Musculoskeletal pain affects the muscles, tendons, ligaments and bones. This pain can be severe and persistent. It is quite possible for the pain to continue even after the obvious soft tissue damage from an injury has healed. An example is chronic lower back pain.
The source of this pain might be a trigger point, which is a focus point or a stimulated point in some part of the body. The pain develops as a result of nerve endings that are in a state of hyperactivity or activation, and have been sensitised at a tender point. These nerve points can also cause, distribute, radiate and refer pain to other nearby or more distant parts of the body. In every case of persistent pain following trauma, it is essential to search for trigger points.
Acupuncture is a simple and effective technique for the relief of musculoskeletal pain because it can be used to deactivate the trigger points. It works by stimulating the nerve endings of both the pain arousing and the pain suppressing mechanisms which are present in the nervous system. Myofascial pain and fibromyalgia syndromes can be treated.
With musculoskeletal pain it is vitally important to identify the source of the pain, the type of pain and where the acupuncture treatment needs to be applied. There can be two types of pain involved, nociceptive pain and neuropathic pain. Nociceptive pain is usually widespread, dull and aching, especially after certain movements. Neuropathic pain may be a burning, sharp or throbbing sensation, which can sometimes feel like an electric shock.
The source of the pain may be an activated trigger point , either in the region of the pain, or some distance from the site of the pain, because trigger points can also refer pain to another part of the body which may be a considerable distance away from the trigger point. Each individual muscle in the body has its own specific pattern of pain referral. This gives guidance as to which muscles should be examined in order to find the trigger points responsible for the pain. So a trauma to the trigger point, such as a muscle, may result in local pain, or pain which is some distance from the affected muscle. This means that particular muscles may need to be examined in order to find the trigger points responsible for the pain. Trigger points can become activated by a direct injury, and by the repeated or sudden over loading of a muscle or group of muscles.
Trigger points are usually in a muscle, and can also be found in the ligaments of the joints, the periosteum, and in the skin, including skin scars. A trigger point may be only slightly tender, or a point of exquisite or maximum tenderness, identified by the application of firm pressure to it. Precisely finding every active trigger point is an important part of the clinical examination. This is especially important when the origin of the pain is not certain. Locating the trigger points requires adequate training, skill and practice. Suppressing chronic pain may require successive acupuncture treatments, for a cumulative pain relieving effect, to obtain gradually increasing, and longer periods of pain relief. The pain relief may also be delayed by up to one or two days, and the pain may even be worse for some days following the treatment, before it starts to improve.
The paths taken by the referred pain from trigger points often correspond to the channels or meridians mapped by the ancient Chinese.
Myofascial pain syndrome frequently occurs after a trauma, and disabilities include chronic head and neck pain, and back pain. This pain can persist long after the healing of the damaged tissue has taken place. The trauma may be the result of a direct injury to a muscle or the sudden or repeated overloading of a muscle, such as occurs with repetitive strain injury. Anxiety may be another cause because a group of muscles are being held in a persistently contracted state. Trigger points can also develop during the recovery stage when weakened muscles become overloaded during attempts to restore movements to them. So it is important to search for pain producing trigger point activity when investigating the cause of pain.
Fibromyalgia Syndrome is a chronic muscle pain disorder that often involves a deep, diffuse, persistent aching in the muscles, early morning stiffness, joint discomfort and restricted movements. Sleep is disturbed when the sleeping position applies pressure to a trigger point, and so sufferers can be persistently fatigued. The pain can be relentless, is usually widespread and may fluctuate with stress and the weather. There may also be headaches, dizziness and light headedness. Although the primary cause of Fibromyalgia Syndrome pain remains uncertain, considerable pain relief may be obtained with long term acupuncture to the traditional Chinese acupuncture points. Acupuncture can also assist with any anxiety and depression from suffering with chronic pain disorders. Another advantage of acupuncture is that the strength of the treatment can be easily adjusted to give the optimum result for each individual patient. Electroacupuncture may also be useful to alleviate pain and has an analgesic effect, but care must be taken not to over stimulate and possibly aggravate the pain, because there is a different amount of needle stimulation required by each individual fibromyalgia patient. Whereas under stimulation will not allow the treatment to give the patient the maximum beneficial effect. Regular daily muscle stretching and aerobic exercises should also be helpful.
To avoid the reoccurrence of musculoskeletal pain it is necessary to identify any posture problems and correct them. For example, when using a computer for prolonged periods, the screen should be positioned to reduce the strain on the neck muscles. Regular muscle stretches can also be helpful. An awkward reading position in bed or sleeping with the wrong pillow can strain muscles. A problem with a muscle may be due to a structural disorder such as one leg being shorter than the other leg.
Stress can cause musculoskeletal pain to both develop and persist. Reducing stress can make a significant difference. Therefore in some cases the reduction of stress should be a part of the treatment. Moxibustion may also be used in combination with thev acupuncture to treat musculoskeletal pain.