Search Results

Most people choose a massage therapist based on referrals, reviews, Instagram aesthetics, Reddit, or Yelp ratings. But in Los Angeles, not every massage provider you see online is actually certified to practice. People talk about where to get a massage. Almost no one talks about how to choose someone legally certified to touch your body. Massage therapy is a regulated health profession in California. State law recognizes Certified Massage Therapists as health-care providers , meaning they must meet established standards of education, ethics, and background screening. This is different from how people usually think about massage. In everyday conversation, “massage” is associated with relaxation, spa environments, pampering, or stress relief. But under California law, when someone is manipulating soft tissue for compensation, they are practicing massage therapy, which means they must be CAMTC certified (or licensed under a recognized local authority). While the word “massage” may sound casual,  massage therapy is a regulated health profession , and the person providing it is legally required to meet professional standards. Before you book your next massage, it’s essential to know whether your therapist is legitimately certified. Two therapists can look the same online — same reviews, same ambiance, same vibe — but only one may be trained, vetted, and legally approved to touch your body. Why This Distinction Matters — Especially in Los Angeles, CA Los Angeles offers a wide range of massage environments, including luxury spas, influencer-branded wellness studios, hotel spas, sports recovery labs, holistic clinics, neighborhood spots, and independent therapists. The variety is incredible but the regulation is not always visible. Two places can look equally professional. The experience can feel equally soothing. The reviews can sound similarly glowing. But only one may be operating with a legally certified therapist. That difference matters not only for the experience but also for your safety, outcomes, and the integrity of your care. Choosing a CAMTC Certified Massage Therapist Ensures: ✔ Formal education & hands-on clinical training ✔ Background screening & ethical standards ✔ Safe, intentional, nervous-system-aware touch ✔ Legal recognition as a healthcare provider in California ✔ Accountability, professionalism, and continuity of care Step 1 — Verify Massage Certification Through CAMTC The California Massage Therapy Council (CAMTC) is the official licensing and certification authority for massage therapists in California. This lookup system allows the public to confirm whether a therapist’s certification is: Active Expired Suspended Revoked How to Verify a Massage Therapist’s Certification Go to: https://www.camtc.org/ Click the Verify Certification Icon Enter the therapist’s: First Name + Last Name , or CAMTC Certificate Number Review their certification status and location . Example — Verifying My Certification Search: First Name: Jesse Last Name: Anoraj CAMTC ID:   77236 You will see: Status: Active / Certified Type: CMT Location: Los Angeles, West Hollywood Important to Know California law requires Certified Massage Therapists to display their certification document at their practice location. If a therapist cannot show their certification → Do not book. California requires certified massage therapists to display their CAMTC certification at their place of practice. This is what an authentic certification document looks like ### Video Walkthrough: How to Verify a CAMTC Certified Massage Therapist Los Angeles Step 2 — Understand the Difference Between CAMTC, ABMP, and Healthgrades Organization What It Is What It Provides What It Does Not  Do It’s perfectly fine to use ABMP or Healthgrades to discover massage therapists, but only CAMTC can confirm whether a therapist is legally certified to practice in California. My own practice, Artisan Neuromuscular & Sports Massage Therapy , is listed among the top results in the Healthgrades Los Angeles massage therapy directory , which reflects profile completeness and professional trust however, even with directory visibility, CAMTC remains the only official authority for confirming active certification. Understanding Professional Massage Language Matters The language used to describe massage environments can reflect whether a space is therapeutic and professional . The term “massage parlor” is widely associated with illicit or non-therapeutic businesses in North America and does not represent licensed therapeutic care. Similarly, the terms masseur and masseuse are outdated and are not commonly used by professional therapists in the United States. Professional Terms to Use Instead Massage Therapist / Certified Massage Therapist (CMT) Licensed Massage Therapist (LMT) Massage Therapy Practice Massage Studio Massage Clinic Massage Therapy Center Massage Establishment Spa (in wellness settings) Using accurate professional language supports clarity, safety, respect, and public trust. What You Can Expect from a Certified Massage Therapist A private and respectful intake process Clear communication and informed consent A clean, professional treatment environment Techniques based on education, anatomy, and purposeful intent A session tailored to your goals, comfort, and capacity Professional therapeutic massage is not random or routine; it is responsive, skillful, and