“The Biscuit Analogy” can explain Natural Healing

“The Biscuit Analogy”

In my family practice, I've stumbled on an additional couple of steps in this recipe of wellness and healing. It has to do with the body and how it has to be include into the 5- elements, mind, body, spirit and soul paradigm.

I’ll use my “The Biscuit Analogy” to explain … it is Simplistic, Practical, Scientific but very Accurate.

Note, The human body has thousands of chemical reactions going on each second. Without the proper ingredients, amounts, ratios and timing of vitamins, minerals, trace elements to fuel and catalyze all these enzymatic reactions, faults or errors will occur.

To get a golden brown batch of flakey biscuits you need;

1. Fresh and wholesome ingredients.

2. Measure all components carefully.

3. Mix or Knead so the ingredients marry into the dough which begins the chemical reactions.

4. Bake the ingredients at the right temperature for the right amount of time.

Ingredients = Diet,

Proportions =  Life-stress-work balance,

Mixing or kneading = 2 types;

A. Exercise, yoga. Hands on with chiropractic adjustments and massage.

B. Mixing with a metallic wire such as with an acupuncture, dry needling and trigger points.

(In some people the flesh is so dense and tight that manual labor will not completely blend or marry of all elements, so you get an incomplete healing cycle. In this case you must use a different tool to blend and mix to ignite the chemical reaction for an effective process. An acupuncture or hypodermic needle are the only modern tool available because the steel wire will depolarize tense, tight stubborn muscles. The more relaxed muscles allow for better energy flow/blood flow which invites the best environment for a more complete healing cascade.) This needle therapy has been in practice but marginalized for a half century and it’s called Myofascial Release Therapy with Travell/Simons protocols for pain and dysfunction.

The Oven = Sleep hygiene.

You can not cheat the process or recipe because every cell in your body will know.

http://dxsummit.org/archives/1591#comment-670

To Mr Burns of Dallas Morning News

Mr Burns, you have stumbled into the abyss of the dark side of medicine. It has taken me a couple of decades in medicine to find a way out of this misinformation to find a brighter view of medicine. I’m fearful of admitting that it is actually much worse than what you have uncovered, but we can discuss the darkest parts later.

What you call Fast medicine, I call it Vending Machine medicine which has been taught for a couple of decades because it works well for the majority of medical issues. Quick and basic quality is efficient when problems are simple and straightforward. These cases can easily be managed by a well trained nurse or Physician Assistant for the majority top 10-20 diagnoses.

It fails miserably for the rest who really need the personalized eye-ball to eye-ball care. In patient who have a set of issues that don’t add up or do not improve with the standard care. There are ways to change this paradigm if all are willing to make the changes.

Reasons why healthcare is failing;

>The business of medicine which focus on the bottom line and marginal patient outcomes.

>Clinical practice micromanaged by the pharmaceutical companies, high technology, orthopedic product manufacturers, cancer and cardiovascular diagnosis and therapies.

>The “I can fix you mentality.” Which in most cases it just medicine usurping natural healing for profits. The number of joint replacement surgeries and cardiac procedures are rampant and mostly unnecessary.

>Disregard for proactive or preventative medicine.

>Disregard for myofascial pain and dysfunction and the time and hands-on care these patients need which is Myofascial Release Therapy with and without needles.

>Disregard for Alternative medicine, which should actually be primary care medicine and that is Wellness, Acupuncture, Travell/Simons trigger point therapy; dry and wet injections, Spray and Stretch and old fashion Physical Therapy.

>Disregard for wellness and balance in our chaotic lives.

>Disregard for the end of life issues and care for the elderly.

>Disregard for polypharmacy.

>Disregard for oversight for malfeasance in the operating rooms, procedure suites and board rooms as it relates to waste, fraud and abuse.

>This one I witness in my daily practice and that is how pain and dysfunction is managed. This aspect is totally ignored and is where billions are wasted and causes the most misery.

The business of medicine is in the way of the humanitarian part and there are ways of finding a balance if all parties can all agree to accept the solutions. And YES, healthcare is on track to implode with or without the ACA because the above issues have not been address. http://www.dallasnews.com/business/columnists/scott-burns/20131026-new-book-is-a-candle-in-the-darkness.ece

This article begs for a solution to the cycle of pain, misery, depression, insomnia, fear, disbelief and abandonment.

