Myofascial pain syndrome

Question 1

Quadratus lumborum pattern?

Answer 1

Hip pain, xray and MRI is normal
may mimic sacroilitis or piriformis problems
2 superficial and 2 deep trigger points, hip and buttocks

Question 2

Activation of Quadratus lumborum?

Answer 2

simultaneous bending over and reaching to ones side to pull or lift
trauma

Question 3

Quadratus lumborum mistaken for?

Answer 3

lumbar radicular pain or piriformis syndrome

Question 4

Quadratus lumborum OMT?

Answer 4

Muscle energy to the 11th and 12th ribs

Question 5

Gluteus minimus pattern?

Answer 5

from the posterior part of gluteus minimis muscle and radiates down the leg, mimic sciatic pain
pain is often attributed to sciatica
the more anterior the trigger point the more lateral the refferal zone

Question 6

Activation of Gluteus minimus?

Answer 6

acute or repetitive overload, SI joint dysfunction, nerve root irritation

Question 7

OMT for Gluteus minimus?

Answer 7

Hip treatment dirrect

Question 8

Iliopsoas pattern?

Answer 8

is pain on the low back and front thigh on same side, following the muscle
aggrevtaed but weight bearing activites and relieved by recumbency

Question 9

Iliopsoas activation?

Answer 9

prolonged sitting with the hips flexed

Question 10

OMT of Iliopsoas?

Answer 10

correct somatic dysfunction of thoracic, lumbar, or sacral areas and avoid proloinged sitting

evaluate the hip and innominate somatic dysfunction

Question 11

Scalene pattern?

Answer 11

refer down the arm, pain over the scalene
common source of back, shoulder, and arm pain
often confused with cervical radiculopathy

myofascial pain or secondary sensory and motor disturbance due to neurovascular entrapment

Question 12

Activation Scalene?

Answer 12

pulling, lifting, tugging with the arm or overuse of these muscles in respiration

Question 13

OMT Scalene?

Answer 13

Cervical kneading, cervical stretching, scalene ligamentous articular strain, scalene strech, cervical restrictor muscle energy, cervical sidebending or rotational

Question 14

Trapezius pattern?

Answer 14

from the back of the neck radiating up to the temporalis muscle and side cheeck (TMJ area)

muscle most often found to have trigger points
frequently overlooked source of temporal and cervicogenic headache

Question 15

Activation of Scalene?

Answer 15

commonly results from the stress of sustained elevation of the shoulder and trauma

Question 16

OMT for Scalene?

Answer 16

similar to the scalenes
trapezius tension release exercise

Cervical kneading, cervical stretching, scalene ligamentous articular strain, scalene strech, cervical restrictor muscle energy, cervical sidebending or rotational

Question 17

General charcteristic pattern?

Answer 17

may look like the muscle itself

Question 18

Active trigger points?

Answer 18

produce a clinical complaint which the patient recognizes when the trigger point is digitally compressed

refer pain at rest, with activity or with palpation

Question 19

Latent trigger points?

Answer 19

can produce other effects characteristic of a trigger point including increased muscle tension and muscle shortening

produce pain only when probed with more steady pressure

Question 20

Activate trigger point directly?

Answer 20

active overload
overwork
repetitive injury
trauma
rediculopathy

Question 21

Indirectly activate trigger point?

Answer 21

other existing trigger points
visceral disease
somatic dysfunctions
emotional distress

Question 22

Differ from fibromyalgia?

Answer 22

males equal to females
local or regional pain
trigger points
decent response to treatment

Question 23

Modalities for trigger point release?

Answer 23

manual therapies including OMT
spray and strech
trigger point injection (and stretch)
other modalities such as ultrasound

Question 24

Spray and stretch?

Answer 24

spray is the distraction, stretch is action
no require precise localization of the trigger point that is needed for injection
it is not as invasive as injections

make sure patient is supported in a comfortable position, home stretch

Question 25

Is it important what you inject into the trigger point?

Answer 25

no, can use dry needle, just as effective