Healing from Chronic Myofascial Pain—Support for Chronic Pain Sufferers

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Disclaimer: The material presented here is provided for informational purposes only and is derived solely from my personal experience. Anyone considering any course of treatment should always check first with a doctor to ensure there are no other underlying medical problems and no contraindications. (Click here to see the full disclaimer to this website.)

I haven't tried some of the treatments listed mostly because of cost. But it is also because I've gained considerable improvement through mind-body—based JFB-MFR therapy and because I understand that I have to address my traumas and emotions before I can continue to heal.


In sum, I have found that paying attention to the needs of my mind and body can lead to relief from pain. This approach has worked not only for me but also for many others. (See books by Sarno, Ozanich, Barnes, Tavolacci, Velicki, and Brady listed in the mindbody and the personal stories sections under the Resources tab).   


A note on the placebo effect: The effectiveness of the treatments that reduce or eliminate pain may indeed be the placebo effect in play. In my opinion, this inherently effective phenomenon is in many cases a good thing, especially if the treatment is non-invasive and inexpensive. The book Mind Over Medicine by Dr. Lissa Rankin is a useful resource that looks at the placebo effect in greater detail.

After more than two years of trying various treatments while still suffering in great pain, I finally found some lasting relief. It did not, however, come in the form of one simple pill. After the first nine months, I gained some modest relief from trigger point (TrP) injections. But the pain continued for another year and a half before I finally found the three key missing pieces that have helped me the most so far:


  1. Knowledge that my body has the ability to heal itself (which I discovered through much reading and some amazing physical therapists)
  2. Acceptance and understanding that my body is not independent of my mind and that the two must work together to create a healthy individual
  3. Realization that facing emotions and past traumas can significantly reduce pain.


Ultimately, a combination of several treatments has helped me in my quest to live without debilitating or limiting pain. In the table on this page I list various modalities that I have come across in my ten-plus years of healing my trauma- and emotion-fed chronic physical pain. Click on each link for a brief description of what I've tried and which modalities have or haven't worked for me.


As a spoiler, receiving myofascial release therapy developed by John F. Barnes (JFB-MFR) and reading about the mind-body connection (via Dr. John E. Sarno and other authors) have had the greatest positive impact on my healing.    

Common Treatments for Myofascial Pain


Many popular medical websites recommend certain therapies for treating myofascial pain syndrome (MPS) (aka, chronic myofascial pain, or CMP). My doctors recommended similar treatments, which I found to be of very limited help. These treatments might be enough for some people, and might provide some level of pain relief for others. For those with stubborn cases like mine, these treatments might provide little or no benefit. Often the underlying causes of the pain are not addressed, and consequently, the patient does not get lasting pain relief.


The following commonly recommended treatments for myofascial pain are found on one or more of these popular websites: Mayo Clinic, Cleveland Clinic, WebMD, Verywell.com. (For comprehensive lists of treatments on each site, click on the links below):


  • Physical therapy — "A therapy program includes stretching, postural and strengthening exercises." (Cleveland Clinic)
  • Medicine — "Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, might be used to help reduce pain." (Cleveland Clinic) "Medications such as non-steroidal  anti-inflammatories, acetaminophen or opioids may be used to treat myofascial pain. Medications for sleep, depression or muscle spasm are sometimes used, as well" (WebMD) "Common drugs for MPS include nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aleve (naproxen) or ibuprofen-based drugs like Advil and Motrin, and tricyclic antidepressants such as amitriptyline, doxepin, and nortriptyline." (Verywell.com)
  • Massage therapy — "Therapeutic massage can loosen tight muscles and relieve cramping or spasms." (Cleveland Clinic)
  • Trigger Point Injections "This involves injecting a pain medicine (local anesthetic) directly into the trigger points." (Cleveland Clinic) "The doctor inserts a needle directly into a TrP or in several places around it to loosen up the taut bands. The doctor may inject a pain-relieving medication, such as corticosteroids or lidocaine. When no medication is used, it's called dry needling. (Verywell.com)
  • Spray and stretch technique  This treatment involves spraying the muscle and trigger point with a coolant and then slowly stretching the muscle. (WebMD) A physical therapist guides you through stretching exercises while spraying a numbing substance on your muscle. The therapist may also use certain massage techniques to loosen your muscles and TrPs. In addition, a therapist can work with you on factors such as poor posture that may contribute to MPS. (Verywell.com)
  • Relaxation techniques — For example, "hypnosis can help you relax and reduce your pain." (WebMD)
  • Acupuncture  Acupuncture is an ancient Chinese practice similar to dry needling. While studies of its use in MPS are limited they are promising, and many patients and practitioners report good results. (Verywell.com)


Mayo Clinic notes, "No conclusive evidence supports using one therapy over another." WebMD explains, "In some chronic cases of myofascial pain, combinations of physical therapy, trigger point injections, and massage are needed." 

Further, Cleveland Clinic accurately points out, "It is also important to address any factors — such as poor posture, workplace ergonomics, or mechanical problems — that might be contributing to CMP pain.​"


However ... 


In my experience, those are not the only factors that impact pain levels." (See the My Healing Journey, Myofascial Pain, and Trauma & Chronic Pain tabs). 


