Just Won’t Stand For It Any More

By

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 to.

Standing in a line for gift returns, Megan had had enough.  Even now her aching back was interfering with her life.  Megan decided she wouldn’t 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.

Megan’s first child had physical challenges that required constant attention.  She often held him for hours as she did her housework.  That’s when she first noticed back pain, but didn’t 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, Megan’s 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 Megan’s pain had to be soft tissue, the doctor said.

An evaluation of Megan’s 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 A)

The pain pattern for this muscle produced pain up and down Megan’s 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, Megan’s 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 it’s now “a piece of cake”.  Walking her dog, Major, however, is still challenging.

Is there a nagging pain in your life that you “just won’t stand for anymore”?  If there is, give us a call at MyoRehab.