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Myofascial release as trigger
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Master
posted
Okay I've got a new weird one to solicit opinions on. Since my car accident in June, twice I've had PT people do myofascial release work on my neck/shoulder. It mostly seems to consist of squeezing various area on my trapezius and side of neck. The first time the pain was so bad to shot from my temple all the way out to my pinky and within an hour I had a migraine so bad half my face was numb and I had pins and needles out my arms. It lasted 18+ hrs and I even contemplated a ER visit ( I loathe the ER Roll Eyes)

Yesterday was slightly different.( different PT person too) The initial pain was much milder but within hrs I had a muscle cramp that ran from the base of my skull, down the side of my neck and out about halfway down my tricep. Think "charley horse in your trapezius". I tried heat and liniment and rubbing it and skelaxin and the pain just kept building until the whole "nausea/prodrome" mess started tipping straight into a migraine and I gave up and took pain meds.

My thought is to tell the PT people I will do their exercises but I'm not letting anybody lay a finger on me, because I can't afford to waste hrs/days of my life fighting the migraines they caused.

Here's another weird piece to the puzzle - the lady I go to for clinical massage work can absolutely squeeze and grind and put half her body weight into squashing her elbow into my knotted muscles and at most I get a few moments of discomfort. No migraine.

Anybody have a thought on a game plan? Solution? Something?


Amy
 
Posts: 360 | Location: Virginia | Registered: 06-22-2009Report This Post
<Nancy Harris Bonk>
posted
Hi Amy,

While I don't have any solutions for you, I do have some thoughts! The first one is if it hurts, don't do it!! Big Grin

But seriously, if a certain type of therapy is not helping, but increasing and aggravating your Migraine pain, that doesn't sound like a good thing. On the other hand if gentle massage helps, I'd go with that. None of these things will "cure" Migraine, as you know, but may help make pain more tolerable.

Having been to a quite a few different PT, sometimes they "have" to try things to see where our pain and muscle injury is. One of my PT's said she wasn't out to increase my head pain, rather help my neck issues. After I got t-boned a year and a half ago, my neck pain shot back up to a daily 8 and I wasn't having any of that. We got it back down to 3 ish, which is still not great, but better than an 8.

I guess it's about goals, and what we can tolerate......I think.
 
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Master
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Hi Amy!

Your experience reminds me of the issues I encountered when I was using chiropractic care in an attempt to reduce my daily migraine pain. One of the chiros specialized in cranio-sacral therapy. Basically, she spent a lot of time adjusting my head position, neck, and jaw. The result for me? Utter agony! I would go to the office in low pain and leave in misery. The nausea hit before I could get out of the office, and I was throwing up as I hit the car. It was an awful thing, and I'll never try it again--ever!

As Nancy said, if the treatment is triggering you, then it's probably not the best intervention for you. Be honest with your PTs and they should adjust your treatment plan accordingly. Healthcare is so frustrating--so much trial-and-error!!

Please check back and let us know how things go!


JennyC
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Posts: 354 | Location: PA | Registered: 04-02-2011Report This Post
Master
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The P T is actually supposed to be for my torn rotator cuff (legacy of that stupid car accident back in June) Appt #2 was today. He started pushing on my shoulder blade and it felt like toss up as to whether I was going to pass out or vomit. 2 hrs later I feel kind of prodrome-ish and the shoulder.... geez feels like someone filled it full of lava. Crying I really really want pain meds but I'm afraid to take them now because I suspect I'm going to need them later for the migraine.


Amy
 
Posts: 360 | Location: Virginia | Registered: 06-22-2009Report This Post
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My guess is that during the release, the PT is either hitting just the right spot to physically trigger you, or is stirring up something that is leading you to trigger, such as built up toxins. I'm also guessing that the massage therapist isn't hitting just the right spot in a way that triggers you. I wonder if it has much more to do with hitting a certain spot than it does with the intensity of the treatment. That might explain why the intensive massage isn't triggering you.

I once went to a chiropractor that used the twisting and popping kinds of manipulations. He was gentle, but his methods resulted in screaming migraines for me. His approach wasn't for me at all. My chiropractor I see now has a whole different approach, without twisting and popping. She can ratchet up the intensity without triggering me. Sometimes it's just a matter of a technique itself being jarring and not a good fit, and has nothing at all to do with how intense the treatment is.

I'm sorry that I don't have solutions for you. It sounds like the second PT didn't trigger you quite as badly. That seems to suggest that there's potential for finding someone with a personal approach to technique that might work out without triggering you, and that myofascial release might not be bad news for you no matter how you slice it. The only problem with that is having to potentially audition several practitioners until you find the right fit. And only you can decide it you can or even want to go there and deal with the fallout from each audition.



Dragondrool
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Posts: 6478 | Location: Montana | Registered: 01-11-2007Report This Post
<Nancy Harris Bonk>
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Hi Droolie,

Would you do me a favor when you get a moment? Ask your chiropractor what method she is using? McKenzie is the only one I know about, but I'd love to hear the name without the "twisting and popping chiros are famed for.

Thank you kindly
 
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I shall try and remember to ask her when I see her on the 10th. (I think that's when my next appointment is!)

I can tell you she uses an electric impulse gadget to nudge things right. It is similar to an actuator, only it's electric and repeating. She also uses a drop table, and some physical traction-type manipulation. She finishes up each session with the electric massager and the option to use the rolly table.



