5 s t e p s - muscle pain solutions · i want to thank you for downloading my ebook 5 simple steps...

5 S T E P S t o F r e e d o m f r o m D e b i l i t a t i n g B a c k P a i n P a g e | 2

©2012 Mary X. Psaromatis, DC

www.MusclePainSolutions.com

5 STEPS to Freedom

from Debilitating Back Pain

No drugs, no surgery, no kidding!

The NATURAL way to long-term pain relief

I've been there... Let me show you the way out of pain!

- Mary X. Psaromatis, DC

Chiropractic Physician




Muscle Pain Solutions

Copyright & Disclaimer

© Copyright 2012 Mary X. Psaromatis, DC. All rights reserved.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by

any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted

under section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission

of the Author. Requests to the Author for permission should be addressed to

[email protected] or on the web at www.MusclePainSolutions.com.

The information and reference materials contained here are intended solely for the general information of the

reader. It is not to be used for treatment purposes, but rather for discussion with the patient's own physician.

The information presented here is not intended to diagnose health problems or to take the place of

professional medical care. The information contained herein is neither intended to dictate what constitutes

reasonable, appropriate or best care for any given health issue, nor is it intended to be used as a substitute for

the independent judgment of a physician for any given health issue. All content, including text, graphics,

images and information, contained on or available through this book and related web site is for general

information purposes only. The major limitation of informational resources like this book is the inability to

take into account the unique circumstances that define the health issues of the patient. If you have persistent

health problems or if you have further questions, please consult your health care provider.

The information provided in this document is not to be considered medical advice and is not intended to

replace consultation with a qualified medical professional. The Author's goal is to provide sufficient

information so that readers are able to become knowledgeable participants in their pain management plan.

The primary responsibility of your pain management plan is with your treating physicians and you should only

follow your treating physicians advice. DO NOT change/modify your pain management plan on your own

without consulting your treating physicians.

The user assumes all responsibility and risk for the use of this book. Under no circumstances shall

MusclePainSolutions.com or its contributors or its affiliated organizations or anyone else involved in creating

this book or affiliated website be liable for any DIRECT, INDIRECT, INCIDENTAL, SPECIAL or CONSEQUENTIAL

DAMAGES, or LOST PROFITS that result directly or indirectly from the use or inability to use this book, that

result directly or indirectly from mistakes, omissions, errors, etc. In states which do not allow some or all of

the above limitations of liability, liability shall be limited to the greatest extent allowed by law.

Cover Photo © Fotosearch.com Stock Photography




Table of Contents

Introduction p. 5

Welcome!

A. Muscles: The Forgotten Organ

B. Danger Signs

C. STEPS Overview

D. Narrow it down for me!

Muscle Pain Questionnaire

E. Add it up

F. Calling all pain sufferers - Water and Sleep!

Stress p. 17

A. Stress: Can you cure it?

B. Meridian Tapping

Trigger Points p. 19

A. Trigger Points: A little anatomy lesson

B. Treating Tricky Trigger Points

C. Where are they?

Exercise p. 24

A. Purpose of Exercise

B. Recurrent Back Pain Episodes

C. How to Sit Properly

D. Seated Pelvic Tilts

Posture p. 26

A. Was Your Grandma Right?

B. Ways to improve posture by "letting go"

Supplements p. 28

A. Supplements for Muscle Pain

B. Supplemental Information




S -Stress

T - Trigger Points

E - Exercise

P - Posture

S - Supplements

Welcome!

I want to thank you for downloading my ebook 5 Simple STEPS to Eliminating Low Back Pain,

and taking your first step toward living a happier, healthier, and pain free life.

I am excited to share with you what has taken me 20 years of trial and error, hundreds of

books, and thousands of dollars to learn myself. I strongly believe that this information

should be available to everyone, but especially to you, who are hardworking, dedicated, and

willing to take the steps to take care of yourself.

I know you don't have a lot of time, so this book will cut away everything you don't need, and

give you the essentials in a usable format... so you can start implementing the STEPS today!

Here's what I know about you

You are in pain and have been for months, even years.

You are sick of taking over-the-counter medications and pain meds.

You are stressed out by life and your pain.

You have sought advice about how to get out of pain, but it hasn't worked for you.

You are ready to get to the root of the problem.