Why are so many people suffering in the dark and alone? Pain is not easily proved by modern technology and thus trust and disbelief gets in the way. “How can she be in so much pain, she looks OK”

If chronic pain could be seen under the microscope, like cancer, it would be on the forefront of healthcare too. Patients would have a team of specialist, supporters, ancillary care givers, guardian angels and a societal acceptance that medications, therapy and medical care would be at your disposal. You would have sympathetic friends and neighbors even strangers who would recognize your situation and offer prayer and support.

… not so much for this invisible killer.

Hope and Help are the missing links in chronic pain. Chronic pain has to be treated like a cancer, aggressively in the very early stages or it will grow and metastasize into other areas of the body and then into the soul. For this to happen we need to understand that pain has to be treated with strong medicine in the form of “therapy.”

I have posted here in the past … if you like you can do a search in the top right corner and follow the links for my opinions on therapy.

http://americannewsreport.com/nationalpainreport/living-pain-demon-depression-8821795.html

Fibromyalgia discussion with a few academics and clinic folks ... interesting.

@ Wolfe you expected a practitioner to perform magic … there is no magic in medicine.
The demonstration was of an unfortunate case the was beyond manual therapy and thus would have require more intensive therapy which included needles and addressing all the perpetuating factors like sleep, mineral deficiency, medication adverse reaction. I see these cases daily and they do respond miraculously. No magic needed.
@Wolfe you discount all the wealth of data Travell and Simons compiled which is an insult to the authors. Most text are compiled and written based on well vetted studies to make it easier to understand and teach.
@Quintin, how many cases would it take for you to believe the word of a patient. 20? 200? or 2000? Well I have a few thousand cases in my files, most I have helped with these techniques. I just hope you are not in a position to impose what you believe on others. That would be immoral and a disgrace to the oath you took to do no harm.
Taut bands in muscles and the all diagnostic criteria are for a “classic unit.” In clinical practice, all the academics, have to be put on the back burner as per Edward Rachlin, MD. A muscle full of trigger points will act very erratically so trying to elicit a twitch maybe a futile task. And the muscle could be 2-6 inches into the flesh. These infected muscle still requires therapy. Delay or neglect will subject the patient to more pain and suffering. Clues that a muscle is affected area density changes, tightness, loss of range of motion and surface sensitivity changes.
The best diagnostic and therapeutic tool to determine if a muscle is infected is a stainless steel needle wire. The thin filament type wire needle once it touches the erratic muscles will elicit a response in the patient. The only person who can tell you that information. The patient is the soul detector of this therapy and has to be a part of the diagnostic team. You have to trust their words! The other detector of MF diseased flesh is the practitioner. What the provider feels in their fingers are vital to a good outcome. Finally the post treatment exam cannot be neglected or discounted. The patient and the examiner has to note a better range of motion and less pain.
I know what you are thinking … I can’t use sophisticated equipment! I have to believe what the patient is saying! I can’t figure out a way to double blind this technique! The simple puny needle is the best diagnostic tool and best therapeutic tool all in one!
In a discussion of open minded scholars the goal should be on how to help the masses not disparaging the clinicians and practitioners. We and the suffering patients need your help not your skepticism.
To gain more insight into these procedure, read these text books … especially Gunn. He linked the myofascial therapy extremes from simple stretching, yoga, spray and stretch, hands-on manipulations, acupuncture, Gunn-IMS, dry needling to finally Travell trigger point injections.
>Intramuscular Stimulation using the techniques of C. Chan Gunn, MD.
>Trigger Point Injections using the techniques of Janet G, Travell, MD, David Simmons, MD and Edward Rachlin, MD.
>Ligament and tendon relaxation techniques of George Stuart Hackett, MD.
>CraigPENS as per William F Craig, M.D.
>Myofascial Release by Gokavi, Cynthia N. Gokavi, MBBS.
>The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief, Second Edition by Clair Davies, Amber Davies and David G. Simons (Aug 1, 2004)
>Fibromyalgia and Chronic Myofascial Pain: A Survival Manual (2nd Edition) by Devin J. Starlanyl and Mary Ellen Copeland (Jun 30, 2001)
>Advanced Soft Tissue Techniques as per Leon Chaitow, ND, DO
>Medical Acupuncture as per French Energetic protocols of Joseph Helms, MD.

http://www.fmperplex.com/2013/02/14/travell-simons-and-cargo-cult-science/#comment-3497
http://www.fmperplex.com/2013/02/14/travell-simons-and-cargo-cult-science/#comment-3497

Therapy! Let's get started!!

