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Myofascial Pain & Fibromyalgia Syndrome

Miofascial

Myofascial pain has been estimated to be the source of pain in 85% of patients attending a pain center. Fibromyalgia affects 4-12% of the population. Both of these are rather “new” diagnoses in our medical system and there has been a great deal of research done recently. Let’s dive into understanding WHAT these diagnoses mean and HOW they should be treated.

Myofascial pain is a local or regional pain syndrome occurring in one or two body regions. Travell (guru type person in my world) has defined the following diagnostic criteria:

1. Palpable taut band in muscle

2. Exquisite spot tenderness of a nodule in the taut band

3. Pressure on the nodule should reproduce patient’s current pain complaint

4. Restricted motion due to pain

Myofascial pain syndrome responds very well to Physical Therapy including manual therapy, exercise, and transcutaneous electrical nerve stimulation (TENS). There is some evidence to demonstrate that outcomes may be improved with use of trigger point injections (performed by an MD) before Physical Therapy.

Fibromyalgia is diagnosed as at least 3 months of widespread pain occurring in each quarter of the body. People with fibromyalgia literally hurt everywhere! Further, people with fibromyalgia commonly present with sleep disorders, fatigue, depression, and irritable bowel syndrome. (Remember, if you aren’t sleeping, you aren’t healing!) Little is known about fibromyalgia, but it is generally accepted to be a disorder of central pain amplification. This causes normally pain free input to be perceived as painful. So, there is enhanced excitability in central pain transmission pathways and loss of pain inhibition. What can be done?

Fibromyalgia treatment requires a multidisciplinary approach involving pharmacological management, psychological treatments, and physical therapy combined for best outcomes. Physical therapy emphasizes an active protocol aimed primarily at an appropriate aerobic conditioning program. There is also moderate evidence for implementing a strengthening home exercise program to decrease pain as well as increasing global well-being.

If you would like more information on either of these diagnoses, please feel free to contact Amy at (425)658-4944 or amykonvalinpt@gmail.com.


Dr. Amy Konvalin

Dr. Amy Konvalin

Struggling with pain and dysfunction can impact every part of our lives — it drains our energy, distracts us from our goals, and keeps us from the people and activities we love. As an Orthopedic Clinical Specialist, Dr. Amy Konvalin understands how frustrating those limitations can be — and she knows how to help get you back to the life you want to live! Beginning with a focused evaluation, Dr. Amy works to determine the root causes of your pain, as well as understanding how it affects the way you move through your world. Dysfunctional patterns of movement often grow worse with time and cause further damage if left untreated — so it’s important to address these issues as soon as possible. Dr. Amy knows there is no one-size-fits-all plan for success, and she partners with patients to identify their unique treatment goals and personal values. Using these goals as a guide, Amy uses her doctorate training in manual (hands-on) therapy and exercise prescription to treat patients with a wide variety of medical challenges and histories throughout the Maple Valley, Black Diamond and Covington areas. Dr. Amy is also a wife to a Boeing superstar/former C-130 navigator. While they lived in Germany, Dr. Amy was able to volunteer with the US Army to treat military personnel and civilians on base. She has two beautiful teenage ballerinas who keep her on her toes and educate her on all things ballet! Bailey, the princess pup, is her running partner and her napping partner. In the spare moments in between, Amy enjoys reading, yoga, wine with friends, Pilates, and walking on the beach.
Dr. Amy Konvalin

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