The Cinderella Hypothesis
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- Curtis McKenzie
- 5 years ago
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1 The Hypothesis
2 The Cinderella Hypothesis The Unique Opportunity that s Unfolding for Trigger Point Specialists For people who think they know all about trigger points There s something 90% of people have MISSED. There s a huge epidemic in the world today that most medical science is spectacularly UNPREPARED for. And the stage is set for trigger points to take the center place in a drama that s playing out right now. Curious to know what this is all about? To do that, we re going to have to go back to the 1800 s. Pre 1800, the myth of the Great Professor reigned. If a leading doctor with years of research and experience put forth a theory or method (usually named after himself - and doctors back then were always men) then with some persistence, this method would be adopted and entered into the great medical doctrine. And the new dogma would then be accepted and taught to medical students going forward. Then, in the 1820 s, a French physician named Pierre Louis began to question this. He started with the most basic of questions - how do we know this fact to be true? Soon, all the accepted tests and treatments were subjected to randomised controlled trials to see if they really performed as promised. And many of them didn t. As Benjamin Franklin said: one of the great tragedies of life is the murder of a beautiful theory by a gang of brutal facts. And the 20th century saw many theories disproved. This was mostly a positive development. It meant that the risks of treatments were understood. Treatments could be compared, and we could just use the ones that were actually effective. But like all progress, there was a downside. Many useful methods that couldn t be proved or disproved by double blind randomised trials were relegated to the alternative treatments pile. They were pushed out of standard medical practice and marginalised.
3 What did many of these treatments have in common? They were manual therapies that relied on the skill of the practitioner. Using evidence based medicine it s easy to test if a pill works. You give half of your patients the pill, and the other half the placebo (or fake pill,) and see if there s a noticeable difference. In the case of treating a trigger point, how do you allow for the fact that one trigger point practitioner may be far more skilled than another? And for that matter - how do you even prove that a trigger point treatment has worked? Certainly a patient can say they feel better, but in the canon of evidence based medicine this is not an objective measure. Anecdotal data lies several notches down the totem pole of what constitutes good medicine - when viewed through the lens of an evidence based approach. To prove something works in evidence based medicine - you need an objective measure. Something a machine can read as a simple yes/no answer. For example - is the white blood cell count up? Is the bone broken? Is the level of cholesterol down? Until recently - there was no objective way to even tell that a person had a trigger point. Because feeling a tight band within the muscle and small thickening (classic signs of a trigger point) is an entirely subjective measure.
4 One person who has sensitive fingers may feel it - another person may miss it completely. So for trigger point treatment to get any kind of recognition within this new evidence based medicine milieu, there needed to be an objective measure. Trigger treatment needed the following three steps: One - you could show there was a trigger point - objectively and consistently. Two - you did your treatment. Three - you needed to PROVE - scientifically, that because of your treatment the trigger point was no longer there. And until recently, there was no way of doing this. But now, thanks to the work of a few medical pioneers, there are ways to test and show - using specific types of imaging - that trigger point treatment works. Now, if you ve been treating trigger points for years, you re probably shaking your head right now. You know it works - and you ve proven it to yourself by helping hundreds of patients. But to ignore the need for an evidence based approach would be to ignore the prevailing force in medicine today. In other words, to thrive as a health practitioner today, you need to understand how the game is played - and then win the game. And being able to prove that trigger points exist and can be treated is a HUGE step forward. It means that Trigger Point treatment can move from being the Cinderella of pain treatments - hidden working away down in the basement - to taking center stage as the belle of the ball. Because trigger point treatment is a wonderful way to treat pain. In my own clinic - it s something I use on a daily basis. My own clinic deals with people who have chronic pain - pain that s being going on for months or years - and isn t getting better. And this leads us to the next big connection.
5 Chronic pain is THE biggest problem in health today. It costs the USA $635 BILLION dollars EVERY YEAR. It s a larger problem than cancer, heart disease and diabetes...combined. The Great Chronic Pain Epidemic And yet for the most part - it s very poorly treated. For the last 10 years, I ve been running a clinic for people with chronic pain in New Zealand. And when people come to see me, there s three things that the vast majority of them have in common: 1. No one has really, properly PHYSICALLY examined them. They may have had lots of scans, bloodwork, MRI s, xrays and ultrasounds. (This is all good, and necessary to rule out dangerous causes for pain like tumours.) But no one has actually put their hands on them and felt for...you guessed it. Active trigger points. And unsurprisingly I find that almost without exception - people with chronic pain have active trigger points. 2. No one has LISTENED to their story. This means their full story. Just listened - without jumping to conclusions or trying to diagnose the problem - until they ve said all they need to say. My wonderful PA tells me that people come out of their consultation and say to her he really Listened to me. Like that was something unusual - that they hadn t experienced before. Really listening is an art. And it requires effort. Effort to stay in the present moment and just listen. And effort to not put on the diagnosing hat until they ve finished talking. I find though, that when I make this effort to truly listen -something surprising happens. Firstly, the person I m listening to feels validated. Being heard is a vital part of healing - especially if no one has done this for them before. And secondly - often without my conscious effort - a clear path forward will appear. I don t know what to call this - intuition, the power of the unconscious - but when you reserve judgement and still your mind, the answers to difficult problems often surface - as if on their own accord.
6 3. No one has looked for signs of Central Pain Sensitisation. This is HUGE. It s a primary driver of chronic pain, overmedication, and people who have been in pain for years - and no one can tell them why. I m not going to go into detail how I look for pain sensitisation right now (that s coming in a day or so) but there s some very specific signs I look for. And then there s a very particular conversation I have with patients to introduce this topic in a way that won t alienate them. It s a delicate moment, but if you do this right - this has more power than anything else I ve encountered to transform people s lives and get them out of chronic pain. There s a video I ve created explaining the new role of Trigger Point Treatment in detail. If you haven t already watched it, click here to go there right now and see why trigger points are set to become a huge opportunity in medicine today - and why you are now ahead of the curve.
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