When Love Hurts

By

Victoria L. Magown, CMTPT, LMT and George S. Pellegrino, LMT, CMTPT

Gretchen was on her way to a dinner party given by an old friend from college. She had been out of touch with her friend for so many years and recently ran into her at an open house held at a local art gallery.

Driving through the winding roads of the rural community nestled in the forest at the foot of the Sandia Mountains, Gretchen became confused and made a wrong turn. She stopped at the side of the road, turning her body to the right with her head down to study the instructions she had hastily jotted down.

Without warning, she was knocked unconscious when her car was rear-ended by a speeding driver unable to see her car around the turn. For the next ten years, Gretchen’s treatment focused on her upper back and neck pain. Although her caregivers were able to provide relief, it was only temporary at best. Her pain would return a few days after treatment.

She came to MyoRehab and during a review of her medical history, we learned that Gretchen was happily married and a retired architect at the age of fifty six. After college, she enjoyed a short career as a ballet dancer. She said her continued pain had some bearing on her decision to retire.

An in-depth evaluation of her posture both seated and standing revealed a slight twist of her torso to the right. On further examination, we determined Myofascial Trigger Points in the abdominal oblique muscles were holding her ribcage in a fixed, downward spiral rotation. (Illustration A) This kept her neck and upper back muscles in spasm, continually trying to keep her head upright.

A Myofascial Trigger Point (TrP) is a hypersensitive spot in a muscle that when stimulated, usually produces pain referred in a predictable pattern away from the Trigger Point. These points also trigger contractions in muscles that are called taut bands. Sustained contraction of a taut band can pull relentlessly at the muscle’s attachment causing painful inflammation.

During her second visit, treatment of her lower abdominal muscles produced an all too familiar pain that had interfered with Gretchen’s life in a very personal way for almost ten years. She explained that palpation of one of the trigger points in her lower abdominal area referred pain “up, inside”. She described vaginal pain that “has kept me from enjoying my relationship with my husband”. In men, these TrPs can produce testicular pain and sexual dysfunction.

    She went on to say she had been diagnosed with Irritable Bowel Syndrome (IBS). She “developed” urinary incontinence and suffered reoccurring symptoms of urinary tract infections without laboratory findings of an actual infection.

Abdominal TrPs can cause irritability and spasm of the bladder and urinary sphincter muscle producing urinary frequency, retention of urine and groin pain. (Illustration B) They have also been associated with bedwetting in older children. These TrPs can also cause chronic diarrhea.

Needless to say, Gretchen was stunned to discover that such diverse symptoms could result from a motor vehicle accident. Even as we spoke, it was evident that she had difficulty making the connection. She admitted her disbelief was reserved however because, as she put it, “My health began to go downhill within a year after my car was rear-ended”. Her symptoms, she said, seemed to “come out of nowhere”.

Her upper back and neck pain finally resolved after treating the TrPs in the abdominal muscles and returning them to their normal “pain-free” length.  Gretchen was given a Home Exercise Program to maintain the gains obtained in treatment.

   If you’ve had a motor vehicle accident and suffer from symptoms that seem to have “come out of nowhere”, give us a call.