MUSCULOSKELETAL PAIN SYNDROMES
Myofascial Pain Syndromes (MPS)
Complex Regional Pain Syndromes (CRPS)
Fibromyalgia Syndrome (FMS)
Myofasical pain syndrome (MPS)
is a musculoskleteral pain disorder characterized by pain caused by hyperirritable spots, defined as trigger points (TP), in one or more taut bands of muscle fibers.
The current hypothesis for TP formation postulates a vicious cycle of muscle overload damaging the sarcoplasmic ratinaculum, actomyosin complex shortening, calcium pump deficeincy, and the sustained post-junctional motor endplate depolarization that causes a regional hypoxic energy crisis, along with tissue sensitization, the increased presence of neurotransmitters (ie. Substance P), and neurogenic inflammatory substances. The primary objectives of treatment include the deactivation of the TPs, the relaxation of the taut bands, and the breaking of the vicious cycle of pain-spasm-ischemia-pain, which is one of the factors implicated in the physiopathology of MPS.
The utility of Flashwave® therapy for MPS is based on it‘s mechanics of action, safety, and systemic neutrality. The current understanding of Flashwave® therapy actions are many, one of which is the biochemical process involving the development of regional angiogenesis.
Therefore, Flashwave® therapy addresses the energy crisis associated with MPS via hypoxic-correction by way of improved regional circulation, and calcium influx correction.
Furthermore, Flashwave®'s neuro and immunological influence suggests that the homeostatic regulation of neurotransmitters (ie. SP), and inflammatory substances help provide pain relief by correcting neuromuscular junction hyper excitability.
Finally, these corrective processes are seen to influence and correct the actomyosin complex contraction on the sacromere resulting in the release of the TP associated with MPS.
Flashwave® offers the clinician a reliable, reproducible, easy-to-use treatment option that addresses multiple cofactors associated with MPS effectively.
Complex Regional Pain Syndrome (CRPS)
is a neuropathic maladaptive pain disorder often caused by soft tissue trauma, postsurgical complication, or fractures, and is classified as
Type I (devoid of nerve damage/reflex sympathetic dystrophy) or
Type II (nerve damage/causalgia).
Ranging from limited to severe, the classic symptoms include: Severe pain in primary and secondary region, odema, temperature dysregulation, trophic changes, atrophy and dystrophy.
Despite the enormous research conducted in this area, complex and neuropathic pain syndromes remain indocile to conventional treatments.
From what has been elucidated of the pathophysiology of CRPS a myriad of peripheral and central abnormalities occur which include: Nutritive hypoxia, aberrant inflammatory and immunologic interactions, increased peripheral nociceptive barrage, hypersensitization, reduced descending inhibition, and pain memory transcription.
In combination these factors introduce debilitating pain and locomotion dysfunction.
The rationale for the use of Flashwave® stem from its safety, mechanics of action and systemic neutrality.
Flashwave® therapy is known to improve regional circulation that reverses the regional nutritive hypoxia associated with CRPS, this simultaneously ameliorates small vessel damage. Flashwave® regulates both inflammatory and immunological responses where correction of these aberrances reduces the peripheral nociceptive barrage and reduces the central nocicep-tive input. This corrective stimulus regulation has been known to produce desensitization of hyperalgesic states, normalizing pain perceptions back to physiological response conditions.
Flashwave® addresses the multiple aberrances present in CRPS in a safe and systemically neutral manner making it an effective, reliable, reproducible, easy-to-use treatment option.
Fibromyalgia Syndrome (FMS)
is known to affect 2 %–8 % of the world’s population with a higher prevalence in developed nations. The exact pathophysiology of FMS remains an enigma, but it is primarily considered to be a centralized pain syndrome with the possibility of peripheral C-fiber pathology, and is indocile to most pain primary medications and pain correcting surgical procedures. Unlike MPS, FMS is an extraarticular chronic widespread musculoskeletal pain syndrome with primary features of pain, stiffness weakness, and fatigue.
FMS often coexists with symptoms of headaches, chronic fatigue, irritable bowel syndrome, mood disorders, other regional pain syndromes (often in the neck and back), presence of trigger points (MPS), and arthropathies (ie. osteoarthritis).
Muscle biopsy studies indicate the presence of increased levels of substance P (SP), ragged and moth-eaten appearance of muscle fibers (suggestive of hypoxia), increased oxidative stress, low mitochondrial density and dysfunction (suggestive of high fatigue and low endurance capacity).
The rationale for the use of Flashwave® in FMS patients stem from its safety profile, systemic neutrality and mechanics of action.
From what has been elucidated about the pathophysiology and chronic persistence of FMS in patients, Flashwave® offers the clinician a tool to address some of the factors influencing FMS. These are noted to: regulation of SP that influence C-fiber pain modulation, trigger point and MPS intervention, increase and improve regional circulation to address muscle fiber health, activation and differentiation of muscle satellite cells toward muscle regeneration, reduce oxidative stress and improve mitochondrial function to improve muscle resilience and reduce fatigue the syndrome. These changes will influence the ability to improve activity levels and influence mood and emotional status.
The ability to influence constellation of pathophysiological factors associated with FMS with a single modality in a systemically neutral manner makes the utilization of Flashwave® a safe, attractive, and economical clinical choice.