The 7 Perpetuating Factors of Pain

In my San Antonio, Texas based Massageabnormal pressure on nerves which can cause
Therapy and Bodywork practice I'm often askedpain, numbness and tingling, or muscle weakness.
by clients how it is that I assess clients andA Nerve Compression occurs when a hard tissue
approach my work. There are a number ofsuch as a vertebrae or vertebral disc directly
methods I use but when it comes topresses on a nerve. A more common occurance
musculoskeletal pain one set of guidelines are "Theis a Nerve Entrapment. Nerve Entrapments occur
7 Perpetuating Factors of Pain". These factorswhen a soft tissue such as muscle, tendon,
were originally presented to me during my trainingligament, or fascia abnormally press on a nerve.
in Neuromuscular Therapy and Medical MassageAn example of a nerve compression would be
and are based on the work of Drs. Janet Travellsciatica. Examples of a nerve entrapment include
and David Simons (and others). By keeping theseCarpal Tunnel Syndrome and the lesser known
factors in mind during assessments and treatmentPiriformis Syndrome, but encompass a wide
a Massage Therapist's potential to help relieve thevariety of painful conditions.
client's pain increases tremendously. The factorsPOSTURAL DISTORTIONS are another factor
are:contributing to musculoskeletal pain. Distortions
1) Ischemiasuch as the head being to far forward, leg length
2) Trigger Pointsdiscrepancies, or an elevated shoulder cause
3) Nerve Compression or Entrapmentmuscular imbalances and joint abnormalities which
4) Postural Distortionlead to pain.
5) Biomechanical DysfunctionBIOMECHANICAL DYSFUNCTIONS include joints
6) Stressthat are either excessively mobile (hypermobile)
7) Nutritionor have an abnormally limited range of motion.
Each of these factors plays a part in a person'sThese Biomechanical Dysfunctions cause pain in
musculoskeletal pain. Any one of these factorsthe joints themselves and contribute to some of
can be the sole cause of pain, but usually athe other perpetuating factors including postural
person will have more than one factor at work -distortion, ischemia, and trigger points.
sometimes all of them.STRESS may be the most common of all
ISCHEMIA is a local deficiency of blood supply andperpetuating factors of pain. A person
the oxygen transported by the blood. Ischemiaexperiencing physical, mental, emotional or spiritual
can occur for a variety of reasons including directstress produces larger amounts of stress
injury to tissues, abnormally tight or overworkedhormones and usually has a nervous system
muscles, clothing or shoes that are too tight, orthat's in overdrive - fight or flight syndrome.
even off-the-shelf splints for tennis elbow.Stress leads to pain in so many ways that it's
Specialized nerve receptors in muscles report painimpractical to list them here; however, stress can
in ischemic areas due to chemical changes thatcause pretty much all of the other perpetuating
occur.factors.
TRIGGER POINTS are hyperirritable spots in aNUTRITION is one factor often overlooked in the
muscle associated with a palpable "knot" and atreatment of musculoskeletal pain. Unfortunately,
taut band of tissue. Trigger Points are painful onMassage Therapists are seldom trained, qualified,
compression and can refer pain and tenderness toor legally able to provide nutritional advice.
other areas. Trigger Points are usually ischemicHowever, most Massage Therapists, including
and often cause an entire muscle to be too tight,myself, do know healthcare professionals in their
weak, and more easily fatigued. Trigger Points canlocale to help with the nutritional side of treating
be caused by overworking or overstressingpain. These professionals often find that there are
muscles, direct trauma to muscles, or even chills.nutritional deficiencies just a Drs. Travell and
NERVE COMPRESSIONS and ENTRAPMENTS areSimons did during their research.
types of nerve impingement. These are areas of