Just Wonít Stand For It Any More
Victoria L. Magown,
CMTPT, LMT & George S. Pellegrino, LMT, CMTPT
Holiday shopping this past season was not as much fun as in previous
years. Standing in long lines at the checkout counter, Megan
became more aware of her nagging backache.
It was not the kind of pain that would drive one to the emergency
room, but for Megan, it was an annoyance that was driving her crazy.
This was the same backache she experienced while standing at the
stove cooking for the holidays; a chore she often looked forward
Standing in a line for gift returns, Megan had had enough.
Even now her aching back was interfering with her life. Megan
decided she wouldnít stand for this any longer.
When she came to MyoRehab, a review of her history showed no major
trauma that could account for her low back pain. As Megan pointed
out, raising two boys and a large dog had taken its toll on her.
Meganís first child had physical challenges that required constant
attention. She often held him for hours as she did her housework.
Thatís when she first noticed back pain, but didnít pay it any mind.
Taking Major, her Great Dane, for a walk was challenging as well.
Often, it was more like Major was walking her as he strained against
the leash, further stressing her low back.
With the addition of a second child, Meganís low back pain intruded
into her life more frequently. Although she loved to cook for
her family and friends, long hours of standing in the kitchen preparing
gourmet meals had become a chore due to her nagging low back pain.
Months earlier, x-rays ordered by her doctor showed no signs of
spinal disorder. The source of Meganís pain had to be soft
tissue, the doctor said.
An evaluation of Meganís posture, pain pattern and movement restriction
combined with her history enabled us to pin point the source of her
low back pain, Myofascial Trigger Points.
A Myofascial Trigger Point is a hypersensitive spot in a muscle
that when stimulated, usually produces pain referred in a predictable
pattern away from the Trigger Point. Trigger Points in the
iliopsoas were responsible for part of her low back pain. (Illustration
The pain pattern for this muscle produced pain up and down Meganís
spine. As seen in the illustration, the iliopsoas also produces
pain in the front of the thigh. Megan attributed this pain
with walking her dog and never associated it with her low back pain.
After having her second child, Megan began doing sit-ups everyday
to help restore her figure. Just before the holidays, Meganís
low back pain increased. When this happened, she sought the
advice of a friend who told her the low back pain was probably due
to weak abdominals. Megan increased the frequency of her sit-up
program which in turn increased her low back pain.
The additional pain Megan experienced was across her low back.
This pain pattern was being produced by Trigger Points in her abdominal
muscles. (Illustration B) Although strengthening her
abdominals was a good idea, when Myofascial Trigger Points are present,
strengthening can increase pain. Trigger Points must be treated
first before strengthening can be accomplished without pain.
Megan was successfully treated for Myofascial Trigger Points in
her iliopsoas, abdominals and other muscles contributing to her low
back pain. After two weeks of pain-free home exercise consisting
of specific stretches to restore normal length to the muscles, she
was able to resume her strengthening program.
The joy of cooking for her family and friends has returned.
Although standing in long lines has never been much fun, Megan says
itís now ďa piece of cakeĒ. Walking her dog, Major, however,
is still challenging.
Is there a nagging pain in your life that you ďjust wonít stand for
anymoreĒ? If there is,
give us a call at MyoRehab.