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Don’t Be Triggered by Musculoskeletal Pain

Dr. Chiam Tut Fu


Dr. Chiam Tut Fu

Medical Director, Consultant Sports Medicine Physician at Thomson Wellth Clinic

MBBS (Singapore), MSS (Sports Medicine), MMed (Occupational Medicine), GD (Occupational Medicine)

Dr. Chiam Tut Fu specialises in the management of musculoskeletal pain due to sports injuries or age-related degenerative and orthopaedic conditions and myofascial causes like trigger points. He also has a special interest in weight management and smoking cessation.

Table of Contents
  1. Pain is the most common symptom of musculoskeletal problems whether acute or chronic.  Pain tells us that something is wrong with our bodies and it is a signal for us to take measures to address it.  Relief of this pain is what prompts people to seek treatment from a medical practitioner or allied health professional.
  2. Muscles are a major component of the musculoskeletal system.  They protect our body organs, help us to move and mobilize our bodies.  However, they are often a major cause of pain in a musculoskeletal disorder.  The surrounding muscles are often in a spasm or tight if the underlying joints are injured.  A good example is tight back muscles in cases of spinal degeneration or spinal disc prolapse.  The tightness serves to protect the body by preventing excessive body movement and to keep the back in the most comfortable position albeit the presence of some pain.
  3. However, prolonged muscle tightness often prolongs the patient’s disability.  Even when the underlying injury has stabilized or become less acute, the muscles often remain stiff and worse, develop localized areas of extreme muscle tightness, tenderness and hypersensitivity.  These areas are called trigger points. These points often radiate pain to the surrounding areas and the pain even radiates to the limbs like in chronic neck pain due to spinal degeneration which is common in the older age groups.
  4. If these trigger points can be treated, released and made to relax, much of the musculoskeletal pain can be relieved though the underlying disorder still remains.  But the patient is made to feel much more comfortable and functional.  Trigger points can be easily identified and localized as they are very tender and very often, they are felt as knots in a muscles.  The most effective and fastest way to release these trigger points is to inject a combination of hydrocortisone derivative and long acting anaesthetic drug into the trigger point.  The physical injection alone will release the point but the medication takes it one step further and gives a sustained release which will reduce the pain dramatically and quickly.  Such injections need skill to do effectively and factors like injection depth and amount of medication and how to inject along the fibres of the muscles need to be considered. 

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