12 - Trigger Points & Prolotherapy (Sandhouse) Flashcards
TQ- What is a point in a taut band or muscle that when palpated gives you a very specific referred pain pattern and can give rise to autonomic phenomenon?
a Trigger Point (TrP)
What is the difference between active and latent trigger point?
Active TrP = pain without palpation
Latent TrP = pain only with palpation
A trigger point located in zone of referred pain of another trigger point is called what?
A satellite trigger point
A 24 yo pt comes in with local tenderness on their butt. With palpation, you feel a small nodular band of taut tissue. The patient jumps and the muscle twitches when you palate it. She also complains of pain to a specific zone. what is the possible diagnosis?
Trigger point!
Not fibromyalgia, because they won’t have the twitch
What is not a cause of Trigger points?
a) acute tissue injury
b) emotional or physical stress
c) repetitive motion
d) activation by another TrP
e) a Jones tenderpoint
f) chronic tissue injury
f) chronic tissue injury
You are NOT RESPONSIBLE for specific zones of referred pain for this lecture.
Wahoo!
[TQ?] A 58 yo patient comes in with palpitations and anxiety. You suspect a SVT. Treatment of what Trigger Point could possibly treat cardiac arrhythmia?
Right Pectoralis major trigger point
T or F: The Quadratus lumborum TrP is a great example of a satellite or associated TrP?
True!
Know the differences between TP, TrPs, and Chapman points! This seems important.
It’s all on a table.
A 24 yo pt comes in with local tenderness on their butt. With palpation, you feel a small nodular band of taut tissue. The patient jumps and the muscle twitches when you palate it. She also complains of pain to a specific zone. You suspect a Trigger Point. Which is not possible cause?
a) anemia
b) nutritional deficiencies
c) Hypothyroidism
d) Somatic dysfunction
e) acute infections
f) short leg syndrome
e) acute infections
A 24 yo pt comes in with local tenderness on their butt. With palpation, you feel a small nodular band of taut tissue. The patient jumps and the muscle twitches when you palate it. She also complains of pain to a specific zone. You suspect Trigger Points isolated to paraspinals, SCM and quadratus lumborum. Which is the possible cause?
a) anemia
b) nutritional deficiencies
c) Hypothyroidism
d) Somatic dysfunction
e) acute infections
f) short leg syndrome
f) short leg syndrome
A 24 yo pt comes in with local weakness of their arm with numbness and tingling. You suspect thoracic outlet syndrome. Which TrP is the possible cause?
a) anterior scalene
b) posterior scalene
c) middle scalene
d) Sternocleidomastoid muscle
a) anterior scalene
What are two possible treatments for Trigger Points?
a) spray with vapocoolant spray with stretch / trigger point injection with local anesthetics
b) spray with vapocoolant spray with stretch / trigger point injection with nothing
c) keep warm with heating pad with stretch / trigger point injection with local anesthetics
d) keep warm with heating pad with stretch / trigger point injection with steroids
e) spray with vapocoolant spray with stretch / topical steroid application
f) A and B
f) A and B
A) spray with vapocoolant spray with stretch / trigger point injection with local anesthetics
B) spray with vapocoolant spray with stretch / trigger point injection with nothing
Why does the Spray and stretch method works as a Trigger Point treatment?
The cold spray acts as a neurologic distraction (nociceptive inhibition) and the stretch breaks the “vicious cycle” via stimulation of Kraus receptors.
Which is not key in successful treatment of trigger points?
a) treating primary TrP
b) treat associated and satellite TrPs
c) treat any underlying or perpetuating factors
d) rest and relaxation
d) rest and relaxation