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24 m a s s a g e & b o d y wo r k m ay/ j u n e 2 0 2 3 Tension injuries occur when myofascial tissues are exposed to high tensile loads. The most common pathology resulting from high tensile loads is muscle strain. Remember that a muscle strain is a particular type of injury that indicates overstretching and potential tearing of muscular or tendinous fibers. People are often diagnosed with a muscle strain when they may have hypertonicity or spasm in the back muscles. Neuromuscular dysfunction is the second category of myofascial pain and includes the most common causes of back pain. Chronic tightness without a specific inciting incident is the most common low- back pain complaint and is often caused by chronic mechanical overload, leading to hypertonicity, which refers to an increase in muscle tension and stiffness. This condition develops when the muscles are trying to protect the spine from injury or strain, which can result from poor posture, prolonged sitting, repetitive lifting, or sudden twisting movements. Pain from hypertonicity can occur from an acute incident in which the muscles reach a tipping point with a particular movement. The back may have been under chronic loads for some time, and one awkward action was enough to go past the back's tolerance limit for that particular load. The result is a high-level protective muscle contraction that perpetuates, becoming chronic back pain. When the muscles in the low back become chronically hypertonic, they can cause discomfort, pain, and limited range of motion. These symptoms can affect a person's ability to perform daily activities, such as bending, lifting, and walking. The muscles may also develop trigger points, areas of increased sensitivity, and tenderness that can refer pain to other parts of the body. Symptoms of myofascial back pain can range from mild discomfort to severe pain and disability. In addition to localized pain and muscle tenderness, individuals may also experience decreased range of motion, muscle weakness, and difficulty sleeping. Although massage does not directly affect disc protrusions or degenerative disc disease, it can still effectively address the pain or problems they cause. symptoms. Therefore, avoid using a lot of pressure and keep in close communication with your client about symptom changes. Another concern when considering massage therapy for these problems is that symptoms associated with herniated discs often involve neurological sensations, such as paresthesia, numbness, or motor disturbance in the lower extremity. It is wise to investigate other possible causes of neurological pain. If symptoms are bilateral, cauda equina syndrome (pressure directly on the spinal cord) could exist, and the client should be immediately referred to a physician. MYOFASCIAL PAIN The most common cause of back pain is myofascial pain, which can result from dysfunction or pathology of the myofascial tissues. Multiple problems fall within that definition and are divided into two categories: mechanical disruption of tissue and neuromuscular dysfunction. Mechanical tissue disruption occurs when mechanical forces cause injury or damage to the myofascial tissues. Most commonly, these injuries occur from excessive compression or tension forces, such as a high-impact contusion, leading to damaged tissue, bruising, and impaired function. This type of injury is less common than tension injuries due to the nature of the forces the back is designed to withstand.