Pathology: Musculoskeletal Conditions: Fms And Mfp

Front 1

Name a chronic pain syndrome involving sleep disorders and active tender points among all quadrants of the body

Back 1

Fibromyalgia

Front 2

What are the two reasons not to overtreat Fibromyalgia with massage?

Back 2

1) Pain sensitivity is high
2) Accumulation of waste product in tissues may be difficult to flush out adequately

Front 3

What is the relationship between hormones and deep sleep in Fibromyalgia?

Back 3

In deep sleep (stage 4) aduls secrete growth hormone which stimulates new cells and collagen for healing. Seratonin levels are also redued, so everything hurts more (pain sensation not modulated). Result is a stress/pain/fatigue viscous cycle.

Front 4

What is the calcium, phosphate and fatigue connection associated with Fibromyalgia?

Back 4

Phosphates which accumulate rather than forming ATP attract calcium ions to maintain pH balance. This leads to energy production and calcium reabsorption issues. This results in inefficient muscle contractions and debilitating fatigue.

Front 5

What is the pain and cerebrospinal fluid connection associated with Fibromyalgia? What three things happen with blood and/or nerves as a result of this?

Back 5

CSF of FMS patients reveal high levels of two neurotransmitters which initiate nerve activity, cause vasodilation, and increase pain sensation.

Front 6

What tender points are associated with Fibromyalgia?

Back 6

Posterior:
Occiput (GB)
Trapezius (GB)
Supraspinatus (BL)
Gluteal (BL)
Greater Trochanter (GB). Anterior:
Low Cervical (ST)
2nd Rib (ST)
Lat Epicondyle Humerus (LU)
Medial Knee (SP).
*(Acupressure Meridians)

Front 7

This vast array of possible factors is associated with what condition? Oxidative stress. Free radical activity. Inefficient hypothalamus-pituitary-adrenal axis. Aspartame use.

Back 7

Fibromyalgia has these possible factors.

Front 8

What type of pain is experienced by FMS patients?

Back 8

deep ache to burning and tingling

Front 9

When FMS is triggered by a specific trauma what may happen?

Back 9

Extra tender points may develop in the area around the injury.

Front 10

Name three signs and symptoms associated with FMS besides tender points and widespread pain (in shifting locations that is difficult to pin down)?

Back 10

Stiffness after rest
Poor stamina
Sensitivity amplification and low pain tolerance.

Front 11

Sensitivity amplification and low pain tolerance include what types of sensations? What three types in particular?

Back 11

All kinds of sensations become more intense and are likely to cause pain. This includes light and sound but is true especially of cold, texture, and pressure.

Front 12

Is there an objective diagnostic test for Fibromyalgia?

Back 12

No. It has a close correlation with IBS and chronic fatigue.

Front 13

People with this condition often also have migraine headaches, TMJ, and restless leg syndrome.

Back 13

Fibromyalgia

Front 14

This condition presents similar symptoms to mild hypothyroidism, low grade Celiac disease, multiple chemical sensitivity syndrome, and candidiasis.

Back 14

Fibromyalgia presents similar symptoms.

Front 15

Does massage help FMS?

Back 15

Massage can help, but manual pressure exacerbates tender points.

Front 16

Tender points in FMS are often hypotonic, and not always in muscle tissue. What is hypotonic?

Back 16

Hypotonic= having a reduced degree of tension (not tense)

Front 17

Name five areas of self care that will help someone with FMS:

Back 17

Proper nutrition, sleep, exercise daily, stretching, and reducing emotional stress.

Front 18

When massaging someone with FMS, remember to avoid the following:

Back 18

AVOID:
cold or ice tx
aggressive pressure of tender points
overtreating
too much stimulation (includes sound, light, but especially cold, pressure, and texture)

Front 19

Name the condition identified when a person develops many trigger points:

Back 19

Myofascial Pain Syndrome

Front 20

Common trigger points are felt as what?

Back 20

irritable spots in muscles that are palpable as knots or taut bands within muscles (can be located in other tissue as well)

Front 21

Do women or men get MPS more often (Myofascial Pain Syndrome) and what age does it affect most?

Back 21

Neither gender, and all ages, though it tapers off with advancing age.

Front 22

Trigger points relate to problems with the *W* between the *X* and the *Y* of the *Z* rather than to an initiating injury.

Back 22

synapse
motor neuron
motor end plate
myofiber

Front 23

In the trigger point phenomenon, there is a sustained involuntary contraction of what?