What can I do for you?

Like you, I have experienced years of pain... I had my first

debilitating low back pain episode in middle school. I couldn't even

walk to the bathroom! So many episodes of different types of pain,

while my friends around me had no idea what I was going through.

I started studying how to get out of pain in high school. I went on to

physical therapy school, and chiropractic school. Added more stress

to my body with a bunch of kids and responsibilities. Found some

answers on the way, but much of what I learned was from

constantly reading, and trying things on myself and my patients.

I finally found a series of STEPS that I use with my patients.

And now I want to share them with you!




A. Muscles: The Forgotten Organ

[Trigger points]... a neglected, major cause of pain and dysfunction

in the largest organ of the body (muscular system).

- Janet Travell, MD

Muscle is an orphan organ. No medical specialty claims it.

- David Simmons, MD Co-author with Dr. Travell

Dr. Janet Travell was a pretty cool woman. I would have loved to

have known her. She became a medical doctor at a time when it was

a man's world. They didn't know what to do with her, so they gave

her the problem cases... the heart patients that still had heart pain,

but no lab signs of heart problems!

What I love about this, is that she figured out the problem... they

had trigger points in their chest muscles that had been created by

the chest pain from their heart issues, but persisted after the heart

pain ended. These were essentially knots in the muscle that could

create referred pain both close to the trigger point and farther away

on the body. She ended up documenting this, and then proceeded to find trigger points in

muscles all over the body, and then write and teach about it extensively.

...So why are muscles a problem?

Because no profession has really claimed them as their own and mastered trigger points.

Many people talk about them, and individual practitioners have learned on their own, but

there is not one profession that really knows them.

How does this affect you?

Trigger points are most likely your main pain generator!

According to Dr. Travell, the main pain generator of 80% of patients in chronic pain clinics is

from trigger points, and the other patients have some contribution to their pain from trigger

points. These patients are the ones that have not found relief, despite going to multiple

practitioners.

The rest of this guide will help you find what is contributing to causing your muscles to

tighten up and get trigger points in the first place, and what to do once you have them.




But first... let's eliminate danger.

B. Danger Signs

I have to give you the usual disclaimer that this information is not intended to diagnose,

treat, or cure any illness. (See full disclaimer on the first page.) If you have already been

cleared by a health professional, you can skip to the next section.

Since I know most of you will ignore the disclaimer, I want be very specific here. Before you

start working on yourself, there are a few signs you should look out for, so you don't hurt

yourself.

Loss of bowel and/or bladder control - This is an emergency situation: your spinal

cord could be pinched. You need to go immediately to the emergency room.

Numbness, tingling, or weakness not due to pain into your legs - This can mean that

there is nerve impingement. Seek medical advice.

New, severe, cramping pain along one side of your low back in the flank area - near

the bottom of your rib cage - This can be a kidney stone. Seek medical immediate

attention

Personal History of Cancer - You need to check with doctor that you are ok to work on

your muscles and that it hasn't come back.

Unintentional Weight-loss - Seek Medical advice: this could be related to a systemic

illness or cancer.

Trauma - If you pain is following a significant trauma, such as a fall or car accident, you

need to make sure that you don't have fracture: Seek immediate attention if you can't

walk, or twist the area of pain.

Infection - If you have a temperature associated with your low back pain, consider the

possibility of an infection, and seek medical attention

Pulsating abdominal mass - This could be an abdominal aortic anurism and should be

evaluated by a medical professional.

Ok, so now that we know you are not in danger, let's get to work!




C. STEPS Overview

These are the 5 major areas that I find need to be addressed to fully eliminate muscle pain. If

the pain is only partly "answered", it tends to come back quickly and with little provocation.

That is not the goal here.

I want you to be empowered to eliminate your pain, and kick it out quickly, if it comes

knocking in the future. We don't have time for pain dragging us down, we got things to do!

tress - This is a huge contributor to pain. It can also cause the formation of trigger points

because it causes you to hold your muscles tightly. You are probably aware of that at

some level, but don't know what to do about it. I have found an amazing tool!

rigger Points - As mentioned above, this is the main pain generator and most of the other

things we talk about here contribute to causing trigger points. It is imperative that you

learn how to get rid of these little buggers.

xercise - Everyone knows exercise is good for your muscles, but there are so many

opinions on how or why. Let me tell you what I have found to actually help with pain!

osture - I am sure you have been told to "fix your posture" before, but I like to think of it

more like using your body well, rather than holding a particular position. This will change

how you move through your life.

upplements - Have wide spread pain? It might be something your body needs. I'll give

you some ideas you can implement yourself.

