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In my own hands

May 26, 2009

I’m reading a very important book, The Trigger Point Therapy Workbook, by Clair Davies. Mr. Davies’s book was recommended in Kimberly Patch’s article, “Advice from planet RSI: how to get better.” You can read this helpful article at Ms. Patch’s website, Sorry, but I’m unable to produce hyperlinks using voice recognition software. WordPress’s interface just doesn’t do it. The book is very important because right now, I’m on my own to find whatever relief I can for a severely painful repetitive strain injury. It’s incredible that such a seemingly simple thing produces migraine-level pain in my wrists, arms, and elbows, and seems to have its origin in my neck. The only relief I have enjoyed since the onset of the pain that at times has reduced me to sobs, has been to see Star Trek and Wolverine, and road trips. Our Audi seats are the most comfortable seating I have anywhere. Monday we headed to the White River and took a few walks on soft ground. Proper, supportive seating, soft ground in beautiful scenery, and high-tech big-screen distraction are inestimable boons.

My doctor originally assigned to me to an occupational therapist who is a hand specialist. I found my first two visits somewhat helpful. However, she was uncomfortable with the diagnosis under which I was sent, because she does not work with neck issues. My doctor diagnosed me with a cervical radiculopathy despite a negative EMG. With my doctor’s permission, the OT sent me on to a physical therapist. The PT will work on neck issues but is not a hand specialist. Worse, I cannot get in into see the PT for two weeks. This presents something of a setback. I decided I would need to take things into my own hands in the interim and began reading Mr. Davies’s book.

So far, every trigger point and its referred pain pattern that I have covered in the book are consistent with symptoms I have. This does not surprise me. I would not readily identify myself as one of the least tense people in existence, and I’ve no doubt that my muscles and trigger points bear testimony to a lifetime of tension, injury, crummy work habits, lousy chairs, and splinting against the pain of fibromyalgia and other pain resulting from all of the above.

I harbor no great white hope that depressing some flaring trigger points even daily for a few minutes will soon liberate me from a lifetime of earned consequences. It probably took years of repetitive strain to culminate in so painful a chronic repetitive strain injury. Of course our sternocleidomastoid muscles are perfectly designed to help us turn our necks. Life presents countless occasions to turn our necks. However, we are not supposed to keep them turned and static indefinitely. That leads to chronic contractures that develop into trigger points.

Trigger points are amazing phenomena. It is not hard to find them on ourselves; the difficult thing comes in understanding the pathways of referred pain. Simply attacking a trigger point that seems to be causing throbbing pain may do nothing. That is because a different trigger point is referring the pain to the point that hurts, and it is the referring trigger point that must be treated to bring about relief.

The groundwork for trigger points and referred pain was laid by Drs. Janet G. Travell and David G. Simons (both MDs; Dr. Travell was President Kennedy’s White House physician), and is recorded in their exhaustive work, Myofascial Pain and Dysfunction: the Trigger Point Manual (1999). The book summarizes more than 40 years’ research. I’m finding Mr. Davies’s book so far to be an interesting and fairly easy-to-follow summation of trigger points and referred pain.

Despite having studied, years ago, the anatomy and chemistry of muscle contracture, and proper compensatory movements to help prevent chronic injury, I have to admit ready reversion to sloppy and destructive use of my muscles. We’re talking a lot of overuse and bad use: I’ve been typing since I was seven. My parents gave me a typewriter when I was seven because my handwriting was so terrible. I couldn’t even print legibly. In teaching me how to type, my mother’s emphasis was on getting the keys right and learning to touch type correctly; nothing was said of how to use my neck, my shoulders, and my hands properly to avoid injury. No one in those days had ever heard of a typing injury. As kids we survived swordfights using construction debris as weapons, and falling out of trees: who was afraid of typewriters? No one, until computers came along to make life easier.

I bought a TheraCane for gently punching out trigger points about four years ago, but didn’t find it consistently helpful because I didn’t understand the mechanisms of referred pain. I simply attacked the points that hurt. However, sometimes it was helpful because the points that were hurting were also referring pain elsewhere. Mr. Davies has systematized referred pain in his book and now I am finding my TheraCane very useful. It wracks my hands to grasp the TheraCane for very long, but I’m learning to use my hands to balance the TheraCane, rather than grasping it.

It tires my hands and elbows to use the TheraCane very much, but at least with practice at locating trigger points and study of Mr. Davies’s book, I will be able to communicate with the therapist when I finally see her. I hope she will prove familiar with myofascial massage and trigger point therapy. Kimberly Patch attributes her recovery to both techniques; however like many other people with chronic RSIs, she has sworn off typing for good and relies entirely on voice recognition software for computer work. I would be satisfied with that and the ability to cook and play croquet without extreme pain.

  1. May 26, 2009 4:55 pm

    Dear Lauren, I’m so glad that you have received some help and encouragement in the healing process with this book. What a gift God gives to the world in people who study and write about these things to help us. I pray that your therapist knows these techniques (or will read the book too!).

    Wearing pain does have a very debilitating effect on every aspect of our being. You’re soldiering on well, dear friend. I don’t know what to do in this regard but send a (very gentle) hug.

    I asked my mom what helped her when she had an injury that hurt her similarly (she couldn’t brush her hair or pick up a teacup etc) though hers was much shorter lived and I’m sure, less complicated. She got a massage and kept slathering the areas in Arnica gel. I read a few studies and Arnica Gel is used in RSI and is medically as effective as something called ‘ibuprofen gel’ for pain management. I don’t know if it would help and knowing you, you probably already know about it; but I’d hate to not pass along something that *might* bring any degree of relief. (No need to reply to this one way or another, of course!)

    With much love and many thoughts of you this evening.

  2. May 26, 2009 5:49 pm

    Heidi, I appreciate this. I have some aspirin cream that has been completely useless for pain that I’m using up as hand lotion. I think arnica would be much better; I remember it being helpful for something in the past. I suspect that complexity is largely iatrogenic :-)

  3. Laura permalink
    May 26, 2009 7:00 pm

    Dear Lauren, I hope the book proves to be every bit as helpful to you as it was for Kimberly. It’s good that you have her experience as a resource; I pray you may be able to relate your successful therapy experiences very soon as well.

    The photo of the river (? I presume) is lovely. I’m glad you were able to take a relaxing road trip yesterday.

  4. May 26, 2009 7:11 pm

    I later learned how to caption a photo in WordPress, but it was all I could do to upload this. It is indeed the White River, near Greenwater, in Federation Forest State Park. Thank you for your kindness and support, Laura; I hope that trigger point therapy will prove restorative.

  5. Jane permalink
    May 28, 2009 8:18 am

    I often remember Pastor saying that ‘God uses means’. Of course this is abundantly clear in our pain issues; we must give thanks for the medical people and fellow sufferers who write books such as the one you just found. I’m so glad, Lauren; I pray for you daily and undoubtedly this is another ‘hook to hang our prayers on’, to quote a friend from the past. I’m also so thankful that you were able to take that road trip, as well! You are a valiant trooper. You encourage me on the Lord’s Day by simply being there (and thanks for the hug last Sunday!)

    Love, Jane

  6. May 28, 2009 8:50 am

    We need to talk, Amiga. This book has things for you, too. :-)

  7. Jane permalink
    May 28, 2009 4:21 pm

    Oooo…I’m interested! Talk to you Sunday!

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