intentional. The Benefits of Choosing a Certified Massage Therapist When you choose a certified massage therapist, you are investing in your health and well-being. Here are some key benefits: Enhanced Safety and Trust Knowing that your therapist is certified provides peace of mind. You can trust that they have completed the required training and undergone background checks. This ensures that you are in safe hands. Tailored Treatment Plans Certified therapists are trained to assess your needs. They can create personalized treatment plans that address your specific concerns. Whether you are recovering from an injury or seeking relief from chronic pain, a certified therapist can help. Professionalism and Accountability Certified therapists adhere to ethical standards. They are accountable for their practice. This professionalism ensures that you receive high-quality care every time you visit. Better Outcomes Working with a certified therapist can lead to better treatment outcomes. You are more likely to experience effective pain relief and improved mobility. About the Author Jesse Anoraj, CMT , is a Certified Massage Therapist and the founder of Artisan Neuromuscular & Sports Massage Therapy in West Hollywood, Los Angeles. He has been a member in good standing with the Associated Bodywork & Massage Professionals (ABMP) since 2018. Jesse specializes in neuromuscular therapy , sports massage helping people in Los Angeles feel better, move better, and build resilience through skilled, consistent, and client-centered care.

Pain Between the Shoulder Blades: Neck-Related and Myofascial Causes Pain between the shoulder blades is commonly attributable to the  neck and surrounding soft tissues  rather than to the thoracic spine alone. Clinical guidelines and contemporary research emphasize that pain location does not always reflect the true source of symptoms. Structures in the cervical spine, including joints, discs, muscles, and neural tissues, can refer pain into the upper thoracic and periscapular region. Periscapular  refers to the structures and muscles located around the shoulder blade (scapula) Educational Disclaimer: This article is for educational purposes only and is not intended to diagnose, treat, or replace medical care. Massage therapy is a supportive, non-invasive approach that may help manage symptoms related to musculoskeletal discomfort. If you have persistent, worsening, or unusual symptoms, or concerns about a medical condition, please consult a qualified healthcare professional. Periscapular Pain Provoked by Neck Movement Periscapular  refers to the structures and muscles located around the shoulder blade (scapula). Pain felt between the scapulae (the periscapular or upper thoracic region) that is provoked by neck movement  is a recognized pattern of referred pain originating from cervical spine structures. In mechanical neck pain and cervical spondylosis, symptoms may extend beyond the neck into the shoulder girdle and upper back, particularly when the neck is moved, loaded, or maintained in sustained postures. Because this pattern is often influenced by cervical dysfunction, learning more about neck pain care in Los Angeles  may be helpful as part of a broader conservative approach. Anatomical causes of referred pain Evidence suggests that pain in the upper thoracic region, shoulder, or upper limb can originate from mechanical issues within the neck , especially structures stressed during cervical motion: Facet Joint Syndrome causing neck and shoulder pain Cervical discs and facet (zygapophyseal) joints Pain-mapping and clinical studies show that referred pain into the head, neck, shoulder, or upper thoracic region may originate from either the cervical discs  or the facet joints . These structures share neural pathways that can cause pain to be perceived away from the actual source. Mechanical neck pain and cervical spondylosis Mechanical neck pain is a broad term describing symptoms related to acute overload or cumulative strain  affecting cervical joints, discs, ligaments, and supporting tissues. Cervical spondylosis refers to age-related degenerative changes in these structures. Importantly, these changes are common and do not automatically explain pain, but they can contribute to symptoms when tissues become sensitized or inflamed. When nerve involvement is present In more specific cases, pain in the periscapular or upper arm region may involve cervical radiculopathy , where a nerve root is irritated or compressed. Radicular pain is often accompanied by arm symptoms such as numbness, tingling, or weakness, and tends to follow recognizable neurological patterns. Why Neck Movement Reproduces Pain Between the Shoulder Blades Neck pain is typically mechanically provoked by neck movements, sustained postures, repetitive activities, or daily tasks. The most common pain mechanism in mechanical neck pain is nociceptive , meaning pain arises from mechanical or inflammatory irritation of involved tissues. Neck movement involves coordinated motion across the upper cervical (C0–2), mid-cervical (C2–7), and cervicothoracic (C7–T4) regions . When a sensitized disc, joint, or ligament is stressed during motion, symptoms can be reproduced locally in the neck or referred into the periscapular area. This helps explain why turning, side-bending, or holding the head in one position can aggravate pain