Myofascial Pain masquerading as Neuropathic Pain

Special Featured Article

This week our featured article comes from one of our club members, Colin Waldock, PT. He has graciously volunteered to have his latest work be the topic of discussion for this week!

In this case study, learn more about myofascial pain and how it can present in different ways when treating patients.  Also, be sure to leave your feedback in a comment below and get answers to your questions directly from the author!

 

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Lets Get Talking!

In order to increase discussion on this weeks article, we have decided to forego the survey and leave you with more open ended questions that can be discussed in the comments below.  As you read the article, consider these points and don’t forget to share your thoughts!

  1. How would you rate the article overall on a 1-5 scale?
  2. Do you consider dry needling as an option when treating patients with neuropathic pain?
  3. Has this article caused you to reconsider your treatment approach with this population?

Thanks again Dr. Waldock for sharing your article with our group!

 

4 Comments

  1. Kyle A. says:

    I liked this article and congrats on getting published! I have a question about how exactly you began to question if the pain was myofascial? It looks like in the exam the only thing you found to be remarkable was some trigger points? Is that what led you in that direction? Also, how is the patient doing now?

  2. Colin J Waldock says:

    Hi Kyle. What initially led me to question the diagnosis of neuropathic involvement was the lack of benefit that gabapentin was offering the patient, and I was aware of the capacity of trigger points in infraspinatus to mimick nerve root radiation. When I therefore palpated the infraspinatus muscle and most importantly reproduced the patients presenting pain, I made the decision that it was likely that the pain was myofascial.

    As far as I know the patient is doing well, though I can’t confirm that he hasn’t gone to see someone else with another issue of course.

  3. Joe Schroeder says:

    Hi Colin, First of all thanks for your work to advance the profession as a research contributor. I like the article, and it is well written and cited. I currently am not trained in the use of Dry Needling, so it was a great case study for me to read how you applied this technique. Did you only see this patient for three visits, Evaluation plus to more visits?

    • colinwaldock says:

      Joe, thank you for your kind comments. Yes I only saw this chap for 3 visits. I guess my average with patients is 3-4 visits, exceptions to that rule are people who present with true chronic pain syndromes, where they need a more co-ordinated multidisciplinary approach. Essentially I was probably a tad lucky really with someone whose pain seemed to be wholly myofascial rather than mixed mechanism in origin. The key as far as I am concerned is in the accurate diagnosis then applying appropriate treatment. If you get the chance to train in dry needling I would jump at the chance, the technique itself is easy peasy :)

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