Let get started!!

It’s vital that everyone realize that to have mind, body and spirit peace you have practice your own medicine and participate in your own therapy; daily, weekly, monthly … for the rest of your life.

What is Therapy?? Sleeping well, exercising, dancing, cycling, loving, singing, fishing, gardening, laughing, living, yoga, sports, reading, praying, massage, soaking in the tub, a visit to the spa, taking off a day from work (a mental health day) etc. Be your best friend and not your worse enemy.

If you do get behind in your therapy and get depleted, only YOU can stop the bleeding to catch up. This means spending more time on yourself. Once you get behind, in this crazy world you have to ASK or help … Friends, family, spouse, kids and boss. Don't be afraid!

Try not to believe folks who see you in therapy and say … “Oh you should not do this or that.” Therapy can not do any harm … none! You make get an injury but accidents happen, you’ll heal from a mishap. Strain your back in the garden … shucks, the treatment is therapy. Pull a muscle in dancing … shucks, the treatment is more therapy. Fall off your bike … ouch, the treatment is more therapy.

So what is the best medicine in medicine?? Therapy!

It always works! Most times safe (bikes and cars don't mix well), non-toxic (some will become addicted to their place of Spa)

What is the most important word in your vocabulary as it relates to Therapy?? NO!

The most important word to use in therapy is NO.  NO to and and all negativity, fear, bosses, PTA, neighbors, etc.There is a loving way to say NO and don't feel guilty for engaging in your wellness program. Some needy folks will say, “You are just being selfish” … not really … you are self preserving and self loving. Why give away energy you don't have or can afford?

What to Believe as it relates to you, your health, future, past, present life and wellbeing?

Actually none of it!! Don’t believe it!

Patients focus on a single diagnosis as it relates to pain, that was given to them a decade ago. Your body is in a constant state of healing and repair, so as time goes my so does the diagnosis. The beauty of Therapy is that you can modify your therapy based on what areas are of concern.

In therapy what is the worse emotion? Fear of the unknown.

Because pain and myofascial dysfunction will not kill you or even shorten your life, y

Back pain guidelines: poor medicine.

This is an unfortunate example of the “confirmation bias” in medicine as it relates to pain.

There are only 2 types of pain. (open for debate)

1. Emergency issues or eminent death issues. (Cancer, infections, tumors and strokes)

2. Sub-acute or autoimmune pain syndromes. (Treatable)

3. Non-Emergency pain syndromes. (Everything else)

The everything else is what causes the most misery, pain and dysfunction, the easiest to treat and manage. Doctors have known this for half a century but decided, for some reason, that the medical community would overlook such “simplicity” because you can’t see it on a scan. Guess what … the only way to “SEE” this issue is to ask the patient! The person who is suffering. Modern technology has made the patient complaint insignificant.

Today, It is easy to just bypass what the patient is saying or feeling and look at the evidence, blood test, scan etc. The most important part of a patient encounter was the history and physical exam. Not anymore! Most doctors look right past the patient to the testing to make a diagnosis. Oh … doctors don’t even do physical exams anymore. So the patient is just a “dummy” a non-entity.

Myofascial pain and dysfunction caused by faults in muscle fibers called Trigger Points, are greatest ignored scourge to human existence! TPs are the culprit is most complex pain syndromes. Medical educators short sightedness as it relates to TPs; the massive impact of TPs on the human body, what they are, how they affect the human body, why they need to be addressed, the circumstances of missed opportunity, the long-term effects and the final results on the human body.