felt between the shoulder blades. Cervical Facet Joint–Related Pain Facet joint irritation in the neck can produce pain in the neck, shoulder, and upper back , often accompanied by stiffness and restricted range of motion. People with facet-related pain frequently notice difficulty rotating or side-bending the head comfortably. Because cervical joints can refer pain downward, discomfort may be felt between the shoulder blades even when the primary source is higher in the neck. Myofascial Trigger Points and Referred Pain A myofascial trigger point  is a sensitive area within muscle tissue that can produce pain locally or at a distance. In the neck and upper back, trigger points commonly refer pain into the area between the shoulder blade and the spine. Persistent pain can alter muscle coordination, leading to increased tone, guarding, and sensitivity even in the absence of structural injury. Myofascial Trigger Point causing radiate Pain in the neck to upper back between shoulder blade. Common muscles involved Scalenes Scalene trigger points can produce deep, aching, and sometimes shifting pain patterns. Symptoms may include pain in the upper chest, upper back, shoulder, arm, and the thumb side of the hand (including the thumb and index finger). Some people experience weakness or clumsiness in the hand. Pain may disrupt sleep and is sometimes relieved by assuming a more upright posture. Head rotation is often less restricted than side-bending. Levator scapulae Trigger points in the levator scapulae commonly cause pain where the neck and shoulder meet, with possible referral into the upper back between the shoulder blade and spine. A hallmark feature is neck stiffness , particularly difficulty turning the head toward the painful side. Semispinalis capitis and cervicis Trigger points in the semispinalis capitis may create a tight, band-like pain around the head, often focused at the temple or forehead over the eye. Semispinalis cervicis trigger points typically cause pain at the base of the skull and into the neck, making both looking down and looking up uncomfortable. The Pain–Tension Cycle Pain often leads to protective muscle tension . As muscles tighten, pain sensitivity increases, which in turn leads to more guarding creating a self-perpetuating pain–tension cycle. Addressing pain sensitivity and contributing mechanical factors early can help prevent the spread of symptoms to other muscles and soft tissues. How Neuromuscular Therapy May Help Example of a neuromuscular technique used to address pain between the shoulder blades Neuromuscular Therapy can play a supportive role in managing neck-related and myofascial pain by addressing muscle tone, trigger point sensitivity, and movement tolerance . While manual therapy does not treat nerve compression directly, conservative, noninvasive approaches are widely recommended as first-line care for mechanical neck pain. Specialized, targeted massage therapy may help reduce discomfort, improve movement confidence, and support daily function as part of a broader care plan. When to Seek Medical Evaluation Most pain between the shoulder blades is musculoskeletal in origin. However, you should seek medical evaluation if pain is severe, unusual, progressively worsening, or persistent , or if it is accompanied by symptoms such as numbness, tingling, weakness in the arm or hand, changes in coordination, unexplained weight loss, fever, or unrelenting pain. Appropriate screening helps ensure safe and effective care. About the Author Jesse Anoraj is a Certified Massage Therapist and Neuromuscular Therapist, and a Certified Member in good standing of the Associated Bodywork & Massage Professionals (ABMP) since 2018. He owns and operates Artisan Neuromuscular & Sports Massage Therapy , a local Los Angeles massage studio specializing  in therapeutic and sports massage for pain and stress management. His work emphasizes evidence-informed soft-tissue techniques, assisted stretch therapy, and collaboration with other healthcare providers when appropriate. References Blanpied PR, Gross AR, Elliott JM, et al. Neck Pain: Clinical Practice Guidelines Revision 2017. Journal of Orthopaedic & Sports Physical Therapy. 2017;47(7):A1–A83. https://www.jospt.org/doi/10.2519/jospt.2017.0302 Jull G, Thomas L, Liang Z, Treleaven J. Current and future advances in practice: cervical spondylosis and mechanical neck pain. Rheumatology Advances in Practice. 2025;9(4):rkaf127. https://academic.oup.com/rheumap/article/9/4/rkaf127/8369052 Kjaer P, Kongsted A, Hartvigsen J, et al. National clinical guidelines for non-surgical treatment of patients with recent onset neck pain or cervical radiculopathy. The Spine Journal. 2017;17(9):1347–1362. https://www.thespinejournalonline.com/article/S1529-9430(17)30918-X/abstract Bogduk N. On the definitions and physiology of back pain, referred pain, and radicular pain. Pain. 2009;147(1–3):17–19. SpineUniverse. Facet Joint Syndrome. https://www.spineuniverse.com/conditions/spinal-disorders/facet-joint-syndrome Medical News Today. Upper back pain between the shoulder blades. https://www.medicalnewstoday.com/articles/upper-back-pain-between-shoulder-blades

