Presenting symptoms
A 17-year old student was sent to Myopain Solutions by her primary care doctor for help with multi-region chronic pain as a result of Ehrler’s Danlos Syndrome (EDS). Her complex medical history also included three motor vehicle accidents within one calendar year. She complained of lingering neck pain from (whiplash), as well as migraines (nausea and photophobia), fainting, chronic fatigue, and sundry other headaches (ice pick). Past and ongoing conditions included Postural Orthostatic Tacchycardia Syndrome, dizziness, and poor GI motility. Prior treatments for the pain had included biofeedback, guided imagery, and cognitive behavior therapy.
Evaluation, clinical reasoning & treatment strategizing
Ehrler’s Danlos Syndrome is a rare genetic condition where the body produces faulty collagen, elastin or other connective tissue. This connective tissue weakness results in hypermobility, joint instability, sleep disturbances and most troubling to this patient, pain. Trigger points are common, but interestingly, by taking up space, trigger points can add to joint stability. Therefore, it may be useful to deactivate a few, but not too many.
Myopain Solutions’ plan was to reduce pain (by treating some active trigger points) and improve proprioception and stability, assist gastrointestinal motility, and use breathing pattern re-education to reduce sympathetic arousal.
Treatment
Treatment began with cutaneous super-stimulation techniques. These signature non-painful stimulations can be in the form of vibration, warm/cold, light pressure on the skin, as well as jostling and snapping. We also employ sharp sensations from a variety of spiky implements. These techniques make use of the ‘gate control’ theory to reduce muscle pain. Next, some of the trigger points were located and deactivated in the trapezius and levator scapulae, SCM, paraspinals, intercostals and diaphragm.
Results and follow-up
While some positive changes were made, the patient continued to have intermittent headaches and the dizziness remained unchanged. She did have improvements in the GI motility and breathing. She was given homecare activities for continued self-treatment.
NMT can assist in pain management of Ehrler’s Danlos Syndrome. Each case is different however. For more information on EDS see www.ednf.org