How do you know where to start?

Let me help you with some questions.

D. Narrow it down for me!

I am going to ask you a series of questions.

I beg you to take the time to answer them... it will give you clarity about what you need to

work on. These are based on questions that I ask my patients.

S

T

E P

S




Muscle Pain Questionnaire

Please be brutally honest with yourself. It is the only way this will work. Try to be open

minded and just write down whatever comes to you. I often find patients resistant to

believing that stress could be behind their pain. Believe me, it doesn't diminish the realness

of the pain, suffering, or injury; But admitting the stress part can help you heal so much

faster. I have seen it time and time again.

Where exactly is your pain? _____________________________________________________

____________________________________________________________________________

When did you experience your pain for the first time? ________________________________

____________________________________________________________________________

What caused it? ______________________________________________________________

____________________________________________________________________________

Was there a time when it got worse? _____________________________________________

____________________________________________________________________________

What kind of pain is it? (aching, burning, sharp etc.) _________________________________

____________________________________________________________________________

How bad would you rate it now? (0-10 if 10 is the most pain you can imagine) ____________

____________________________________________________________________________

What is the worst it ever gets? __________________________________________________

____________________________________________________________________________

What makes it worse? _________________________________________________________

____________________________________________________________________________

What makes it better? _________________________________________________________

____________________________________________________________________________




0 1 2

0 1 2

0 1 2

0 1 2

0 1 2

0 1 2

0 1 2

0 1 2

0 1 2

0 1 2

0 1 2

0 1 2

Total___

Stress

Think about your answers to the above, and please rate each question:

0 - Not True 1 - Somewhat True 2 - Very True

1. Was the experience that caused your pain traumatic, embarrassing, or emotional in

any way? Explain______________________________________________________

2. Was there something stressful going on in your life at the time you FIRST

experienced pain? What happened?__________________________________

3. Were you going through a transition at the time the pain started or got worse?

(marriage, new baby, new job, move, death of family member) What happened?

_____________________________________________________________________

4. Did you experience a loss at the time the pain started or got worse? (money, job,

relationship, death) What happened?________________________________________

5. Did you do something that made you feel guilty at the time the pain started or got

worse (intentional or unintentional)______________________________________

6. When you think about your pain, does a particular person come to mind, such as

"Suzy Snowflake is a pain in the butt..." Who?__________________________________

7. If your pain was an emotion, what would it be? When did you feel this emotion? Is

from a particular situation?______________________________________________

8. Are you stressed out by your pain? What stressed you out?

______________________________________________________________________

9. Are you angry about your pain? What makes you angry?

_______________________________________________________________________

10. Are you depressed by your pain? Why?

_______________________________________________________________________

11. Do you feel like you are unable to participate in life the way you should because of

your pain? What are you missing out on?

_______________________________________________________________________

12. Do you have trouble sleeping because your mind is racing? What do you think

about? _____________________________________________________________




0 1 2

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0 1 2

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Total___

Trigger points



I know how I injured it.

My pain started after I started exercising.

My pain started after I got new shoes, bed, pillows, desk etc.

My pain started after starting a new job.

I can re-create my pain by pushing on it, stretching it, etc.

I can get out of the pain by moving, walking, stretching, etc.

My pain happens in a certain position, every time I am in that position.

I have pain every morning when I wake up.

I get pain after sitting at my desk for a set amount of time eg. 15 min, 1-3 hours etc.

I get the pain when I drive.

I get pain when I lift heavy objects or do house work.

Massage helps for a day or so.




0 1 2

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Posture



I have been told I have bad posture.

I can't hold "good posture" for very long.

I can't sit up in chairs for very long and tend to "squirm" around.

I can't stand for long periods of time.

I have to move around constantly to keep the pain from getting worse.

My head hangs forward in front of my body.

Sitting at my desk for long periods makes me uncomfortable.

Holding any position makes me uncomfortable.

My shoulders roll forward.

Feel constricted in my chest when trying to breath.

