#Travell and simons jfk manual#
This article from the American Family Physician journal gives a comprehensive summary of what is understood about treatment approaches for myofascial pain.īut published studies in the peer-reviewed literature of specific Bonnie Prudden-approved manual techniques are completely lacking. Trigger-point injections with local anaesthetic, dry needling and even botulinum toxin have good supporting evidence of short- to medium-term benefit. Some of the techniques that form the armamentarium of myotherapy are supported by some positive evidence. Myotherapists use manual techniques to alleviate tissue and muscle pain. They also give advice about posture and prescribe exercise programs to remediate the biomechanical imbalances that caused the trigger points to form in the first place. Manual techniques including massage, focused pressure from hands, fingers, knuckles or elbows and the use of modalities such as heat, cold, electrical stimulation and sticking acupuncture needles into the trigger points form the bulk of what myotherapists are trained to do. This is largely due to the slow progress of basic science research into muscle and soft tissue pain. Few clinicians who see large number of patients with musculoskeletal pain would argue against the idea that painful areas exist in the locations described in the Trigger Point Manual.Īs a pain specialist, I have certainly been able to help sort out dozens of patients referred by colleagues with otherwise inexplicable pain by applying the general principles of Travell and Simons.īut nearly half a century after the terms trigger points and myofascial pain were coined, the scientific understanding of them, and the best means of treating the latter remain sketchy. Trigger points and myofascial pain remain a controversial area of medicine. She published her book Pain Erasure in 1980 and devoted the rest of her life to teaching and expanding myotherapy from her base in Tucson, Arizona. Bonnie Prudden was an early leader in promoting physical fitness for the masses, and became interested in the work of Travell and Simons in the early 1970s.