Pain

Most pain in the body has an origin in myofascial dysfunction.  That means that the pain is coming from a form of dysfunction between the muscles and nerves that leads to a contracture of the muscle and a feedback loop of contracture-pain-contracture.  The contracture itself is caused by nerve root insult, which is just damage to nerves caused by falls, spills, sporting accidents, car accidents, and the like. 

For younger people, injury to the nerve root will often heal on its own, without causing a muscle spasm or contracture.  As we age, so do our nerves, and our ability to recover from these nerve root injuries decreases.   The nerve begins to short out, becoming super-sensitive, and leaving the muscle permanently spasmed.  For a much more comprehensive treatment on the subject, click here.

Trigger Points

Muscle contractures due to nerve root super-sensitivity quickly for what are called 'Trigger Points (TrPs)'.  These are essenstially a blister in muscle tissue at the endings of peripheral nerves, which send (refer) pain to sometimes distant locations in the body.  For example, a TrP in one of the scalene muscles in your neck can refer pain to the chest, shoulders, back, and arm.  The TrP is in the scalene, but it is felt elsewhere.  This can make it very difficult to locate the source of the pain, but fortunately there are now inexpensive and excellent books on the market that can help you do just that.  The point of TrPs is that they REFER pain elsewhere in the body.  I've included a link to a very useful book on this subject below. 

 Treatment

The good news is that this muscle spasming can be treated relatively quickly and cheaply.  There are several progressions of care, but let's look at some ineffective (and dangerous) ones first.

•  Chiropractic:  There are as many different methods as there are chiropractors.  Very few are effective.  We'll get to them later for treatment of conditions like fibromyalgia, rheumatoid arthritis, reflex sympathetic dystrophy/complex regional pain syndrome, migraines, and trigeminal neuralgia.  Chiropractic is not an effective treatment for most types of spinal pain.  It is dangerous for neck pain, unless done by a specific upper cervical chiropractor.  Like I said, more on this later.  Neck manipulations can cause a stroke, and it's unclear how many strokes chiropractors cause each year.  Suffice it to say, spinal pain is not worth risking a stroke.
• Physical Therapy:  This can range from very helpful to detrimental, depending on the PT's knowledge of myofascial pain.  If your are exercising muscles that are littered with focal myofascial dysfunction (trigger points), you are likely to worsen your problem.  Myofascial trigger points (TrPs) must be treated at the same time as postural or strengthening exercises are prescribed.  Ask your PT if they're familiar with the work of Drs. Travell and Simons to determine whether or not he or she understands myofascial pain.  Newly minted PTs usually are.
• Nerve Stretches:  The first time I heard of these was from a PT.  These are specific stretches to break scar tissue and adhesions off of nerves.  These adhesions cause the nerve to become irritated, causing the pain-spasm-pain cycle that leads to the formation of TrPs and pain.  These are extremely useful for Thoracic Outlet Syndrome and back pain, but must be used IN ADDITION TO trigger point therapy. 
  
• Trigger Point Therapy:  Basically, this involves self-massage of trigger points several times a day until they go away.  It is based on the work of Drs. Travell and Simons, mentioned above. This is best done in conjunction with some form of nerve stretching,  muscle stretching, and posture therapy.  You can teach yourself how to do this by buying this book and reading up on the sections that cover your pain.  This requires a learning curve and persistence, but is a lot better than attempting to find a massage therapist that is familiar with Travell and Simons.  Most are not, and therefore don't provide much in the way of lasting relief.  It is far more effective and cost effective to treat yourself.
• Intramuscular Stimulation:  This form of treatment is based on Travell and Simons, but also incorporates its own model of pain, discussed above.  It basically involves inserting an acupuncture needle into the TrP and twisting it, causing the muscle to contract and relax like a spring, thus calming down the muscle, treating the TrP, and telling the hypersensitive nerve root to calm down as well.  It is more effective than self-massage, but there are few practitioners of it because it is a difficult technique to learn.  It can also be painful initially.  It is best done in conjunction with stretching, nerve stretching, and posture work.