1 / 19

Faculty of Physical Education & Rehabilitation Department of Human Physiology & Sports Medicine

VUB Congress 2007. Andre Farasyn Ph.D. PT DO Referred muscle pain is primarily peripheral in origin: “The barrier-dam theory”. Faculty of Physical Education & Rehabilitation Department of Human Physiology & Sports Medicine. Referred muscle pain. INTRODUCTION. 1. An infitration….

noelle-porter
Download Presentation

Faculty of Physical Education & Rehabilitation Department of Human Physiology & Sports Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. VUB Congress 2007 Andre Farasyn Ph.D. PT DO Referred muscle pain is primarily peripheral in origin: “The barrier-dam theory” Faculty of Physical Education & Rehabilitation Department of Human Physiology & Sports Medicine

  2. Referred muscle pain INTRODUCTION 1. An infitration… 2. …on a muscular “Trigger Point”… 3. …activates a referred pain... .....Kellgren, 1937

  3. Referred muscle pain INTRODUCTION Overview of different possible mechanisms of referred muscle pain:

  4. Referred muscle pain INTRODUCTION Hypothesis of Travell & Simons (1998)‏ E 1. Mechanical pressure… A 2. …on a muscular “Trigger Point”… B F C 3. activates (A & B) via spinal reflex… D 4. …(C) …a bodily area of referred pain... 5. …and in turn activates (D) the CNS 6. other stimuli (E & F) co-activates…

  5. New hypothesis for the phenomenon of referred muscle pain Andre Farasyn Referred muscle pain is primarily peripheral in origin: “The barrier-dam theory” Medical hypotheses 2007;68:144-50.

  6. Referred muscle pain is primarily peripheral in origin:“The barrier-dam theory” New hypothesis: Farasyn A.: “The barrier-dam theory” 1. Mechanical pressure… 2. …on a “Trigger Point” … B 3. ..disturbes firstly the afferent “prelocal” nerve (A) …upstream: with the consequence of… A 4. ..the creation of a referred pain zone..(sec)… Just like a barrier-dam… 5. secondly activates the afferent “postlocal” nerve (B) …downstream…and in turn via spinal transduction… 6. …actives the CNS

  7. Referred muscle pain is primarily peripheral in origin:“The barrier-dam theory” New hypothesis: Farasyn A.: “The barrier-dam theory” Co-activates parallel sensitive nerves (E => C) creating adjacent zones of referred pain… B A E C

  8. Referred muscle pain is primarily peripheral in origin:“The barrier-dam theory” Discussion & Conclusion New hypothesis: Farasyn A.: “The barrier-dam theory” Confirmation needed in experimental referred muscle pain provocation tests

  9. Referred muscle pain is primarily peripheral in origin:“The barrier-dam theory” Examples of referred muscle pain syndromes: 1. Repeated strain injury 2. Tension headache 3. Bilateral (non-specific) low back pain 4. Pseudo-ischialgia Fig. from Gray’s Anatomy (1919)‏

  10. Examples of referred muscle pain syndromes: Repeated strain injury M. Infraspinatus Trigger Point Hypothesis of Travell & Simons (1998)‏ =…according to segmental innervation when stimulated…

  11. Examples of referred muscle pain syndromes: Repeated strain injury M. Infraspinatus Trigger Point Hypothesis of Travell & Simons (1998)‏ =…not the brain is the misleader, but the human interpretation…

  12. Examples of referred muscle pain syndromes: New hypothesis: Farasyn A.: “The barrier-dam theory” Repeated strain injury M. Infraspinatus Trigger Point = …what happens upstream of the peripheral sensitive nerve entrapment …

  13. Examples of referred muscle pain syndromes: 2. Tension headache = …peripheral sensitive nerve entrapment syndromes of… 1. The N. Occipitalis major 2. The N. occipitalis minor (C2-3)‏ 3. The N. Auricularis magnus Fig. from Benninghoff & Goerttler, 1967

  14. Examples of referred muscle pain syndromes: 2. Tension headache = …peripheral sensitive nerve entrapment syndromes of… 4. The N. Supraclavicularis & N. Transversus colli Fig. from Benninghoff & Goerttler, 1967

  15. Examples of referred muscle pain syndromes: 3. Bilateral low back pain = …peripheral sensitive nerve entrapment syndromes of… Fig. from Gray’s Anatomy (1919)‏

  16. Examples of referred muscle pain syndromes: 4. Pseudo-ischialgia =…peripheral sensitive nerve entrapment syndromes…

  17. Referred muscle pain is primarily peripheral in origin:“The barrier-dam theory” Conclusion: The primary pathogenesis of referred pain is presumed… • to be a peripheral sensitization with additionally • a central modulation and ….not vice versa…. • probably nothing else than a simple local peripheral sensitive nerve entrapment syndrome….

  18. Referred muscle pain is primarily peripheral in origin:“The barrier-dam theory” Recommandations • In the future we need to generate a greater interest in: • muscle tenderness research and ….. • exploring electrographical & myometrical measurements of peripheral sensitive nerve entrapment syndromes.

  19. Referred muscle pain is primarily peripheral in origin:“The barrier-dam theory” Thank you for your attention…!

More Related