I don't breath into my belly, ie my belly doesn't move with my breath.

My usual sleeping position causes me pain.




0 1 2

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Total___

Exercise



I don't have a regular exercise routine.

I feel weak in my back.

I feel like I have weak abdominal muscles.

I feel vulnerable to injury.

I hurt my back very easily.

I am very stiff.

I am rigid in my movements.

I have very strict routines (what kind of movement you perform) and don't vary

them much.

I don't know how to tilt my pelvis.

I don't get up regularly from my desk to move.

I don't do any exercise to stabilize my pelvis.

I don't know how to lift in a way that doesn't hurt my back.




0 1 2

0 1 2

0 1 2

0 1 2

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Total___

Supplements



I have pain in many areas of my body

I have cramps in my legs, feet, or other muscles at night

I have tried trigger point work, but the relief doesn't last

I don't take a magnesium supplement

I don't take a multivitamin.

I don't eat much fruit

I don't eat many vegetables

I don't get 20 minutes of sun exposure per day or take 4-5000 IU of Vitamin D

I get more pain after eating sugar

I get more pain when I eat gluten (products that contain flour such as bread)

I get more pain when I don't drink enough water

I get pain if I increase or decrease my caffeine intake




E. Add it up

Now that you have answered the

questionnaire with complete honesty, let's

take a look at what it means. Add up your

answers and see what you get. I find that

the place people need to work the most, but

don't want to admit, is the contribution to

pain from stress. There is always a

component of stress to your pain. That is

the program default to putting the stress

component first. Your answers that you

wrote above are going to guide you to what

you need to work on with the stress

relieving technique.

Now that you have added it up, if you have

any significant points in the stress section, I

would start there regardless of your other scores. If not, use the order suggested below. You

may or may not need to work through each area. Keep going until you find your solution.

Most points in the Stress category:

1. Stress

2. Trigger Points

3. Exercise

4. Posture

5. Supplements

Most points in the Supplements category:

1. Supplements

2. Stress

3. Trigger Points

4. Exercise

5. Posture

Most points in the Trigger points or

Posture category:

1. Trigger Points

2. Posture

3. Exercise

4. Stress

5. Supplements

Most points in the Exercise category:

I. Exercise

II. Trigger Points

III. Posture

IV. Stress

V. Supplements




F. Calling all pain sufferers - Water and Sleep!

One final note for all pain categories. Anyone in pain should check a few simple basics. Make

sure you are drinking enough water... this is so important I have a whole section devoted to

it on MusclePainSolutions.com. It can even be important for allowing the stress reduction

method to work. (Links to http://www.natural-solutions-for-muscle-pain.com/treatment-of-dehydration.html)

Dehydration - Can contribute to most types of pain and is

free to fix! You should be going to the bathroom frequently,

and the color of your urine should be light yellow to clear.

Just getting properly hydrated doubled my energy and cut

my pain in half.

Most people need:

8-10 glasses water per day

1/2 tsp of sea salt (preferably a non-white salt, such

as Celtic or Redmond's Real Salt)

Sleep Deprivation - This will also increase any existing pain that you have. I know this is really

hard for you new mothers, but do the best you can to get quality sleep. If you have sleep

issues, try the stress exercise on your sleep problem. It has helped many who have sleep

issues.

http://www.natural-solutions-for-muscle-pain.com/treatment-of-dehydration.html




S - Stress

A. Stress: Can you cure it?

Let me start with a story, one that convinced me of the power of what I want you to learn.

Katie's Hip Pain Cure

I had a woman, whom we will call Katie, come to me after a car accident with low back and

neck pain, which were aggravated by her work. The worst of it was hip pain that would wake

Katie up 7-10 times per night ruining her sleep. It made it so difficult for her to work as a

nurse's aide and to play with her young grandkids. We had been working on these problems

for about a month, and the neck and back pain were subsiding, but the hip pain seemed to be

getting worse despite acupuncture, massage, trigger point work, Graston, and chiropractic

treatment!

I am always looking for new and better ways to get people out of pain, so in the middle of

this, I learned about Meridian Tapping. I was skeptical, but I tried it on myself with some

success, so I decided to try it with her.

