In September 2021, the United States Centers for Disease Control published guidelines and findings based on various studies related to the condition that has come to be known as “long COVID.” You may have heard about COVID-19 patients whose post-infection recovery periods are complicated by a host of pernicious symptoms that do not seem to go away. To this effect, some of the most common ailments reported by long COVID patients include:
- Persistent headaches
- Shortness of breath
- Stomach aches
- Musculoskeletal pain
Of the aforementioned symptoms, musculoskeletal pain has been one of the most difficult for medical researchers to understand. Lingering headaches, respiratory issues, nausea, and fatigue are commonly associated with other coronavirus infections caused by pathogens such as SARS, MERS, and even influenza. It is not uncommon for myofascial pain to afflict COVID-19 patients, often along with symptoms from upper respiratory infections and gastrointestinal upsets, but these are mostly temporary muscle aches accompanied by high core temperatures. Once the fever is under control, the pain tends to go away as well. Lingering myofascial pain after a coronavirus infection is not something physicians are used to dealing with.
Long COVID patients report that their most chronic and troublesome symptoms, the ones that linger long after their recovery periods, are related to musculoskeletal pain, with some even reporting the development of fibromyalgia. A study published in the Journal of the American Medical Association’s JAMA Internal Medicine in May 2020, found that patients suffering from coronavirus infections and their recuperations suffered significantly more musculoskeletal pain than healthy controls. In fact, after one month of recovery, the coronavirus-infected patients reported chronic pain in over 60 percent of their muscle areas, compared to only 12 percent in the control group.
There is still a lot left to evaluate, investigate, and determine with regard to long COVID. For the time being, physicians are treating these patients in a symptomatic manner, which means that neuropathies such as myofascial pain can be addressed through chiropractic therapy. It may take a while before we are able to get a better grasp on long COVID, and we may still need to treat each long-term condition symptomatically until patients make progress on their own. In other words, we may still need to alleviate and provide holistic care so that the body can heal.
Understanding Myofascial Pain Syndrome
Let’s say one day you decide to climb over a wall despite not being conditioned to do so. You get a running start and use all the muscles you can engage to go over. Since you are surprising your muscles with sudden stress that they are not used to, chances are that you will feel sore afterward, particularly in your dominant shoulder. This pain is expected, and it should go away on its own in a few days. Analgesics can provide relief; anti-inflammatory medications can help you heal faster, but you should be “cured” from this pain in a few days unless there was a fracture involved.
If the pain takes a long time to subside, or if it worsens as it radiates to other muscles, you are now dealing with chronic pain that could be described as myofascial pain syndrome. The muscles in your body store tension, and you often use them without understanding when they are engaged in certain functions. You probably do not know if a certain movement that you perform is causing pain. If you are engaging those muscles and they feel sore after normal use, your pain could very well be myofascial.
Here are some of the symptoms typically observed in myofascial pain disorder:
- Unexplained tightness of muscle tissue.
- Lower back pain.
- Periodic headaches.
- Feeling heavy pressure on the joints.
Once you start feeling other symptoms such as insomnia, migraines, tightness of the jaws, or wrist pain, chances are that you may be going through fibromyalgia, mandibular disorder, or carpal tunnel syndrome. These are conditions that chiropractors treat on a regular basis with a therapeutic approach known as myofascial release.
How Myofascial Release Can Improve Quality of Life
A major aspect of chiropractic care focuses on the management of trigger points, which can be described as areas of muscle tissue that become painful through repeated, improper, or forceful contractions. Trigger points represent small areas of muscle tissue in which something is wrong and the muscle is unable to relax and stretch. One of the reasons they are painful is because of chronic spasms. As the muscle is stretched, it tightens to the point of developing pain.
Small knots of muscle tissue are located in various parts of our anatomy, but the ones associated with myofascial pain syndrome are most commonly are found on the back and the neck. Furthermore, trigger points may be found in the muscles that allow movement and contraction of the joints and are thus also referred to as myofascial trigger points commonly located in the deeper fascia.
Trigger points associated with repetitive movements are more frequently found in people who sit on chairs for many hours each day, and who use a computer keyboard extensively and for extended periods of time. These points can be found in both young and old patients; they are not necessarily a sign of disease if they happen to heal on their own.
You will rarely see trigger points with obvious bulges, bumps, or deformities on the affected area. In many cases, they will not be tender to the touch. It is actually more common to feel pain radiating towards extremities than to find physical signs of the muscle’s problem. Myofascial release therapy seeks to determine which trigger points are causing pain, which is why chiropractors go over large regions of muscle tissue instead of focusing on single points. In the cervical region alone, there are three bilateral trigger points: Trapezius, occiput, and supraspinatus.
Patients who have not suffered strains, sprains, long COVID, fibromyalgia, or neurological conditions such as Guillain-Barré syndrome may experience myofascial pain because of incorrect posture, repetitive motions, or inadequate biomechanics. With myofascial release, the goal is to provide physical therapy that can alleviate pain so that the body can have an easier time healing. As previously mentioned, chiropractors will first set out to discover the affected trigger points. The next step may involve applying gentle pressure towards the fascia for the purpose of smoothing out the tissue. If adhesions are detected through a medical examination or diagnostic imaging, the adjustment of trigger points will be different.
Spinal Adjustment and Myofascial Pain
It is not uncommon for chiropractors to determine that spinal subluxation or scoliosis are at the heart of myofascial pain syndrome. When there is an absence of trauma, or when there is no indication that repetitive strain is to blame, the next logical step is to check for subluxation. What happens to many patients who are unaware of their spinal misalignment is that they unconsciously overcompensate for their condition with inadequate biomechanics; it is not unusual for this situation to devolve into trigger points and myofascial pain.
The bottom line of chiropractic treatment for myofascial pain is that it can be very effective. Since chiropractic always prioritizes spinal and joint adjustment over prescription medications and surgery, it is considered to be a holistic practice. Chiropractors are skilled in adjusting the spine and spinal joints using their hands and often by applying direct gentle pressure. For example, adjusting the spine can be done by using a cervical-thoracic-lumbar adjustment which involves bending the spine, adjusting the facet joints, and possibly using a traction table for more deep pressure on the joints.
When your myofascial pain symptoms include deep discomfort of the neck or lower back, chances are that spinal subluxation could be the underlying issue. Going back to patients whose pain worsens after COVID-19 episodes, a chiropractic assessment may reveal trigger points and subluxation that can be treated in a safe, non-invasive manner.