I browsed the article and Arachnoiditis Society for Awareness and Prevention site … no mention of alternatives, acupuncture, myofascial issues or other resources. This is an example of poor research, medicine and obvious bias.

Read Travell-Simons, Rachlin, Gunn, Hackett and other MDs to get a real idea of how to really treat back pain.

http://americannewsreport.com/nationalpainreport/study-many-doctors-dont-follow-guidelines-for-treating-back-pain-8821019.html

Why??

Good morning, When I read these testimonial stories, it ignites my frustration at the amount of pain and misery this modern healthcare system is causing. The age old system was more hands on and touchy-feely, using treatments that were used for millennia. Then the pill and surgical repair paradigm is in vogue.

Why is a medical page using the testimony of these wounded souls to advertise treatments that are counter to their well-being and will cause harm? (Look up at the headliner and sidebar ads ... in 2013, I would NEVER recommend those procedures)

Why are so many souls suffering in pain and having to find peace with this miserable fate?

Why are the researchers, physicians and academics looking to the future for answers when we already have some answers that work?

Why do physicians deny how patients feel?

Why don’t physicians “touch” patients anymore?

Why are physicians allowing the advertising firms to dictate how to practice medicine?

Why are insurance companies dictating how to treat patients?

Why have primary care/front-line/battle field physicians defaulted all treatment strategies to researchers, politicians and the AMA?

Why do we glorify a person or entity just because it snazzy and famous?

Why is it more lucrative to the bottom line to order an MRI than to improve quality of life?

Why do we allow what we think to completely override the truth?

Why do we have the idea that a person or physician or a surgery can “fix-me” back to normal?

Why do we think the “The Bionic Man” imagery is actually better than nature?

Why do we discount nature and God from medicine?

Why is all the dedicated contributions of Janet Travell-David Simons, Edward Rachlin, Chan Gunn and Stuart Hackett, MD and many others discounted and relegated to quackery?

The answers are all embedded in the questions.

http://americannewsreport.com/nationalpainreport/a-pained-life-appearances-8821003.html

Pain Therapy a new thought

I've been in primary care for 30 years and If I may try to clarify some of the lessons I have learned along the way. This journey of discovery started 15 yrs ago while studying Acupuncture to help my patients suffering with Fibromyalgia. I had a FM patient be well with the help of this therapy. I had to know why and how this worked.

Well I discovered as many years of study and trials, Acupuncture was NOT what I thought. To sum it up, Acupuncture or Traditional Chinese Acupuncture is a way to complement the healing process using needles a tools to unblock energy. This therapy also incorporates a way of life, peace and balance.

Then I also discovered pain was NOT what I thought! Pain is not “Trigeminal neuralgia or Sciatica,” these are names modern doctors use to classify a thought processes to help insurance companies complex payment and denial system. What I found was that pain is an alarm signaling the need to be on alert. Any signal is an alert whether it is an itch, a burning sensation, a sting or electrical. Pain only comes from a few causes; Infections, cancer, tumors, broken bones, torn flesh, hunger, a hot stove or what we call space occupying lesions (aneurysms). 

There is one other cause of pain that all of us seem disregard because this pain usually will go away all by itself. Like a smashed thumb from a hammer, it automatically self-repair under the laws of natural healing. A pulled muscle, twisted ankle, broken, cut abrasion and lacerations will ALL automatically heal. Automatic repair is a given that we just overlook and discount because it is God given and just the way it is. 

But what happens if the automatic repair process stalls or is incomplete, like a faulty repair. What happens if the pain signal get “stuck-on.”. What happens with these “errors of repair” or faulty signal will not heal is that these “blaring-alarms” place the person in a high awareness state. The brain and consciousness will try to verbalize or analyze the problems continuously, 24-7. This stresses the brain and the person will become worried, anxious and fearful. Guess what stress will further stall the repairs and feed a vicious cycle.

What happens when this worried person goes to doctor and the provider finds nothing on the exam, scanners, test and X-rays. The worried person thinks, “wait a minute you mean I am in this amount of pain and you can’t find anything ...you think I’m crazy”

This is where my journey comes full circle from medical school, to Acupuncture and Traditional Chinese medicine and then to what I stumbled over with a crash. Nowhere in any of my textbooks, articles or told to me my mentors. There were clues along the way but no one really informed me with authority. Massage therapist, Chiropractors, Physical Therapist all knew but were belittled and marginalized by renowned surgeons and prestigious well articled physicians. 