If I was skeptical, Katie was down-right incredulous, but being out of options, she learned the

technique. In the office we were able to get the pain from an 8/10 to a 2/10 on the pain

scale. I was impressed, but Katie was not. The pain would creep back up over time. And she

wouldn't use it at home because she said she felt ridiculous doing the tapping.

One day she came into my office with a huge smile and big hug, saying, "It worked!" She

looked like a new woman, rested and relaxed!

That week at work, she had been in so much pain she just couldn't keep going. After much

hesitation, she went to the bathroom, feeling ridiculous and tapped. The pain immediately

subsided. She had to do it a few more times through her long day, but every time it subsided

even more. That night she used it and was able to sleep.

Eventually, the pain subsided completely and didn't come back!




I use this story for several reasons:

She didn't believe it could help her

It was a mechanical injury that you wouldn't usually blame on stress

She had "real" reasons for her pain

Nothing else had worked

Moral of the story: You have to try it consistently to know if it can help you!

B. Meridian Tapping

The tool I want to teach you is called

Meridian Tapping, because you will tap

on meridian acupuncture points while

bringing up any possible emotional or

stress connection to the problem.

How does the Tapping work?

This is a technique in which you access negative memories or feelings while tapping on acupuncture points along your meridians. The tapping acts to calm down the amygdala, which is the part of the brain responsible for negative emotions. This area creates a physical stress response with the "fight, flight, or freeze" response.

Learn more about my astounding story! (Links to http://www.natural-solutions-for-muscle-pain.com/the-

tapping-solution.html)

http://www.natural-solutions-for-muscle-pain.com/the-tapping-solution.html




T - Trigger Points

A. Trigger Points: A little anatomy lesson

What are they?

Myofascial trigger points are balled up areas or "knots" in the muscles that create pain.

Everyone has some trigger point to one extent or another. I often find them even on infants,

though they are usually mild and released quickly. However, in some people, they become

extremely painful and debilitating, creating constant or episodic pain. In other people, they

are only tender when pushed, but create stiffness.

How do myofascial trigger points create pain?

A trigger point is like a part of the muscle "stuck" in contraction. The continuous contraction prevents blood flow to that part of the muscle, creating pain. This pain is due to lack of oxygen and a buildup of waste products. Muscle trigger points create pain that can be local (around the area of the trigger point), but more often is referred to distant areas in the body.

Example of Referred Pain

I frequently have patients come in and tell me they have "sciatica". They assume that because they have pain down the back of their leg, that it must be coming from the sciatic nerve. Fortunately, it is usually just a pain referral from the piriformis muscle or the gluteus minimus muscle. These are two muscles that are deep in the buttocks and can be treated with the methods below.

Theory Behind the Referred Pain

It is theorized that the pain signals that a trigger point creates, link in the spinal cord to nerves sending signals from other areas of the body so it "feels" like the pain is coming from somewhere else. They can also create other responses such as muscle twitching, goose bumps, or even nausea and dizziness. The stiffness in the muscles is caused by the fibers with trigger points not being able to lengthen, preventing the rest of the muscle from stretching.

What does a myofascial trigger point look like?

Below, you can see an image that shows a trigger point enlarged. A shows a normal fiber. B shows the shortened balled up area in the trigger point, and C shows the over stretched part of the fiber that creates the shortness and tightness in the muscle as a whole. (Adapted from The Trigger Point Therapy Workbook by Clair Davis). (Links to http://www.natural-solutions-for-muscle-

pain.com/trigger-point-manual.html)

http://www.natural-solutions-for-muscle-pain.com/trigger-point-manual.html




Why do myofascial trigger points form?

It is thought that trigger points form due to a lack of energy in that part of the muscle. This can happen as a result of diminished blood flow, reduced oxygen, or local injury. Since energy is required to make a muscle relax, the lack of energy causes the muscle to get "stuck" in a contraction. The contraction then restricts blood flow, making it even harder for oxygen to get to the area to allow energy production to resume.

How does this happen in your daily life?

Think about when you are sitting at the computer with many muscles in a sustained contraction to hold you still and upright. When you do this repeatedly or for long periods of time, it can create trigger points. What about when you have bad posture? This makes certain muscles have to hold a continuous contraction to keep you upright. Repetitive motion can also create trigger points because the muscles do not have time to rest.