A Humble Beginning My journey as a clinical massage therapist in Los Angeles began in 2018, fueled by a passion for helping others manage their pain. I specialized in sports massage & soft tisse therapy and pain management techniques. Stepping Out of My Comfort Zone With the encouragement of my colleagues and friends, I participated in the California Massage Championships . This was a big step for me, as I was used to the quiet of my treatment room. Their support was instrumental in pushing me to showcase my skills on a competitive stage. Jesse Anoraj's Achievements and Recognition To my surprise and honor, I received several awards at the championships: Second Place Silver Overall Winner of CA Massage Championships First Place Gold Medal in Sports Massage First Place Gold Medal in Freestyle Eastern Massage Best Freestyle Eastern Massage 2024 , awarded by the Royal Thai Consulate-General Los Angeles and the Nuad Thai and Spa Association of America (NTSAA) Certificate for the Second-Highest Competitive Score in Sports Massage in the USA , recognized by the US Association of Massage Championships Gratitude and Reflection I want to thank my colleagues, supporters, and everyone who believed in me. This experience has boosted my confidence and strengthened my commitment to providing the best care for my clients. I am thankful to the judges for recognizing my sports massage skills. I am receiving outstanding reviews from clients, and being recognized as a top-rated sports massage therapist by the massage champion judge is truly an honor! Looking Ahead I am excited to represent California at the American Massage Championships, bringing the skills and knowledge I've honed to a national stage. I aim to continue offering top-notch sports massage therapy to help athletes and individuals manage pain and improve their performance. Conclusion My journey is a testament to the power of community support and dedication. I look forward to welcoming you to my practice in Los Angeles, where I am committed to helping you achieve your wellness goals. Thank you for being a part of my story. Suppose you're looking for an experienced and passionate sports massage therapist. In that case, I invite you to visit my practice, Jesse Anoraj at Artisan Neuromuscular & Sports Therapy and experience the benefits of expert sports massage therapy.

Sports massage is a specialized form of massage therapy that caters to athletes and fitness enthusiasts. It is a targeted therapeutic technique designed to assist individuals at various stages of their training, from pre-workout to post-workout recovery. But how does it work, and what are the benefits? Let's delve into the science behind sports massage and its impact on performance and recovery. Understanding Sports Massage: Sports massage is not just for athletes. It can be beneficial for anyone who exercises regularly to prevent injuries, increase flexibility, and aid in healing after a sports-related injury. Unlike a typical relaxing massage, sports massage can be vigorous and intense, stretching tight muscles, activating inactive muscles, and improving the overall condition of soft tissue. The primary goal of deep tissue sports massage is to alleviate stress and tension in the body's soft tissues caused by physical activity, which may help increase endurance, improve athletic performance, decrease the likelihood of injuries, and speed up recovery after an injury. The Science Behind Sports Massage: A systematic review published on PubMed Central titled "The Effects of Massage Therapy on Sport and Exercise Performance" examined the effects of massage therapy on sports and exercise performance [1]. The review found that massages generally do not affect motor abilities, except for flexibility. However, some studies showed that muscle force and strength improved 48 hours after the massage was given. Regarding neurophysiological parameters, massages did not change blood lactate clearance, muscle blood flow, muscle temperature, or activation. However, many studies indicated pain reduction and delayed onset muscle soreness, likely correlated with the reduction of the level of the creatine kinase enzyme and psychological mechanisms. The Psychological Benefits of Sports Massage: Massage therapy can also help improve mental clarity and focus by promoting relaxation and reducing stress, which can be especially beneficial for athletes preparing for competitions or events. The review found that massage treatment led to a decrease in depression, stress, anxiety, and the perception of fatigue and an increase in mood, relaxation, and the perception of recovery [1]. Conclusion: While the direct usage of massages just for gaining results in sport and exercise performance seems questionable, it is indirectly connected to performance as an important tool when an athlete should stay focused and relaxed during competition or training and recover after them [1]. If you're in Los Angeles and looking for a sports massage therapist, consider checking out Jesse Anoraj at Artisan Neuromuscular & Sports Therapy. As a local sports massage therapist in Los Angeles and West Hollywood, Jesse specializes in helping athletes and active individuals improve their physical performance, prevent injuries, and aid recovery. References: [1]Dakić, M., Toskić, L., Ilić, V., Đurić, S., Dopsaj, M., & Simenko, J. (2023). The Effects of massage therapy on sport and exercise Performance: A Systematic review. Sports, 11(6), 110. https://doi.org/10.3390/sports11060110 Archer, P. A. (2007). Therapeutic massage in Athletics. Lippincott Williams & Wilkins.

