Myofascial pain is a term used to describe inflammation of the muscles. This inflammation can occur anywhere in the body including the abdominal area. The pain is often found in the upper abdomen just below the ribs or in the lower portion of the belly near the pubic bone. Most people with this disorder find the pain begins or increases when these muscles are stressed. Women may feel the pain coming from the vaginal area due to pelvic muscle irritation. Men can develop this problem after hernia surgery because it leaves the muscle less flexible due to scar tissue.
Diagnosis
Abdominal pain can result from a variety of disorders. The doctor will conduct a careful history and physical exam. The doctor may possibly order blood tests, urine analysis, and X- ray studies like ultrasound or computed tomography (CT scan) to rule out diseases affecting the internal organs. Once internal problems have been eliminated, the most likely diagnosis is fibrositis or abdominal muscle inflammation. This diagnosis can be confirmed through a physical exam, which shows the muscles to be painful to light touch. There are no X- ray or laboratory studies that determine if a patient has abdominal myofascial pain. These tests are only useful to rule out serious internal problems.
Treatment
In many cases, doctors can prescribe nonsteroidal anti-inflammatory drugs like Motrin and/or muscle relaxants for some relief. Heat and massage can also be helpful in relieving some of the pain, but will not do anything to improve the underlying condition. Injection of the muscles with local anesthetics and anti-inflammatory drugs can control long-term pain by decreasing the underlying irritation of the muscles. In addition, there are times when the cause of the pain comes from a group of nerves in the lower abdomen. In these cases injections may be given in the abdomen where the nerve is trapped in a scar, or in the back where it originates. Injections are usually given as a series of three over a period of weeks. All procedures can be given under light, intravenous sedation so there is no discomfort. If injections fail to relieve the pain, the doctor may prescribe an external electronic nerve stimulation device (TENS unit). These units work only for abdominal pain and not for pelvic or vaginal pain. While they do not cure the underlying problem, they can bring pain relief as long as they are worn. Physical therapists place these devices on patients and provide the necessary instruction for long-term use. Patients occasionally benefit from a behavioral and psychological analysis to determine whether there is something in their lifestyle or behavior contributing to the pain. This testing can reveal the emotional impact the pain is having, and whether it is aggravated by psychological or emotional problems. Some patients find biofeedback, stress reduction and muscle relaxation therapy beneficial for reducing symptoms aggravated by stress and emotional tension.
The Priority Health Spine Centers of Excellence program was created to ensure that all patients with persistent neck pain, back pain or other spine-related problems receive a comprehensive, non-surgical medical evaluation for their condition. For patients whose condition does not require urgent or emergent surgical intervention, an evaluation by a certified Priority Health Spine Center of Excellence is required prior to any referral to an orthopedic or neurosurgeon for back or neck care.
Tri-County Pain Consultants, PC is honored to be recognized by Priority Health as a Spine Center of Excellence for West Michigan. Our team of pain management specialists have a proven track record providing high quality medical care that meets and exceeds the strict criteria required by Priority Health for a Spine Center of Excellence designation.
Acupuncture
Acupuncture is the practice of using small needles inserted at very precise points on the body to promote natural healing and improve functioning. Acupuncture stimulates nerves, muscles and connective tissues, prompting increased blood flow to injured areas of the body, boosting the body’s natural healing process. Acupuncture provides a low risk treatment option that can be beneficial for pain syndromes due to an injury or associated with chronic degenerative diseases.
Cryoablation
Cryoablation is a procedure done in office that utilizes a specially equipped needle guided under fluoroscopy to freeze the area surrounding a nerve that is causing pain or discomfort. The goal of cryoablation is to interrupt the nerve’s ability to send pain signals to the brain and provide pain relief.
Discography
A discography is a diagnostic tool your pain management specialist may use to help determine the disc or discs that are the source of your pain. For this procedure, a contrast dye is injected into the gel like center of the suspected disc or discs, allowing your pain physician to see cracks or leaks in the disc membrane. Typically a patient receiving a discography will be given a local anesthetic or numbing agent. All discographies are performed by a certified pain management specialists under fluoroscopy.
IDET
IDET, or Intradiscal Electrothermal Therapy, is a procedure used to treat discogenic back pain. IDET involves the use a heated probe inserted into the gel like disc which heats up the inside of the affected disc. Heating the inside of the disc can destroy pain causing nerve fibers and seals any cracks or holes in the disc.
Intrathecal Pump Therapy
An intrathecal pump is an implanted medical device that delivers pain medication directly to the intrathecal space surrounding the spinal cord. An intrathecal pump is indicated in cases where patients have difficulty with oral medications or where previous pain interventions have been ineffective.
Kyphoplasty
Kyphoplasty is a procedure designed to help relieve pain caused by compression fractures of the spine. During a kyphoplasty procedure, a small tube is inserted into the fractured area. Once the tube is in place, the physician inflates a small balloon within the fractured area to raise the area, returning the broken pieces to a more normal position. The balloon is then deflated and the space is filled with a bone cement, effectively stabilizing the fractured area.
Manual Therapy
Manual therapy, or manipulative therapy, is a direct contact physical treatment used primarily to treat musculoskeletal pain and disability, intended to restore joint or soft tissue mobility. Treatment may include joint mobilization and manipulation, muscle stretching, and resistance therapy to advance muscle timing and activation.
Medication Management
Mecication Management is medical care provided by your pain management physician to optimize the use of prescribed medication to improve therapeutic outcomes for patients.
Nerve Block Technique
A procedure in which an anesthetic agent is injected directly near a nerve to block pain. A nerve block is a form of regional anesthesia.
Occupational Therapy
Occupational therapy is a task orientated treatment program designed to help patients regain their ability to perform daily living and work activities after serious illness injury or disability. Therapy focuses on the facilitation of daily tasks of self-care, work, and play/leisure activities, to help patients regain the ability to perform daily living and work activities.
Radiofrequency Lesioning
Radiofrequency lesioning is an advanced procedure using a specialized machine to interrupt nerve conduction on a semi-permanent basis. The nerves are usually blocked for 6–9 months. The procedure is typically most effective in treating joint pain in the spine.
Spinal Cord Stimulation
A spinal cord stimulator is a small electrical device implanted just under the skin in the lower back that delivers low level electrical signals to tiny electrodes implanted in the epidural space of your spine. These electrical pulses interrupt the pain signal from reaching your brain, replacing them with a mild tingling in the area where pain is felt. The device is controlled through a magnetic remote control, which allows patients the ability to turn the device on or off, and adjust the intensity as needed.
Stress Management
Stress management is clinical therapy designed to help individuals cope with or lessen the physical and emotional effects of strain and anxiety. Stress-management may include relaxation techniques, time-management skills, counseling or group therapy, exercise, and maintaining an overall healthy lifestyle.