Another mechanism for creating trigger points is trauma... when you damage a muscle, it allows the calcium "storage tanks" in it to leak out. Since calcium is the trigger for contraction in a muscle, this will create a continuous contraction, and create trigger points. Knowing how they form is important in trigger point treatment as well, because you need to stop creating the trigger points with the posture, repetitive motion, and local trauma.




B. Treating Tricky Trigger Points

There are a whole number of ways to treat trigger points, but I am going to keep it simple and show you the BEST way that I have found.

It's really quite simple... you find the nodule in the muscle, that often feels like an uncooked pea, and is quite tender. If you push on it, you can often feel the referred pain areas light up. I will give you the specifics about each muscle in the next section.

Self Massage: Trigger Point Pressure Release

1. Lengthen muscle to the point of resistance (optional but best) 2. Gradually apply pressure to the trigger point until you feel a resistance (discomfort)

in the muscle 3. Hold pressure until the resistance/discomfort fades (30~90 seconds) 4. Increase pressure again to the resistance (discomfort) 5. Repeat process 3-4 times per trigger point 6. Repeat on all trigger points in the muscle 7. Work each trigger point 1-6 times per day (3 is about ideal)

I. Lengthen muscle to the point of resistance

This is probably the hardest part in the whole self massage procedure, since you have to know which way to stretch it. The release will still work without a stretch, though not as optimally. One way to figure it out, is stretch the area in different ways until you feel the pain or tightness you are trying to get rid of. (Remember, the pain is not at the location of the trigger point 70% of the time. Then back off till there is no pain, and apply the gentle pressure on the trigger point. I have a patient that discovered that this method could be used during class to stretch further in yoga!

II. Gradually apply pressure until you feel a resistance (discomfort) in the muscle

What we are looking for in this step is to find the "barrier" which can be slightly challenging for a beginner. Think of it this way: if you have a very soft pillow on a firm bed, push through the pillow until you reach the bed, but not into it. In the same way, you will push into the tissue through the soft part, but not into the firm part of the muscle. This is usually where you first start to feel discomfort, but not pain. It is important not to stimulate pain, because this can prevent the muscle tissues from softening.

III. Hold pressure until the resistance/discomfort fades

This should happen in 30 to 90 seconds. If it lasts longer, it usually means you are pushing too hard. I often use the discomfort as a marker, since it is easier for patients to relate to. Around




the same time that the discomfort fades, the trigger point will soften and you can apply more pressure. You may want to use a massage tool for self massage because holding this pressure can be hard on your thumb over time, or you may not be able to reach the area. (Links to

http://www.natural-solutions-for-muscle-pain.com/trigger-point-tools.html)

IV. Increase pressure again to the resistance (discomfort)

Again, use the same guidelines as above. Engage the barrier, but don't cause pain.

V. Repeat process 2-4 times per trigger point

Sometimes I will do more repetitions if it is a very large or deep trigger point, but usually, I will stick to 2-4 repetitions. You can push in the same direction each time to get deeper, or you can vary your angle to get different aspects to the trigger point. Both are helpful depending on what the muscle needs.

VI. Repeat on all trigger points in the muscle

Make sure to scan the whole muscle for other trigger points, because they can re-activate the trigger point you just worked on. You should also check the opposing muscles as well, since they often will be affected in a set.

VII. Work each trigger point 1-6 times per day

If I have learned one thing about self massage, it is that persistence and consistency are key to conquering muscle pain. Once you have figured out where the trigger points are, keep working them consistently until they go away. This can take one day to several months. You should see some changes happening in about 2 weeks.

Not working? Might be one of the following reasons:

Too Much Pressure — You might be pushing too hard, creating pain and guarding in the muscle.

Too Little Pressure — Maybe you are not pushing hard enough to reach the barrier, or maybe your body would respond better to deeper pressure

Trigger Point too Irritated for Self Massage — In this case, any additional pressure is too much for the trigger point. You may need to find other methods on my website. (Links to http://www.natural-solutions-for-muscle-pain.com/trigger-point-treatment.html)

Perpetuating Factors — You need to use the rest of this manual to find them!

http://www.natural-solutions-for-muscle-pain.com/trigger-point-tools.html

http://www.natural-solutions-for-muscle-pain.com/trigger-point-treatment.html




C. Where are they?

To find the trigger points causing your pain, you have to start with where you pain is exactly. You need to draw it, because we tend to be too imprecise with words. Make sure to include an occasional symptoms as well. Here is a body diagram... I wait while you draw out your pain.