As Earth Day approaches, it is important to reflect on the interconnectedness of all things on this planet, including ourselves. One way to honor this connection is through the practice of Thai massage, which has its roots in ancient healing traditions that recognize the balance and flow of energy throughout the body and the natural world. At the heart of Thai massage is the concept of Sen energy lines, which are pathways that run throughout the body, similar to the meridians of traditional Chinese medicine. These energy lines are believed to connect us to the elements of earth, fire, wind, and water and to the natural cycles of the environment around us. Thai massage incorporates a variety of techniques to stimulate and balance the Sen energy lines, including stretching, compression, acupressure, and rhythmic rocking. By working on these energy lines, Thai massage can help to release tension and blockages, promote relaxation and flexibility, and enhance overall well-being. The earth element in Thai massage is associated with stability, grounding, and nurturing. How to connect with Earth element, Thai massage may include techniques that focus on the feet and legs, such as foot reflexology and leg stretches, to help you feel more rooted and supported. The fire element in Thai massage is associated with passion, energy, and transformation. How to connect with the fire element, Thai massage may include techniques that focus on the belly and chest, such as abdominal massage and chest stretches, to help you tap into your inner fire and ignite your vitality. The wind element in Thai massage is associated with movement, creativity, and freedom. How to connect with the wind element, Thai massage may include techniques that focus on the arms and hands, such as shoulder massage and arm stretches, to help you feel more expansive and open. The water element in Thai massage is associated with flow, adaptability, and harmony. How to connect with the water element, Thai massage may include techniques focusing on the back and hips, such as spinal twists and hip stretches, to help you release tension and move with greater ease and grace. As we celebrate Earth Day, let us remember the importance of honoring the natural world and our connection to it. Thai massage and the elements of earth, fire, wind, and water offer a beautiful way to connect with the planet's rhythms and energies and promote healing, balance, and harmony within ourselves and the world around us. Jesse Anoraj, NMT | Certified Advanced Practitioner and Teacher Training Program endorsed by ITM - International Training Massage School | Los Angeles Massage Therapist Book https://bit.ly/massagemenow

There is ongoing scientific research on the benefits of massage therapy. Some of the current findings include: Pain relief: Massage therapy has been found to be effective in reducing chronic pain, including lower back pain, neck pain, and osteoarthritis. Stress reduction: Massage therapy has been shown to reduce levels of cortisol (the stress hormone) and to increase feelings of relaxation and well-being. Improved sleep: Massage therapy has been shown to improve sleep quality and duration, particularly in people with insomnia. Improved range of motion and flexibility: Massage therapy has been shown to improve flexibility and range of motion, making it particularly useful for people with conditions such as fibromyalgia and myofascial pain Improved athletic performance: Massage therapy has been shown to improve athletic performance by reducing muscle soreness and stiffness, and improving recovery time after exercise. It's important to note that the benefits of massage therapy can vary from person to person, and that more research is needed to fully understand the mechanisms behind its effects. References The Rise of Massage Therapy in Pain Management | Massage Therapy Journal. (n.d.). American Massage Therapy Association. https://www.amtamassage.org/publications/massage-therapy-journal/massage-therapy-in-pain-management/ Nazari, Fateme, et al. “The Effect of Massage Therapy on Occupational Stress of Intensive Care Unit Nurses.” Iranian Journal of Nursing and Midwifery Research, U.S. National Library of Medicine, 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4525352/ Sable, Amol, et al. “Effectiveness of Back Massage on Sleep Pattern among Patients with Congestive Cardiac Failure.” Iranian Journal of Nursing and Midwifery Research, U.S. National Library of Medicine, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637143/ Yeun, Young-Ran. “Effectiveness of Massage Therapy on the Range of Motion of the Shoulder: A Systematic Review and Meta-Analysis.” Journal of Physical Therapy Science, U.S. National Library of Medicine, Feb. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333006/ Davis, Holly Louisa, et al. “Effect of Sports Massage on Performance and Recovery: A Systematic Review and Meta-Analysis.” BMJ Open Sport & Exercise Medicine, BMJ Specialist Journals, 1 May 2020, https://bmjopensem.bmj.com/content/6/1/e000614

