walking uphill and
inactive when walking downhill. (Illustration B) After successful
treatment of the adductor magnus, a specific exercise for this muscle
was added to Anita’s Home Exercise Program.
As part
of a complete treatment protocol, patients are given a Home Exercise
Program specifically designed for their individual needs. This program
retrains the muscles to stay at their normal resting length in a
pain-free state.
Do
you have “A Matter of Urgency” in your life? Give us a call at MyoRehab
OR click here to set up your thirty minute consultation |