Delusions in Musculoskeletal Medicine: From Trigger Points to Weak Muscles
Myofascial pain is caused by trigger points (MTrPs) – a tenet in musculoskeletal medicine world. But in reality, it is merely no more than a conjecture or a hypothesis with a constant controversy over its diagnostic usefulness and its unequivocal existence (Quintner, JL, 2015).
An Unproved Theory Built on “Appear to Be”
Much of the entire myofascia pain system today depends on a statement by Dr Travell et al (Ingraham P, 2023): “The critical trigger point abnormality now appears to be a neuromuscular dysfunction at the motor end plate of an extrafusal muscle fiber.”
A Theory Advanced to Nowhere
Since the term “trigger point” coined in 1940s, we have spent 80 years in examining, investigating and testing this hypothesis, The basis of the hypothesis was an episodic clinical finding related to an abnormal morphology of your flesh – a tiny muscle cramp called “trigger point”. But this hypothesis & the ensuing technique “trigger point therapy” have advanced to nowhere in the past 80 years. The efficacy of trigger point therapy performed by practitioners today is no more effective than that performed by practitioners 80 years ago.
"Going Nowhere" Does Not Bother TrP Believers
However, science “going nowhere” does not bother the TrP believers. A Google search mouse click for “trigger point massage” I did a few weeks ago when I was writing this post produced 235,000,000 results (in 0.36 seconds). I only took a look at the first 30, and found that all of these 30 results were touting TrP massage as a legitimate, factual and effective medical intervention even as a magic wand, except only one. Guess where that one came from? It was from wikipedia.com. An elusive conjecture is treated as an unquestionable fact, dragging all blind believers into a dead end constructed with beautiful delusions.
Delusions: M-TrPs Not Alone
"Myofascial TrP causing pain", a charming delusion. A same scenario as meridians in acupuncture, subluxation in spinal therapy, "like for like" in substance usage, “weak muscle”, "tight muscle" or "bad posture" in pain relief through passive movement (or active movement)... and the list goes on....
In physical science, we can send a man to the moon. In molecular biology and biochemistry, we are almost able to clone a human. But in musculoskeletal medical science, we are still unable to reduce a patient's muscle or joint pain more than a placebo does, even when the pain is merely a penny-sized spot (for example, at lateral elbow).
The reason is pretty much clear: Too many delusions flooded our closed minds. Few of us, if any, tried to widen their mind to the human body tissues beyond muscle or fascia. They totally ignored the fact that without nerves, myofascial tissue is nothing but chunks of dead flesh, incapable to sense anything including pain.
Is There A Truly Effective Way for Pain Management?
Today's myofasial medicine miserably failed in pain management. Is there a truly effective to fight against pain? Currently, it seems few of us have a clear answer.
However, as I am aware, at least a creative physical therapist, a heretic chiropractor and a critical thinker massage therapist's eye-opening findings or clinical experiences for pain relief (by entirely ignoring the bible TrP theories, subluxation dogma or meridian tenet etc ) presented an insightful hint. Their truly magic ways & conceptions in pain management may help us recognize where we are stuck now and at which direction we may consider to move forward.
Interested readers may read the following to learn more about these heretic ways of pain management:
References
Paul Ingraham • Sep 2, 2023 , Trigger Point Doubts. https://www.painscience.com/articles/trigger-point-doubts.php
Kaufman S, How Pain Signals Travel to Your Brain, and How to Block Them In Seconds. Permanently.2008. www.painneutralization.com
Travell J et al, Myofascial Pain and Dysfunction: The Trigger Point Manual. 2nd ed. 1999.
Quintner, J.L.; Bove, G.M.; Cohen, M.L. A critical evaluation of the trigger point phenomenon. Rheumatology 2015, 54, 392–399.
Whelton Ryan, Whelton Myofascial Referral Technique. https://wheltonmethods.com/
#myofascialpain #mtrp #triggerpoint #deadend #meridians #subluxation #weakmuscles #magicwand #drtravel #painscience