Dragondrool
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Posts: 6478 | Location: Montana | Registered: 01-11-2007Report This Post
Master
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PT trip number 3. I didn't even make it half way home before the eye pain started creeping in. I don't know what to do Frowner I can't afford to sacrifice two days a week to being incapacitated.


Amy
 
Posts: 360 | Location: Virginia | Registered: 06-22-2009Report This Post
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Dagnabbit, anyway! Did you mention to the PT your issues with triggering? He or she might have some suggestions.



Dragondrool
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Posts: 6478 | Location: Montana | Registered: 01-11-2007Report This Post
Master
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Yes, I said something about it. The PT guy didn't seem to have a clue. The only thing he did different was to NOT squeeze my shoulder. My body never ever reacts the way medical people think it should. I don't know what to do. I don't really want to go back at all. It's not just the migraines either. The pain is so much worse in my shoulder and scapula. Every time I go the pain gets worse. Crying I feel such an utter wimp, but I just can't handle this.


Amy
 
Posts: 360 | Location: Virginia | Registered: 06-22-2009Report This Post
Apprentice
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Amy,

Honestly, you're not a wimp. Your PT should not be triggering worse pain than you began with! I'd go back to my doctor if I were you and let him/her know the PT is making things worse and triggering migraines too. Have they done any scans of your shoulder? It could be the injury is worse than originally suspected.

I say this because similar things happened to both my husband and brother-in-law.

My husband was referred to PT because he had pain in his neck that the doctor told him was muscular in origin. He went to PT as ordered and did all the exercises they gave him every day, but he was in excruciating pain the whole time. Finally he went back to his doctor and told him the PT was not helping, so the doc ordered an MRI and found out my husband had a severely herniated disc. He ended up having neck surgery to remove the disc and fuse the vertebra on either side.

In my b-i-l's case, he also tore his rotator cuff (moving an appliance) and was also sent to PT. Again, he ended up in agony after every visit. Eventually he went back to the doctor in worse pain than when he began. He's another one who ended up in surgery to repair the badly torn cuff and remove bone spurs that were complicating the picture.

I'm not trying to scare you, but your doctor won't know what is happening unless you tell him/her.
 
Posts: 227 | Location: LA County, California | Registered: 02-25-2009Report This Post
Apprentice
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I have had that experience even with just massage therapists. I am "out of alignment" (according to my MT) in my neck (a big lump appears every once in a while and really keeps me in pain and with migraines) and the massage therapist keeps telling me I need to see the chiro.

Over the years I've seen 3 different chiros, tried accupuncture, PT, yoga, heat and ice and live with Thermacare sticking out the top of my shirt. But I can tell you that nothing makes it better, the massage therapist I've been seeing for about 10 yrs is the best and the others I've tried off and on at 2 other places can make or break a day for me. Right now I'm on edge to see my regular one again b/c she "worked" my neck last time and gave me a big migraine b/c I told her I'm not keen on seeing a chiro right now. I want to wait until I see the neuro next week and ask her about it b/c it's been 2 years and I just want another opinion. I started with her partner who got me in to see the PT. I know the chiros have new, easier technology but I don't want to waste my money or time - though my back hurts daily too... But I love my regular MT best b/c she asks what I want and need before each visit and doesn't charge different prices b/c I only need work on my "top" (ie no legs) like some places in town. (They call that a stress busters and charge $15 extra!)

But I think the key is really to find what works and who works best. I had that electrical stim done years ago -15+ - for a midback problem by a PT and it helped tremendously. I asked this PT about it for my neck and I guess they didn't think it would help. They used heat and ice at the beginning and end- otherwise it was basically babysitting me while I did exercises on my dime....

Good luck, it's a shame we leave and feel as though we've wasted our time by getting sicker after we leave than when we went in. I have so many days I need a massage. I just read 10 minutes every day would benefit everyone. Ahhhhh... If only...
 
Posts: 194 | Location: VA | Registered: 01-31-2008Report This Post
Master
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I have had 2 MRI's since the accident, one for neck and one for shoulder. The neck one revealed bulging disks ( that everyone I've been to claims are irrelevant because they aren't ruptured) and a 50 % tear of the supraspinatus tendon ( aka one of the rotator cuff pieces). The PT is SUPPOSED TO be helping with the rotator cuff tear (I had PRP done on that a month ago)

I suspect, with no way to prove it, that the weird neck stretchy-neck squeezy thing the PT make me do, is the biggest piece of the migraine trigger. I have been taking skelaxin at night for a couple years now to calm/control the neck part of my migraines.


Amy
 
Posts: 360 | Location: Virginia | Registered: 06-22-2009Report This Post
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I'm with you. I don't see how bulging discs are necessarily irrelevant. They could be impinging nerves, and the resulting irritation could very well be triggering you. If the neck stretchy-squeezy bit is further irritating things, it could easily be a big part of the issue. I think that sounds logical and rather straightforward to me, anyhoo.

You are soooooooo not a wimp, so take that idea right back! You're doing the best you can to try and help the situation, trying therapeutic options with an open mind and a pocket full of hope. That's all anyone could ask of you. It shows incredible strength to go through what you have and to try again.

I shall keep rooting my heart out for you. Group Hug



Dragondrool
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~~8=:>>>>
 
Posts: 6478 | Location: Montana | Registered: 01-11-2007Report This Post
Master
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I talked to my neurologist and he suggested that I try taking pain meds / migriane meds before I go to PT. Now I have to wait on another appt with the ortho to see if this is a viable option. And of course there's no guarantee it will work Frowner


Amy
 
Posts: 360 | Location: Virginia | Registered: 06-22-2009Report This Post
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