Back 23

... of a group of sarcomeres.
Sarcomeres are overlapping units of myofibrils that create the striations in a skeletal muscle)

Front 24

What are sarcomeres?

Back 24

Sarcomeres are overlapping units of long fine skeletal muscle fiber.

Front 25

When a sarcomere bundle sustains an involuntary contraction near a neuromuscular conjunction, what is it called?

Back 25

a central trigger point

Front 26

A "central trigger point" is the result of a sustained involuntary sarcomere bundle's contraction WHERE?

Back 26

A central trigger point appears when a sarcomere bundle sustains an involuntary contraction near a neuromuscular conjuction.

Front 27

What is an attachment trigger point?

Back 27

An attachment trigger point refers to a contraction that develops close to the tenoperiosteal junction and may also involve folded and dehydrated collagen fibers.

Front 28

What are the two simultaneous problems that arise when a microscopic contraction pulls on the rest of the myofiber and reates a taut band?

Back 28

1) there is an increased need for fuel
2) there is a decreased supply of blood due to local ischemia.

Front 29

Describe an ATP energy crisis that is related to a MPS (Myofascial Pain Syndrome)

Back 29

A microscopic contraction pulls on the myofiber and creates a taut band. The area loses blood and demands fuel. Chemicals that increase sensitivity and pain are released. The muscle attempts to constrict further, more ACh is secreted. Poor local circulation limits ACh-neutralizing enzymes and inhibits the movement of calcium back into channels in the cell membrane. This results in a tiny, involuntary but prolonged and painful contraction of one part of a muscle cell.

Front 30

What may happen to local sensory neurons when a trigger point brings prolonged immersion in pain-causing chemicals?

Back 30

Neurons may become locally demyelinated and this may contribute to unique referred pain patterns seen with trigger points. (Lots of assumptions in these theories, though, such as the idea that a chemical is the cause of pain.)

Front 31

What are "satellite points"?

Back 31

Satellite points are trigger points that form as secondary issue to primary trigger points.

Front 32

Name four areas where a satellite trigger point may appear:

Back 32

1. where referred pain is perceived
2. where muscle fibers are overloaded because of compensation patterns to protect a primary trigger point
3. in antagonist muscles to the agonist muscle with a trigger point
4. in muscles which are referred pain areas for an organ, eg the heart.

Front 33

What are two characteristics of a latent trigger point?

Back 33

1. not painful
2. do not refer pain

Front 34

What are two characteristics of a latent trigger point with regard to pain?

Back 34

1. not painful
2. do not refer pain

Front 35

What signs are associated with latent trigger points (2)?

Back 35

Latent trigger points are associated with restricted range of motion and muscle weakness.

Front 36

True or False: A latent trigger point can turn into an active trigger point.

Back 36

True. Very little stimulus can turn a latent TP active, whihis locally and distantly painful even when the muscle is "at rest".

Front 37

Trigger points that are not irritated may turn into what?

Back 37

Latent trigger points

Front 38

Trigger points form at areas under stress due to (3 things) but can also be a complication of what?

Back 38

Trigger points form at areas under stress due to postural habits, poor ergonomics, and repetitive motion, but can also be a complication of accomodating to the limited ROM and pain following a standard injury e.g. automobile accident, sports injury, etc.

Front 39

Qualities unique in musculoskeletal conditions to trigger points are (4):

Back 39

1. taut bands or nodules
2. predictable trigger point map
3. referred pain pattern
4. regional pain (vs whole body)

Front 40

Is there a definitive diagnosis of MPS (Myofascial Pain Syndrome)?

Back 40

No special criteria has been agreed upon to diagnose MPS. Since many people have trigger points, there is a vague line between many people and someone with MPS.

Front 41

Is MPS considered a chronic pain disorder?

Back 41

Yes.

Front 42

Give two reasons why massage helps MPS.

Back 42

1) effectiveness in improving myofiber function
2) helps clean up cellular debris from chronic muscle tightness.

Front 43

When muscle cells are not working, they can't exchange X for Y.

Back 43

When muscle cells aren't working they cannot exchange nutrients for waste products.

Front 44

Is it possible to overtreat someone with trigger points?

Back 44

Yes, metabolic wastes trapped in the area need to be flushed from the system gradually, not all in one session or too much strain on the organs.

Front 45

What is a more common name for a "muscle flicker" that occurs when palpating a trigger point?

Back 45

twitch response