9: Muscle Spasm Flashcards
What’s a muscle spasm?
An involuntary contraction of skeletal muscle that causes increased tension and pain.
The pain associated with a muscle spasm results from:
- Ischemia and metabolic imbalance
- Mechanical overload of muscle and irritation of nociceptors.
What’s an AKA for spasm?
Muscle Guarding (Some people use it as aka for holding pattern, but this is not accurate)
What are some layperson terms for spasm?
cramp, stitch
What are the two types of spasm?
- intrinsic muscle spasm
- protective spasm/reflex spasm/muscle splinting
What’s an intrinsic muscle spasm?
The prolonged contraction of a m in response to local circulatory and metabolic changes that occur when a m is in a continued state of contraction. Pain is the result of the altered circulatory and metabolic environment, so the m contraction becomes self-perpetuating.
Will feel cold on palpation
What’s protective spasm/reflex spasm/muscle splinting?
Sustained m contraction in response to painful stimuli or injury. The primary cause of pain/injury is usually nearby or in the underlying tissues. This type of spasm occurs primarily to limit movement of the involved tissues (protecting it from further injury). This type of spasm will typically resolve when the underlying cause of the initiating pain is relieved. If the underlying cause has been relieved and the spasm persists, it has become an intrinsic spasm (self-perpetuating).
Will feel warm on palpation.
What are the three ways a spasm can produce pain?
- by overloading parts of the m
- by subjecting nociceptors between active and non-active parts of the m to shearing forces
- through ischemia
It’s important to identify the source of the pain so it can be treated.
When should heat or cold be used re tx mm spasm?
Intrinsic spasm: heat or cold can be useful. Heat for relaxation and softening (of non-contractile tissue) effects. Cold its analgesic effect – can reduce pain perception and therefore help interrupt pain-spasm cycle.
Protective spasm/reflex spasm/muscle splinting: use only cold. When in doubt, use cold.
When are Connective Tissue Techniques (MFR, Frictions) useful?
These techniques are useful when treating MRT that has a connective tissue component involved. Reduced extensibility/mobility of the connective tissues will contribute to increased MRT.
What’s Reciprocal Inhibition Technique?
Relies on the principle that when the m on one side of a joint is working to produce a movement, the antagonist is neurologically inhibited. Tx looks like:
- target m is taken to the restrictive/pathological barrier
- 7-10 sec contraction of antagonist mm group at about 20% effort
- after relaxation period increase length to next barrier
What’s Golgi Tendon Organ technique?
Apply further tension to a tendon (of a m with high MRT or in spasm) by bowing/deforming it. Applied as:
- locate the tendon
- increase tension on the tendon by applying specific compression as close to the musculotendinous junction as possible
- hold for 30-60 seconds and monitor for m relaxation
What’s Origin Insertion Technique?
(Similar to GTO technique)
Uses specific compression and cross fibre petrissage along the attachments of a m. Best suited for flat tendons, mm that don’t have a distinct and obvious tendon (e.g. scapular attachments of infraspinatus)
What’s Muscle Approximation Technique?
This tech attempts to reduce tension on the m spindle. (The m spindle monitors the amount of tension in a m and causes it to contract as a protective mechanism.) To apply:
- The two ends of the m are passively (i.e. no effort by patient) brought closer together
- The m is held in its passively shortened position for approx 30 secs
- The muscle is then slowly released and allowed to return to its normal position
