component, including fibromyalgia. Many of the localized symptoms now considered as fibromyalgia are actually due to trigger points. The central sensitization of fibromyalgia amplifies symptoms that trigger points cause, and this book teaches care providers and patients how to identify and treat those causes.   Chronic myofascial pain due to trigger points can be body-wide, and can cause or maintain fibromyalgia central sensitization. Trigger points can cause and/or maintain or contribute to many types of pain and dysfunction, including numbness and tingling, fibromyalgia, irritable bowel syndrome, plantar fasciitis, osteoarthritis, cognitive dysfunctions and disorientation, impotence, incontinence, loss of voice, pelvic pain, muscle weakness, menstrual pain, TMJ dysfunction, shortness of breath, and many symptoms attributed to old age or "atypical" or psychological sources.   Trigger point therapy has been around for decades, but only recently have trigger points been imaged at the Mayo Clinic and National Institutes of Health. Their ubiquity and importance is only now being recognized.   Devin Starlanyl is a medically trained chronic myofascial pain and fibromyalgia researcher and educator, as well as a patient with both of these conditions. She has provided chronic pain education and support to thousands of patients and care providers around the world for decades. John Sharkey is a physiologist with more than twenty-seven years of anatomy experience, and the director of a myofascial pain facility. Together they have written a comprehensive reference to trigger point treatment to help patients with fibromyalgia, myofascial pain, and many other conditions.   This guide will be useful for all types of doctors, nurses, therapists, bodyworkers, and lay people, facilitating communication between care providers and patients and empowering patients who now struggle with all kinds of misunderstood and unexplained symptoms.   Part 1 explains what trigger points are and how they generate symptoms, refer pain and other symptoms to other parts of the body, and create a downward spiral of dysfunction. The authors look at the interconnection between fibromyalgia and myofascial trigger points and their possible causes and symptoms; identify stressors that perpetuate trigger points such as poor posture, poor breathing habits, nutritional inadequacies, lack of sleep, and environmental and psychological factors; and provide a list of over one hundred pain symptoms and their most common corresponding trigger point sources.   Part 2 describes the sites of trigger points and their referral patterns within each region of the body, and provides pain relief solutions for fibromyalgia and trigger point patients and others with debilitating symptoms. Pain treatment plans include both self-help remedies for the patient—stretching or postural exercises, self-massage techniques and prevention strategies—as well as diagnostic and treatment hints for care providers.   Part 3 offers guidance for both patients and care providers in history taking, examination, and palpation skills, as well as treatment options. It offers a vision for the future that includes early assessment, adequate medical training, prevention of fibromyalgia and osteoarthritis, changes to chronic pain management and possible solutions to the health care crisis, and a healthier version of our middle age and golden years, asserting that patients have a vital role to play in the management of their own health.

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