Acute Traumatic Myofascitis
Acute traumatic myofascitis is a very painful condition that can affect any area of the body. The most prevalent area affected is the area over the shoulder blade (scapula). This muscle pain syndrome will affect almost everyone at one time or another. Very often this condition will be misdiagnosed as being related to arthritis. Acute traumatic myofascitis is not due to arthritis and is a myalgia, meaning muscle pain.
Very often the trauma causing a myofascitis can be of such a minimal degree that it can be unrecognized at the time of occurrence. At other times the individual will be quite aware of it happening due to the severity of the trauma. The occurring pain can be on a scale of 1 to 10, from slight to severe, again depending on the trauma sustained.
The pain can start on the low number of the scale and if left unattended, it can become more painful as time goes on. The longer the pain exits, inflammation and possible swelling and redness of the tissues will become a serious factor in the condition. Inflammation is the body’s response to tissue damage. There is also a very good chance that at this stage the condition can become chronic. As this develops into the chronic stage, treating the condition becomes more difficult and can take longer to resolve.
Several areas of the body can be affected at the same time. Should this occur, the condition might be diagnosed as polymyositis, an inflammation of many muscles? In the older patient it is often called polymyalgia rheumatica. Muscles are covered by sheets of tissue, and is called fascia, a fibrous tissue. The fascia facilitates the movement of the muscles between other structures. When the inflammation occurs in the fascia it is called fibrositis. An injury can occur affecting only the fascia and not the muscle itself. An injury or damage to the fascia will impact the movement of the underlying muscle. There are many types of injuries that can cause an acute traumatic myofascitis. There are several ways these injuries can occur. An example would be pushing an object, pulling an object, reaching above your head for something, lifting a package (no matter how light), or even a whiplash injury. Household chores, gardening, etc. can also be a source of getting injured. Occupations where repetitive actions are necessary are fertile ground for injuries to muscles.
When an injury occurs, a “knot” forms in the muscle itself. This knot is called a “trigger point”. A trigger point can cause pain, not only at the injured site, but can also send a radiating pain to points emanating far from the site that was injured. A pain caused by a trigger point in the area of the shoulder blade (scapula), top of the shoulder or upper arm, can cause pains radiating into the chest. Very often these pains have been mistaken for heart problems and even a possible heart attack. Trigger points can also be caused by poor posture, lack of exercise, repetitive motion injuries and even poor nutrition.
As previously mentioned, inflammation is natures first step to the healing process. When this occurs, there is a proliferation of certain cells called “fibroblasts” that act as patches to the injured muscle fibers, much like a patch on a leaking tire tube. These patches result in the formation of scar tissue and adhesions, causing the loss of flexibility of normal muscle tissue. As the healing process progresses, the muscle will lose its full range of motion because of the scar tissue formation and adhesions.
Treatment at the earliest stages of an injury is extremely important so that prevention of the scar tissues and adhesions will be lessened or completely prevented. It is therefore advisable to see your healthcare provider as soon as possible. The longer the condition is left unattended, the greater the possibility of extensive scar tissue and adhesions forming, and a greater loss of normal range of motion. At this stage, more extensive treatment will become necessary to restore normalcy. Treatments by the healthcare provider, may consist of several types of treatment such as, electric muscle stimulation (EMS), ultrasound (US), and massage therapy. If the injury occurred within a 48-hour period, cold packs or ice massage may also be used. If, after the 48-hour period, heat packs (preferably moist) can be used. The healthcare provider will also instruct the patient on stretching exercises to help prevent loss of range of motion and restore normal range of motion.
The individual must also take an active role immediately after an injury and at the onset of pain. Here too, they should use ice packs, or they can even apply ice massage to the injured area. This should be applied for 15 to 20 minutes on and an hour off, several times daily. After the 48-hour period they should use heat, preferably moist heat, applied 20 to 30 minutes, several times daily. From the onset of injury the patient should also use a good analgesic gel applied 3 to 4 times daily. This will prove very soothing and help relieve pain. It also increases circulation to the injured area, helping the healing process to begin.
As the pain lessens, stretching exercises can be started, slowly at first and gradually increased as pain tolerance permits. The bottom line is that when an injury occurs, it should not be ignored. First see your healthcare provider to have it examined and evaluated. If they do not feel they have to take an active role in treating the injury, then the patient should definitely follow through by treating the condition as mentioned above. Many individuals will just take an attitude that in time it will just go away. True, the pain may lessen as time goes on, but there will definitely be remaining scar tissue and adhesions left to some degree. Most of this is preventable by devoting a little time to your own care.