The trailblazer was Janet G. Travell, MD. took on this task. She unlocks all the confusion. She proves that the core of most chronic pain issues is in the muscles or Myofascial tissues. Stress will breakdown muscle tissue fibers that sometimes will not heal correctly. These defects called “Trigger Points” within muscles and tissues (Myofascial tissues) will accumulate until they reach a points of “dis-ease.” Myofascial tissue is everywhere there are muscles, from around the head and sinuses to the feet and toes. Sick and weak MF tissues will restrict the full ability of a muscles to function well and cause pain and misery: Weakness, Numbness, tingling, stinging, burning pain, pinched nerves. Achiness, stiffness and restricted movement of any joint. Accelerated joint wear and tear plus bursitis and tendinitis. Headaches and sinus issues. Block arteries and swelling due to block venous return.

JGT and others in the world of Myofascial Tissues Therapy have vivid effective protocols on now to begin the healing process. ALL are safe, effective and straightforward. Myofascial Release Therapy (MRT) comes in simple to complex forms. Yoga, stretching, massage are all forms of MRT. Hands-on therapy is the foundation. Acupuncture is part of the invasive needle therapy. Why invasive and why needles? (later)

So MRT will reignite the healing cascade so the MF tissues will complete the healing cycle. Then all the false signaling will go away allowing better peace and harmony. MRT will disable the modern diagnostic terms physicians give to pain issues. MRT must be done at the beginning of a chronic pain illness so that a fleeting ache, spasm, sting or shock will not evolve into a full blown entity.

The most powerful tool in my practice

The most powerful tool in my practice

Soon after I began practicing medicine,  I noticed an odd phenomenon.   Despite my best efforts some patients were NOT getting better. And other patients who I would normally expect to have difficulty in getting better were actually improving.  The patients who were not improving  had an odd array of symptoms and didn’t fit in any traditional category. They had unexplainable aches, pains, stiffness, fatigue and emotional problems that were not responding to treatment. My inability to help these patients was frustrating for both of us.

The other category of patients whose symptoms, I would normally have expected to resist treatment but were actually improving was exemplified by an early patient of mine with fibromyalgia. Fibromyalgia patients usually have a complex array of physical, mental and emotional symptoms.  These symptoms test the ability of  most providers to provide therapeutic relief.  Because of the difficulty in diagnosing Fibromyalgia, having no definitive blood test,  both the patient and  the physician  often experience major frustration.   At the time, my patient was also getting regular acupuncture treatments.  Because acupuncture was not in my arsenal of therapies, I had no idea what this treatment involved. But because it was obviously providing relief for my patient, I enrolled in  an acupuncture course offered by UCLA to help my understanding and see  if this knowledge could be applied to help my patients.

The Acupuncture course was founded by Joseph Helms, MD.  The first Medical Acupuncture for Physicians course was held in 1980 under the sponsorship of the American Holistic Medical Association. From 1982 through 2008 HMI offered the course in collaboration with the continuing medical education offices of UCLA and Stanford Schools of Medicine.  The Medical Acupuncture course opened the door to a whole new approach to medicine. The lecturers and attendees were excited by this new approach to healing. I began incorporating some of the treatments into my practice. But after  months of effort, and treatment  with individual patients, I was  dissatisfied with the results.  Fortunately the Medical Acupuncture course  offered more options for using  acupuncture in  pain therapy. Two practitioners who had done significant research in the field were mentioned, specifically, C. Chan Gunn, MD and Janet G. Travell, MD .
 
The key component to most chronic pain issues are trigger points that develop in stressed muscle fibers. TPs are discrete, focal, hyper-irritable spots located in skeletal muscle.  Muscles are engines of movement and when infected with TPs became shorter, tighter, stiffer and denser. These infected muscles altered the natural functioning of the muscles. Muscles function in locomotion and are made up of the fibers of movement, the coverings, the transition to a ligament and then the attachment to the bone. This muscular unit is call Myofascial Tissue and is the focus of therapy.

