Clean Run - January 2014 - 10
© DOGHOUSE ARTS
Myofascial Pain: The Hidden Health Problem
By Michael C. Petty, DVM, CVPP, CMAV, CCRT, Dipl. AAPM
Myofascial Pain Syndrome is a common but rarely diagnosed
pain issue that is almost always present in the face of other underlying disease, whether it be osteoarthritis, trauma, repetitive
strain injuries in performance dogs or as a sequelae to orthopedic
surgery. Myofascial pain syndrome was brought to the attention
of modern human medicine by Janet Travell in 1952.1 although
it has been described in literature as long ago as the 16th century2.
Despite this, it has failed to enter mainstream medicine, and this
is especially so in veterinary medicine. Most veterinarians do not
even know of its existence! However, within the past decade this
aspect of pain medicine along with many others has been steadily
gaining a foothold in the general veterinary practice.
How Does Myofascial Pain
Syndrome Develop?
tinue even after you relaxed your arm, and it would be even more
intense should you try to repeat the same exercise. Why is it so
hard to hold an object that weighs less than a pound? The answer
to this question is key in the development of this syndrome.
Whenever a muscle is asked to perform a task that does not
require much strength, only a few muscle fibers are put into
action. (Imagine what our motions would be like if we used
every muscle fiber for every single action, no matter how small!
Disaster would ensue!) However, as those few muscle fibers
become fatigued, no other muscle fibers step in to help out. This
has been described as the Cinderella Hypothesis4 because Cinderella was the first one to get up in the morning and start a job,
the last one to go to bed, and no matter how tired she was her
sisters never offered her any help!
The pathophysiology of myofascial pain is a complex syndrome
involving in part, motor, sensory, and autonomic nerve components which is beyond the scope of this article, but which is well
described in Myofascial Trigger Points by Dommerholt and Huijbregts; 2011 Jones and Bartlett Publishers. Basically, extended
contraction of a few muscle fibers results in painful contracted
knots of muscle called "trigger points."
To demonstrate this problem, pick up any small object that
weighs a pound or less and hold it out in front of you at arm's
length. In about 90 seconds you will start to feel some significant
fatigue in the muscle, making it difficult to keep your arm out.
Within another minute or two it will start to become painful. If
you were to force your arm to keep holding this object for as little
as 30 minutes, trigger points could form3. The pain would con10
Stretched
muscle fiber
Contracted knot
Healthy muscle fiber
Clean Run | January 14
Clean Run - January 2014
Table of Contents for the Digital Edition of Clean Run - January 2014
Contents
Clean Run - January 2014 - 1
Clean Run - January 2014 - 2
Clean Run - January 2014 - Contents
Clean Run - January 2014 - 4
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