Myofascial pain syndrome should not be confused with fibromyalgia, which has similar symptoms. Fibromyalgia is a chronic condition that causes pain and tenderness throughout the body — not just in particular areas — and does not include trigger points. For more information, see the Made for This Moment fibromyalgia page. A person can have both fibromyalgia and myofascial pain syndrome. That makes it especially important to consult with a medical specialist who can diagnose the difference and apply the proper treatments for each condition. This information is not intended to provide medical advice or to replace the advice of a licensed physician. Portions of this information, however, may be used to provide material to your physician for review. Reference: American Society of Anesthesiologists. Fibromyalgia. (https://www.asahq.org/madeforthismoment/pain-management/types-of-pain/fibromyalgia/)

Myofascial Made Simple The word myofascial means muscle tissue (myo) and the connective tissue in and around it (fascia). Myofascial pain syndrome has been defined by the International Association for the Study of Pain (IASP) as a painful regional condition associated with the presence of trigger points. Myofascial trigger points are spot of hyper-irritability, which, when subjected to mechanical pressure, give rise to characteristic patterns of referred pain. Trigger points have both a sensory and a motor component. Clinical characteristics of a trigger point include circumscribed point tenderness of a hard nodule that is part of a palpably tense taut band of muscle fibers, patient recognition of the pain that is evoked by pressure on the tender spot as being familiar, and pain referred to in the pattern characteristic of the trigger points in that muscle, a local twitch response or “jump” sign, painful limitation of stretch range of motion (ROM), and weakness of that muscle. Often multiple muscles are involved. Myofascial pain syndrome is a chronic pain disorder. In this condition, pressure on sensitive points in your muscles (trigger points) causes pain in the muscle and sometimes in seemingly unrelated parts of your body. This is called referred pain. This syndrome typically occurs after a muscle has been contracted repetitively. This can be caused by repetitive motions used in jobs or hobbies or by stress-related muscle tension. The terms trigger points and tender points are often incorrectly used interchangeably. A tender point is a widespread, nonspecific, soft tissue pain often associated with fibromyalgia, as compared to a trigger point which is a localized area within a taut band of skeletal muscle which has a characteristic nodular texture and, upon palpation, generates a twitch response or referral pattern as seen in the myofascial pain syndrome. Trigger points can be active or latent. An active trigger point is associated with spontaneous pain present without palpation, either at the site of the myofascial trigger point or remote from it. Palpation increases pain locally and usually reproduces the subject’s remote pain. A latent trigger point is not associated with spontaneous pain. However, pain can often be elicited in an asymptomatic issue by a mechanical stimulus. The exact mechanism of myofascial trigger points is still unclear. They can develop after trauma, overuse, or prolonged spasm of muscles. The “energy crisis” hypothesis states that an overload of the muscle causes an increase in calcium release, which stimulates prolonged contractility and increased metabolic activity causing localized ischemia. Key elements of the physical examination include evaluation of posture (symmetry, stance, and scoliosis), palpation, ROM of the lumbar spine and restrictions due to pain, neurological examination, and palpation (flat or pincer palpation) of superficial and deep soft tissue looking for: tenderness, taut bands, twitch responses, and referral patterns. Potential tools for diagnosis under study include measurement of biochemicals associated with pain and inflammation in the trigger point region, sonographic studies, magnetic resonance elastography for taut band imaging, and infrared thermography. Many methods have been used to treat myofascial pain, including stretching, massage, trigger point pressure release, laser