WebMd also includes cognitive-behavioral therapy as a treatment approach. The site states, "cognitive-behavioral therapy can teach you how to change your negative thoughts about pain. This can also help you be more active." 


Although I give credit to WebMd for including a psychology-based approach, the link between the mind and body is often involves more than just the patient's negative thoughts about her or his pain. Psychological influences can include negative thoughts and automatic physical reactions to any trauma that the mind or body has endured in a lifetime.

Treatments I tried—some helpful, some not—or that I considered trying

Quote from Scientific Study

"[T]he frequent characterizations of the available treatments as insufficient suggest an urgent need for clinical research to establish evidence-based guidelines for the treatment of myofascial pain syndrome."  

Johannes Fleckenstein, et al., BMC Musculoskeletal Disorders 2010, 11:32.

 

Treatment Options

Recommended Reading 


Click here for books about healing.


Click here for books describing "traditional" treatments, such as trigger point therapy.


Treatments I've Tried, Considered Trying, or Been Urged to Try

Treatment Modality

My Rating 

Bottom Line

Surgery

--
Surgery fixed the neurological deficit from my ruptured disc, but likely triggered my myofascial pain

Soft collar

+
Only helpful immediately after surgery
-
Hardly worked

Oral steroid pack

+
Temporarily relieved some of the excruciating nerve pain from my ruptured disc

Other oral medications (& vitamins)

--
Medicines didn't help or had unacceptable side effects; vitamins haven't reduced my pain

TrP (trigger point) injections

+
Initially helpful but eventually became less effective and had unacceptable side effects 

Dry needling 

?
Haven't tried but might be somewhat similar to TrP injections but without side effects

Facet joint injection

---

Made my pain temporarily worse

Other injections (prolotherapy)

?
Haven't tried, but don't expect to

Traditional PT (physical therapy)

--
Strengthening didn't help, sometimes made me worse; TENS (transcutaneous electrical nerve stimulation) had nominal positive effect

Traditional MFR (myofascial release) PT

+
Didn't provide lasting reduction in my pain

Other manual therapies (IMT, OMT, Rolfing)

?
Haven't tried

Patches/heating pads

++
Help to temporarily moderate symptoms, but don't permanently or completely eliminate my pain

Reading about mindbody

+++
Very helpful

JFB (John F. Barnes)-MFR PT

+++
Very effective

Somatic experiencing

++/?
Reduced spikes in my physical pain

Other mind-body treatments

?
Likely very effective if one is ready to treat mind and body

Acupuncture

--
Tried briefly; it aggravated my pain

Chiropractic

?
Haven't tried, but it scares me 

Movement practices

+

Haven't tried extensively, but potentially helpful

Bicycling

+
Somewhat helpful; psychologically positive

Dance classes

+/-
Temporarily aggravated my pain to a small degree, but psychologically positive

Yoga

+/-
Flared up my symptoms, but I don't necessarily discredit it

Pilates

--
Greatly flared up my symptoms

Jogging/walking

+ 
Likely helpful; jogging tolerable and helpful only after I embraced the mind-body connection and had already healed significantly; walking more tolerable

Swimming

+/-
Sometimes slightly flares up my symptoms; good for general health

Kickboxing

+/-
Flared up my symptoms, but cathartic

Tai Chi

?
Don't know; haven't tried yet

Talk therapy

+
Helpful in processing the psychologically based causes of my chronic pain, but hasn't eliminated my physical pain

EMDR (eye movement desensitization & reprocessing)

++/?

Some positive results so far

EFT  (emotional freedom technique/tapping)

+
Helped me reduce strong feelings related to past trauma, but didn't permanently reduce my pain

Other psychology-based 

?
Don't know; probably helpful if psychological issues are behind the pain

MFR self-treatment

+
Helps reduce my pain, but not eliminate it completely

Meditation/breathing

+
Likely helpful in the long run, but hasn't greatly reduced or eliminated my pain

Sleep/rest

++
Helps reduce my pain, but not eliminate it completely

Support

++
Very helpful psychologically

Nutrition/environment

+
Beneficial to overall health, but hasn't resolved my chronic pain; eating every few hours helps reduce spikes in my pain

Posture/ergonomics

+
Most likely helpful to moderate symptoms; however, I haven't yet seen major improvement

Therapeutic writing

++
Probably very helpful; to date, unsure of long-term effect on my pain

Relaxation/hot tub

+
Helpful for temporarily reducing tension and pain

Work-life balance

++
Important when managing symptoms and for allowing time to heal

Creative expression

++/?
Probably helpful; still to be determined for me
++/?
Could be very important; still to be determined for me

++

Temporarily very helpful after my pain came down through acknowledging emotions, but difficult to maintain
++
Very important

Let go

+++
Critical (but very difficult for some of us)

Rating Key:
+++ Most effective

++ Effective

+ Somewhat effective
- Not effective or hardly effective
-- Not effective or partial negative impact
--- Not effective and negative impact
+/- Unsure or some positive and some negative impact
? Do not know because I haven't tried at all or enough


Note: This table is based on my personal experience in treating my trauma- and emotion-fed chronic physical pain. This modalities are presented roughly in the order I tried them.

Healing is a Process