By: Mary Biancalana, MS, CMTPT, LMT
Identifying myofascial trigger points that can cause low-back pain as well as their key perpetuating factors
Myofascial trigger points are finally becoming an increasingly recognized etiology for (non-visceral) low-back pain. More and more research is pointing to the efficacy of low-cost intervention strategies due to the fact that we now know that many cases of acute low-back pain will resolve with soft-tissue and low-cost manual intervention, according to a July 2011 article in Spine Journal. Whether or not the cause of the episode is eliminated, however, can be the difference between chronic, multi-episodic occurrences or a full-function, pain-free life with minimal flare-ups. Considering the impact of muscular, postural and occupational perpetuating factors on the development of trigger points can improve clinical outcomes.
Doing a History
Our case scenario is a 53-year-old male who reports 2-3 times per year crippling low-back pain episodes. He reports that the pain runs up and down his back and into his upper buttocks. Imaging studies are unremarkable.
The report in the patient's own words often sounds like this: "My back just 'goes out' and I'm stuck crawling on all fours to go to the bathroom. There is no rhyme or reason, it just grabs me and I'm off work for a week flat on my back, in bed; it's too painful even to roll over and get up. This time, all I did was bend down to pick up a tissue I dropped. Not a heavy box or anything! Then on my way to stand up, pain shot into my low back, I was so mad and fearful, I just crawled into bed and stayed there."