therapy, heat, ultrasound, transcutaneous electrical nerve stimulation (TENS), biofeedback, pharmacological treatments, trigger point injections with local anesthetic and/or steroid solutions, shockwave therapy, and botulinum toxin type A injection. While nearly everyone has experienced muscle tension pain, the discomfort associated with myofascial pain syndrome persists or worsens. Myofascial pain occurs in about 85% of people sometime during their life. Even this high percentage may not be accurate. Myofascial pain is often under-diagnosed, misdiagnosed or overlooked because it’s hidden in another type of diagnosis such as headache, neck and shoulder pain, pelvic pain, limb pain or nerve pain syndrome. Men and women are equally affected, though middle-aged inactive women are at the highest risk. This information is not intended to provide medical advice or to replace the advice of a licensed physician. Portions of this information, however, may be used to provide material to your physician for review. What are the symptoms of myofascial pain syndrome? Symptoms are different for each person with myofascial pain syndrome. Sometimes the pain happens suddenly and all at once, and that is called a “flare-up” of symptoms. At other times it’s a constant, dull pain that sort of lingers in the background. Symptoms of myofascial pain syndrome include: Pain that’s described as deep aching, throbbing, tight, stiff or vice-like. Trigger points (a small bump, nodule or knot in the muscle that causes pain when touched and sometimes when it’s not touched). Muscles that are tender or sore. Weakness in the affected muscle(s). Reduced range of motion in the affected areas (e.g., you may be unable to completely rotate your head). People with myofascial pain syndrome often have other health problems that coincide. Commonly reported problems include: Headaches. Poor sleep. Stress, anxiety, depression. Feeling tired (fatigue). What causes myofascial pain syndrome? The jury is still out about all of the causes, contributing factors and exactly how the pain mechanism works. Causes of myofascial pain syndrome include: Muscle injury. Muscle strain/repetitive muscle use (e.g. hammering). Muscle weakness/lack of muscle activity (e.g. a leg in a cast will not get enough movement). Poor posture. Working in or living in a cold environment. Emotional stress (can cause muscle tension). Pinched nerve. Other factors thought to contribute to the development of myofascial pain syndrome include: Metabolic or hormonal problems such as thyroid disease or diabetes-related neuropathy. Vitamin deficiencies, including vitamin D and folate. Presence of chronic infections. Where does myofascial pain syndrome most commonly occur? Myofascial pain and trigger points can develop in any muscle in the body. However, the most commonly affected muscles are those in the upper back, shoulder and neck. These muscles include the: Sternocleidomastoid: This large muscle helps rotate your head to the opposite side and flexes your neck. It is located on both sides of your neck, running from your skull behind your ear area to your collarbone and breast bone. Trapezius: This large, broad, flat triangular back muscle tilts and turns your head and neck, shrugs and steadies your shoulders, and twists your arms. The muscle extends from the base of your skull to the middle of your back. Levator scapulae: This pair of strap-like muscles help raise and rotate each of your shoulder blades. They run from the first four cervical vertebra to the top edge of your shoulder. Infraspinatus: This triangular muscle, located on the back side of each of your shoulder blades, helps rotate and stabilize your shoulder joints. It’s one of four muscles of the rotator cuff. Rhomboids: This pair of upper back muscles pull your shoulder blades together when they contract and attach the upper limbs to your shoulder blade. These muscles run diagonally from the neck and chest vertebrae of the spine down to the back of the shoulder blades. How can I describe my pain? Different categories are used when describing or attempting to gather information about pain. These include: oLocation, Site: where the pain is felt(ie Head, Neck, Shoulder, Shoulder Blade, Low Back, Glute, Buttock etc) Intensity: how severe the pain is (ie Most pain scales use numbers from 0 to 10). Frequency: how often the pain occurs (ie morning, night time) Quality: the type of pain (ie. Deep, Ache, Dull, Sharp, tender, shooting etc.) Duration: how long the pain lasts when it occurs Pattern: what causes the pain and what improves it Movement: what movement causes the pain Dull pain is often chronic, lasting a few days, months, or