Does Myotherapy for Pain Relief Really Work?
Experts weigh in on the massage-like practice, plus whether or not it can help ease chronic pain.
Pain is a hot-button topic. Somewhere around 100 million Americans struggle with chronic pain, according to the American Academy of Pain Medicine. And in light of the opioid crisis, people are searching for more natural solutions, which has led to interest in newer treatments, like myotherapy for pain relief. Never heard of it? Here's what you need to know.
What is myotherapy?
"The term 'myotherapy' literally translates to 'muscle therapy' and is often used to describe a wide variety of manual therapy techniques applied to the body's soft tissues by massage therapists (LMP/LMTs), physical therapists (PT/DPTs), chiropractors (DCs), and possibly acupuncturists (LAcs) or naturopaths (NDs)," says Ya-Ling J. Liou, D.C., a chiropractor and author of Every Body's Guide to Everyday Pain. "In my experience, it can include any number of techniques, like trigger point release work, myofascial release work, and post-isometric relaxation technique." (FYI, myofascial release work is generally the point of a sports massage.)
Myotherapy aims to correct myofascial pain, which refers to any pain initiated by musculoskeletal dysfunction in an area different from where the pain is actually felt. "This means you can have pain in your arm or shoulder or hand, but focusing on where it hurts may not resolve the problem," says Liou. "Unless you get some help re-patterning/retraining/rehabilitating other areas that don't necessarily hurt but are partially responsible for the pain-like your neck, shoulder blade, upper back or chest muscles, and joints-you'll continue to have that arm, shoulder, or hand pain." The idea is basically that through a variety of muscle-focused techniques, you can relieve pain throughout the body.
Does myotherapy for pain relief work?
You might be wondering if myotherapy is as "legit" as other similar practices, such as physical therapy, chiropractic care, or even orthopedic medicine, and there are definitely some important differences. "Myotherapy focuses primarily on the dysfunction and pain that is generated from the muscular tissue," explains Alex Tauberg, D.C., a chiropractor at Tauberg Chiropractic & Rehabilitation. "While myofascial pain (pain generated from muscular tissue) is common, it is not the only source of pain." Pain can come from joints, nerves, inflammation, or other systemic causes, he explains. And while muscle pain often comes along with other types of pain, it's not usually the root cause. If you tweaked or strained something minor during a workout, though, it could be worth a try. (Related: Are Sore Muscles a Sign of a Good Workout?)
What's more, physical therapists, chiropractors, and MDs will do thorough examinations and take medical histories of patients in order to diagnose the problem and then treat the cause using a variety of techniques, which could possibly include myotherapy. "Hypothetically, a myotherapist who has a license that allows them to diagnose could do this," says Tauberg. "However if all they do is myotherapy, the treatment they provide may not be of use. Many times, pain does not just come from muscles." The moral of the story? If you're interested in myotherapy, it's best to find a health care provider who is also skilled in other evidence-based techniques.
One confusing thing about myotherapy is that it has different methods and levels of credibility in different parts of the world. "The myotherapists in Australia, Cambodia, New Zealand, and the U.K. are part of the Allied Health Professions, have insurance privileges, and membership in the Pain Society," explains Sandy Hilton, P.T., D.P.T., a physical therapist at Entropy Physiotherapy and Wellness. That means they have a degree in myotherapy, accept insurance, and are considered health care practitioners in their own right. Some of them even have PhDs in fields like exercise physiology. "They treat musculoskeletal conditions using manual therapy, interventions such as the application of pain science education, transcutaneous electrical neural stimulation (TENS), dry needling, heat/cold, and corrective exercises," says Hilton.
In the U.S. (and the rest of the world), things are a little bit different. "The myotherapists in the United States have a certification (not a degree), and it is typically massage therapists who have gone on to get this certification," says Hilton. "While they hold the same name and also treat musculoskeletal conditions, the training is not the same as in Australia." What's more, depending on the practitioner, the methods they use may not be completely evidence-based. "U.S. myotherapist treatments are based on the trigger point theory popularized by Travell and Simons, which is being phased out of evidence-based courses in physical therapy programs to include U.S.-based dry needling courses." That's because many researchers believe trigger point theory to be largely inaccurate.
Who should try myotherapy?
One thing experts agree on is that there's really no harm in trying myotherapy for pain relief if you think it might help you-as long as you're seeing a licensed practitioner. "My bias as a chiropractor, not surprisingly, is to explore drug-free approaches for all pain first," says Liou. That being said, she says there are some patients who will require mainstream medical intervention or even medication for a certain period of time in order to get relief. "When pain medication is prescribed with an endpoint in sight, it can be a powerful tool." (BTW did you know there's an app for chronic pain relief?!)
But since it works on muscle tissue and fascia, myotherapy is probably going to bring you relief if that's where your pain starts. "Myotherapy is an appropriate therapy for patients whose pain generator is their myofascial tissue," says Tauberg. Heading to a qualified practitioner is your best bet to find out if this is the case for you. "In order to determine that the muscles and or fascia are the source of pain, one must do an in-depth history and examination of the patient. But being that myotherapy is a conservative rehabilitation technique, there is very little risk associated with trying this technique."
Your issues probably won't be solved in one myotherapy session, but you should be seeing some progress over time. "Ideally, if the person is not progressing within two or three weeks, the myotherapist would refer on to an evaluation by a physical therapist or an MD," says Hilton. As for who should not try myotherapy, she has some thoughts: "Myotherapists are not trained in pelvic health (internal examinations), so [people with] those conditions, including continence issues and sexual dysfunction, should see a physical therapist with proper training, as well individuals with complex medical conditions."
More than anything, Hilton encourages anyone struggling with pain to get help as early as possible from a practitioner with whom they feel comfortable. "Pain is pain, be it in the back, neck, shoulder, or knee. Getting treatment soon if acute pain doesn't improve in the first few weeks is a great idea, and a skilled therapist can help to resolve the issue before it becomes chronic."