A weekly series called PANACEA OR PLACEBO assesses the scientific support for complementary and alternative medicine.
In order to treat painful and dysfunctional muscles and soft tissue, American Bonnie Prudden developed Myotherapy Fitzroy in the 1970s.
The phrase is also used to refer to a range of general massage and soft tissue procedures.
Myofascial pain is a specialty area for myotherapists.
This concept was developed by Janet Travell and David Simons to explain pain that originates in areas of muscles and ligaments that can both cause pain on their own and refer pain in predictable ways.
While Simons was a pioneer of stratospheric flight and the first person to see the curvature of the planet from the edge of space, Travell was better recognised for serving as JFK's personal physician.
Their Trigger Point Manual has become the go-to resource for physicians interested in myofascial discomfort.
In the early 1970s, Bonnie Prudden, a pioneer in the promotion of widespread physical fitness, developed an interest in the work of Travell and Simons.
After publishing her book Pain Erasure in 1980, she lived out the rest of her days in Tucson, Arizona, where she developed myotherapy as a field.
Techniques and evidence
In medicine, myofascial pain and trigger points continue to be divisive issues.
There aren't many professionals who treat a lot of patients with musculoskeletal pain who would deny that the trigger points described in the Trigger Point Manual actually exist.
I have been able to sort out dozens of patients referred by colleagues with otherwise unfathomable agony by applying the general concepts of Travell and Simons to dozens of individuals who had been described as having such pain.
However, some 50 years after the terms trigger points and myofascial pain were created, scientific understanding of the two still isn't clear, and neither are the most effective treatments for the latter.
This is largely due to how slowly basic scientific research into the causes of muscle and soft tissue pain is developing.
The majority of the techniques taught to myotherapists include massage, focused pressure with the hands, fingers, knuckles, or elbows, and the use of modalities like heat, cold, electrical stimulation, and inserting acupuncture needles into trigger points.
To address the biomechanical abnormalities that initially caused trigger points to emerge, they also provide posture counselling and exercise programmes.
Myotherapists employ manual therapies to relieve muscle and tissue pain.
Scientific evidence supports some of the myotherapy treatments that are available.
Trigger-point injections under local anaesthesia, dry needling, and even botulinum toxin have all been demonstrated to provide short- to medium-term advantages.
In my perspective, myotherapy in general still gives off the vibe of a personality cult given the charismatic individuals involved in its inception and the dearth of follow-up studies establishing an empirical foundation.
Contrarily, myotherapy is based on sensible principles and does not frequently guarantee results in areas unrelated to myofascial treatment.
Seeing a myotherapist for muscular pain may be helpful if your pain is brought on by trigger points and responds to manual therapy.
It seems like a prudent precaution to prefer a therapist who is a member of the IRMA, which represents about 500 therapists, or the Australian Association of Massage Therapists, which mandates that its members have indemnity insurance and take part in ongoing professional development.
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