These short , stiff myofascial tissue irritate and compress associated nerve fibers, pain fibers, joints, lymphatics, arteries and veins.  A shortened muscle will alter the alignment of a joint and cause premature wear and tear. If this alter alignment if left for decades, it can destroy the natural design of a joint and increase degeneration. The compressed nerve fibers will switch on pain alerts, alarms and alter normal sensations called neuropathy. The broken pain signals will be oppressive and unrelenting as would happen after Shingles. Alter sensory fibers will cause a slight innocent pressure to be interpreted as scalding hot or burning. Compressed arteries will choke off nourishment to limbs leading to cold fingers and toes and could lead to ulcers. Compressed veins which bring blood back to the heart will cause swelling and another type of ulcer. Myofascial disease will lead to  fear, anxiety, insomnia and worry. Even suicides.
Some providers think that myofascial tissue will masquerade as a number of maladies that will delay therapy for weeks, months and even years. The triggers will growing in numbers per muscle as in density and spreading to others areas of the body.  Most provider do not know that myofascial tissues infected with trigger points will have a local pain clinical finding and in a referred pain pattern that may be a joint segments away.

The  technique  to relieve  this stressed muscle tissues is now called myofascial release therapy (MRT) and is focused on these “trigger points” that develop in muscles. MRT is already in use today in regular physical therapy, massage therapy, sports medicine and in chiropractic medicine. Myofascial Release Therapy, when used correctly can begin the healing process for patients with complex muscle and skeletal and/or neuropathic pain issues. MFRT or MRT is as simple as a stretch to as complex as using a thick needles to breakup the muscle fibers. Once can use leverage to unwind the muscles floor exercising, stretching and yoga. Hands-on therapies like deep tissue massage, a light touch release and chiropractic adjustments.

Some myofascial tissues can not be effectively released just with leverage and powerful hands. The muscles require an electrical depolarization by using a stainless steel or metal tool. A solid needle as an acupuncture needle or a sharp cutting tipped hypodermic needle. I imagine myofascial tissue as different grades of beef from Filet Mignon to a tough leathery hunk of meat. Take a sewing needles and push it through the filet, easy. Now try to push a sewing needle through a belt, almost impossible with a sewing needle. But if you take a needle with a knife like tip and you can penetrate the belt. If you tried to bend or twist or pierce a leather belt with a sewing needles.

Traditional Chinese Acupuncture was know to be highly effective at muscular and ligamentous type medical problems but the myth was a mystery to modern doctors had not incorporated it into routine care. TC Acupuncture is a powerful therapeutic modality but somehow it is lost due to the ancient  foreign language and tradition.

Fortunately for us, C. Chan Gunn, MD who studied TCA uncovered an article published in the 30’s that sheds light on  the ancient discipline. This article noted that a muscle could be stimulated to twitch with a stainless steel probe.  Gunn used this idea to offers a parallel theory of “Traditional Acupuncture.”  Gunn uses the tool or acupuncture needles to unlock these TPs. He called his technique Intramuscular Stimulation or IMS. He stated in his textbook the differences in IMS and traditional acupuncture as: 1. IMS requires a medical diagnosis. 2. A medical examination is imperative. 3. The placement of the needles is indicated by the examination. 4. Knowledge of modern anatomy is essential. 5. An immediate positive change in the subjective and objective finding is expected.
 
Gunn’s philosophy went beyond  traditional acupuncture for a new vision of what was truly happening within the muscle tissues. Gunn believed that using the acupuncture needles in IMS created the following benefits:
1. Inserting the thin flexible solid stainless steel needle  into the skin and muscle caused microscopic tissue injury. That injury triggered a healing cascade of repair which repaired the tissue injury and  any local secondary injury. Muscle stem cells proliferate to restore muscle health and power.
2. The stainless steel needle, once it entered the muscle, triggered a muscular re-polarization creating a  muscle twitch. After the twitch, the muscle would  relax. The relaxed muscle would be  a little longer,  less tense and tight. Better able to fit and correctly realign a joint.
Gunn’s IMS is a powerful technique that allows one the freedom to use the needles in places that were disregarded by all other authors. and wisdom of Gunn is at the core of all successful needle myofascial therapy. The down side of Gunn is that it is time consuming, labor intensive and for some patients can be painful and intolerable.  