Body diagram

Here's a secret about trigger points: They are only in your main area of pain about 30% of the time...

That means 70% of the time, they are not where you think they are! Crazy, isn't it?

You will need a guide to show you how to find them! (Links to http://www.natural-solutions-for-muscle-

pain.com/trigger-point-manual.html)

http://www.natural-solutions-for-muscle-pain.com/trigger-point-manual.html




E - Exercise

A. Purpose of Exercise

I am not here to beat you over the head with "You should exercise more." You hear it all the time. How much, how often etc... That is really a discussion for another day.

For our purposes, brisk walking is great. It gets the blood flowing, gets you breathing more deeply, and gets more oxygen to your muscles which is the most important thing to decrease muscle pain.

So if you are not walking, (or performing some other physical exercise at this time) I think it is important that you do that. It doesn't have to be perfect... you can run after your kids on a walk, park further away from the store, take the stairs... if that is all you have time for right now.

So what kind of exercise are we talking about?

I want you to reconnect your brain with your joints and muscles. I want you turn the learning back on in your brain.

The term for knowing where your joints are in space is PROPRIOCEPTION.

This is the most important kind of exercise you can do. If you have back pain, you have inhibited muscles, meaning they are not contracting with the full force that they can.

They are neurologically weak.

This weakness eventually turns into physical weakness because they have not be able to contract fully for a long time. It is so important to reverse this, but this is the most often overlooked aspect of exercise.




B. Recurrent Back Pain Episodes

One of the most dramatic turning points in the history of my low back pain happened because of these principles. Here's what happened.

I was pregnant with my second child and went to pick up my son out of his crib. He was about a year old and quite heavy, and I was on the phone... I know! Big mistake!

He twisted in my arms, pulling my back "out". I fell to the ground in excruciating pain... it rivaled the pain of my 60 hour natural labor. I couldn't even roll over! Finally, I was able to drag myself to the couch with my son crawling after me. I couldn't even pick him up to feed him until my husband got home three hours later.

I determined while lying there, that I was NEVER going to go through that again. When I recovered, I learned every propioceptive exercise I could find and mastered them completely. I have never had an episode like that since.

I would like to teach you some of these exercises, the way I perform them. I have modified them based on information I have learned to make them more effective over the years. Learn my version of seated pelvic tilts. (Links to Natural-solutions-for-muscle-pain.com/pelvic-tilt.html)

http://www.natural-solutions-for-muscle-pain.com/pelvic-tilt.html




P - Posture

A. Was Your Grandma Right?

Posture is really important... but as I mentioned earlier, I like to define it slightly differently. I think Grandma would agree. It is not about holding a certain position stiffly, it is about using your structure well.

Frankly, this is a huge topic that I could write a whole book about. For now, I want to give you the general principle that you can apply to housework, picking up kids, housework, office work, driving etc. Remember, I already showed you how to sit in the exercise section!

Good posture is perfect balance. You need to think about opening and relaxing the areas that are pulling you off balance. Try this "postural exercise" based on the Alexander Technique. (This is best done in front of a full length mirror.)

B. Ways to improve posture by "letting go"

First, stand as you normally would and just observe where you are. Don't try to change anything, just notice where you have tension and/or pain. Now put a hand behind your neck with your pinky finger against the bottom of your

skull. Notice the tension in the muscles in the back of your neck. Release your neck and allow your head to balance forward and up. Release your torso and allow it to lengthen and widen. You will probably find you need

to move you feet apart, even with your shoulders. Allow your legs to release away from your hips. Make sure you aren't locking your

knees. Let your shoulders release to the sides. Let your whole arm to your hand hang freely. Notice your breathing... are you breathing? =) I often find people holding their breath

when they think about posture. Make sure you are breathing with your diaphragm, allowing your belly to go out and in

with each breath. Many people have trained themselves not to "belly breath" to keep a flat stomach.

Take a look at yourself again, and check in with your body. Did your tension and pain change?

What to do when you can't let go

Not being able to let go usually comes from one of three problems - stress, trigger points, or not being able to identify that problem area. If you can identified the area and the tension, use the meridian tapping technique above to try to release it. You can try this even if you don't feel you can identify the area.