more. Commonly, dull pain results from an old injury or a chronic condition. If you have a new, dull pain that doesn’t improve in two to three weeks, bring it to your doctor’s attention. Questions your therapist may ask to assess myofascial pain syndrome: Your healthcare provider may order a few tests to rule out other conditions and ask you questions about your pain and symptom, including: Where do you feel the pain? How would you describe your pain? How often do you experience pain? What makes your pain better? What makes your pain worse? Have you had any recent injuries? Do your symptoms get better at certain times during the day? What does your work day look like (to look for activities in which there is muscle strain/repetitive motion)? Can myofascial pain syndrome be prevented? There are certain factors that can put you more at risk for developing myofascial pain syndrome. Managing these risk factors may not prevent you from developing the syndrome, but could help reduce the severity of the condition. Many of the prevention suggestions to follow are also pain management strategies: Maintain proper sleep hygiene. Reduce your stress. Get exercise. Avoid preventable muscle injury. (e.g., is the shoulder bag/purse you carry too heavy and digging into the muscles in your shoulder?). Practice relaxation methods. How do I take care of myself? Living with myofascial pain syndrome is uncomfortable at best, unbearable at worst. Take care of yourself by following your healthcare provider’s treatment plan and using your at-home remedies listed above. Exercise, change your diet, soak in warm water, get massages, etc. You’ll likely have to experiment to figure out what treatments work best to reduce your pain. References: National Association of Myofascial Trigger Point Therapists. Myofascial Therapy. (https://www.myofascialtherapy.org/myofascial-therapy) Accessed 7/1/2020. American Society of Anesthesiologists. Myofascial Pain Syndrome. (https://www.asahq.org/whensecondscount/pain-management/types-of-pain/myofascial-pain-syndrome/ ) Accessed 7/1/2020. Mayo Clinic. Myofascial pain syndrome. (https://www.mayoclinic.org/diseases-conditions/myofascial-pain-syndrome/symptoms-causes/syc-20375444) Cleveland Clinic. Myofascial pain syndrome. (https://my.clevelandclinic.org/health/diseases/12054-myofascial-pain-syndrome)

Neuromuscular therapy is a manual therapy for pain management, rehabilitation, and prevention therapy. It is a treatment for myofascial trigger points. The trigger points are microscopic spasms at the neuromuscular junction, where the nervous system communicates with a muscle, causing pain, weakness, and discomfort in a referred pain area. It effectively breaks the stress-tension cycle by promoting a parasympathetic response in the body through precise manual techniques that encourage the neuromuscular junction back to healthy function, reduce resting muscle tension and spasm and move metabolic waste products, which irritate nerves, out of muscle tissue fibers. This technique is a highly effective form of Deep tissue massage that focuses on the unique communications/relationship between the body & the brain, identifying whether the brain is giving the body lousy information or vice versa. It also addresses getting the brain to accept that trauma is over, the body wants to move again, and vice versa. Neuromuscular therapists are highly skilled in muscle anatomy, connective tissue work, palpation and pain management. It integrates diverse techniques such as trigger point therapy, positional & neuromuscular release, deep-transverse friction, myofascial approaches, and muscle energy. On the right hand, neuromuscular therapy is a highly effective treatment for chronic pain, muscular trauma resulting from an accident or injury, or strain caused by overuse. On the other hand, neuromuscular therapy gets clients back to a healthy lifestyle, doing the activities they want to do. "Rebuild your strength. Regain your balance. Revive your energy. Refresh your mind. Rekindle your soul." Benefit of Neuromuscular Therapy. Decrease stress & pain via gate control and reduce pressure on the nervous system to help create a positive state of mind that is leading to a greater sense of ease with movement. Many orthopedic conditions and sports, automobile and work-related injuries respond well to this form of therapeutic massage, including: Neck & shoulder pain Low back pain Sciatica Migraines & tension headaches Frozen shoulder Whiplash Rotator cuff injuries Temporomandibular joint (TMJ) dysfunction Carpal tunnel syndrome Tendonitis Sprains & strains Arthritis Plantar fasciitis Shin splints Iliotibial (IT) band syndrome Knee pain