Janet G. Travell, MD, who’s worked extensively  on Myofascial Pain Therapy, was an orthopedic doctor in the 1950s-60s. She realized that focused therapy at the joints was less successful that focusing the therapy on the muscles. Many physicians saw musculoskeletal pain issues as originating in joints or static structures; she understood that many of these pain and disability issues originated in the muscles. She also discovered that treating the muscles would also alleviate a lot of movement disorders and pain syndromes. She noted that if the muscles were treated then the ligaments, nerves and circulatory dysfunctions would naturally resolve. She called her therapy  Trigger Point Injections.

Travell, MD injected lidocaine into a trigger before activating the release which is less painful, but take even more time that Gunn. In the world of Travell you compliment the trigger points with some hands-on therapy. Still both of these authors techniques can be painful so a lot of patient would simply suffer with the pain than the injections.

These intensely miserable patient had nowhere to turn until Edward S. Rachlin, MD. modified both techniques. Rachlin, MD. is an orthopedic surgeon who has written  a text on Myofascial pain issues. He was able to see the benefits of the disciplines proposed by Gunn and Travell and blend them into an integrated package. His therapeutic package  is also focused on the muscular trigger points. The Rachlin injection procedure does not require the twitching-response as Gunn/Travell taught in schools of MRT. Plus Rachlin would perform a pre-trigger point anesthesia injections to soothe the trigger before the release. Much less pain and much more tolerable to already depleted miserable patients.
During this evolution of myofascial release therapy a provider focused his injections at the junction between the tendon/ligaments and the bone. This procedure is now called Prolotherapy introduced by George Hackett, MD. His contribution is now global and in essence, it too involves injections and needles, but the focus is on the tendons and ligaments. I contend that this is a valid procedure just as the others but due to some misunderstanding due to the substance being injected. A very mild caustic agent is injected in an attempt to stimulate fibroblastic cell to renew and thicken thus strengthening the joint.
In  15 years of treating complex pain in my patients I have used these therapies extensively. With all these options, all  patients can receive the  benefits of less pain and misery.  Each patient’s overall well being and the fortitude determine whether the  necessary work can  be completed in one visit. In others, the pain tolerance is a limiting factor and may require a series of visits.
I believe, MRT can revolutionize our healthcare system. MRT is already in use today in regular physical therapy, massage therapy, sports medicine and in chiropractic medicine. It can become the treatment of choice for hundreds of medical ailments.  Medical Benefits of MRT:

• Remarkably effective
• Can decrease the need for back, knee, or hip surgery
• Can decrease the need for some medications
• Can eliminate the need for medications in some ailments
• It has minimal side effects
• No drug interactions
• No contraindications
• Few precautions
• Help contain the rising cost of healthcare.
• Simplify care so these procedure can be put into the hands of NP. PA. PT and even the patients themselves. Sort of like a DIY needle therapy at home.
• Empowering patient to help in their own care.

Disadvantages:
The downside of MRT is that it is time consuming, labor intensive, can be painful and requires a team of additional helpers to  assist the patients and the administer the wellness program. As with most medical illnesses preventive care is valued and early therapy can  avert some of the intensity. But nothing that could not be dealt with in the global scheme of medical care.

Recommended reading on  pain therapy:Gunn Approach to the Treatment of Chronic Pain: Intramuscular Stimulation for Myofascial Pain of Radiculopathy Origin, C. Chan Gunn MD, PhD Click to order on Amazon
Travell & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual (2-Volume Set) David G. Simons, MD Janet G. Travell, MD Click to Order on Amazon
Myofascial Pain and Fibromyalgia: Trigger Point Management Edward S. Rachlin, MD Click to order on Amazon
Ligament and Tendon Relaxation (Skeletal Disability: Treated By Prolotherapy) George S. Hackett, MDAcupuncture Energetics: A Clinical Approach for Physicians [Hardcover] Joseph M. Helms (Author) Click to Order on Amazon