If the problem is mechanical, check the muscle for trigger points (see above). Once you have released it, come back to the posture exercise.

If you can't identify the source of the tension, I would suggest finding a local health care provider that could help you find the muscles that are tight.

Learn more about standing posture here. (Links to http://www.natural-solutions-for-muscle-pain.com/ways-

to-improve-posture.html

Or more about sitting posture here. (Links to http://www.natural-solutions-for-muscle-pain.com/proper-

sitting-posture.html)

http://www.natural-solutions-for-muscle-pain.com/ways-to-improve-posture.html

http://www.natural-solutions-for-muscle-pain.com/proper-sitting-posture.html




S - Supplements

A. Supplements for Muscle Pain

In general, I would contend that supplements are very individual, and should not just be

widely recommended. There are however, a few that would greatly influence muscle pain

and won't cause problems for you if you don't need them. Your pain is more likely to be a

deficiency if you have multiple areas of pain.

Vitamin D

This is probably the most widely experienced deficiency, and is fortunately finally becoming

well known. What you may not know is that vitamin D deficiency can actually cause muscle

pain. According to articles by the Vitamin D council, at least 50% of the world's population is

Vitamin D deficient. This is from less outdoor time, strong pushes for sunscreen use, and low

recommended doses from the FDA. In areas with less yearly sun (further from the equator),

the effects can be devastating.

Taking a vitamin D supplement has

helped with my pain and energy

levels, as well as many of my patients.

In some that couldn't get better with

trigger point work, it was the vital

missing piece. I would recommend

that - pain or no pain - you make sure

you have enough vitamin D. It is

critical to all your systems.

Take away message: Make sure you

are getting 20 minutes of sun

exposure to arms and legs in the

summer per day. You will need more time in the winter, or take a vitamin D supplement. The

level is around 5000 IU per day. Make sure your blood levels of vitamin D are high enough

with a blood test. This is especially true if you have chronic wide spread pain.




Magnesium

Interestingly, magnesium is probably the most important cofactor for proper vitamin D

activation. It is also widely deficient in people's diets. It's the first thing I try for muscle

cramps. Here's what it does for your muscles:

Allows relaxation of the muscles

Is important in nerve function

Deficiency leads to muscle cramping

Is used up faster when you are stressed

How much and what kind: I like to use the powdered version of magnesium citrate so it can

be dosed to need. Basically, you use enough so that your bowel movements are soft but not

runny. That can be from 200-500 mg. It can also be taken as an oil through the skin. Either

way, you won't absorb more than you need. Only people with severe renal insufficiency and

rare neuromuscular transmission disorders need to be cautious.

B and C Vitamins

If you are deficient in B or C vitamins, this can make it difficult to get rid of trigger points. I am

not fond of most of the supplements available, though, because most are synthetic and don't

have the natural cofactors needed that come with these vitamins in food. Because of that, it

is better to get these vitamins from food, or at least a food based vitamin.

B. Supplemental Information

There are many medical conditions that can have a side effect of muscle pain. If you suspect

something else is going on in your body, you should seek the help of a health care provider.

The suggestions in this book can still help you, but you should make sure that you are taking

care of the underlying condition. Here are some of the conditions:

Fibromyalgia

Chronic Fatigue Syndrome

Hypothyroidism

Influenza

Infection

Lupus

Lyme Disease




Dermatomyositis

Intermittent Claudication

Tetanus

Polymalgia Rheumatica

Polymyositis

It is also possible that your muscle pain is secondary to

medication. This is especially true of the cholesterol

lowering medications, the statins. It can also be from

interactions of medications. If you suspect this might

be the case for you, it is imperative that you check with

you prescribing physician, because some of these side

effects can have long term effects.




Congratuations!

You made it through the STEPS

I hope you have found out more about your pain, and learned how to decrease and even eliminate it. I am excited to share more with you through my website, newsletter, and through books and videos.

Please let your friends and family know that they can get this Ebook for FREE for a limited time at www.MusclePainSolutions.com.

Looking forward to sharing more!

Dr. Mary X. Psaromatis

http://www.musclepainsolutions.com/

5 s t e p s - muscle pain solutions · i want to thank you for downloading my ebook 5 simple steps...

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