Travell and simons forehead pain
Writing in the Journal of the National Chiropractic Association in 1957, Nimmo 9 discussed the concept that excessive contraction produced by muscle strain, or other trauma, engages numerous receptors, producing a vicious cycle of noxious impulses. Good, who previously published under the names Gutstein and Gutstein-Good, reported in 19 that the patterns of pain referral from tender points in individual muscles are the same in everyone, mapping these in well-executed illustrations. The vapocoolant acts as a distraction while stretching the affected muscle is the desired action. 8 In addition to procaine injections, they described the less invasive treatment of trigger points, recommending stretching of the affected muscles, following topical spraying with vapocoolant. 4 Since that time, Travell has written extensively on this topic, publishing, with Simons in 1983, Myofascial Pain and Dysfunction: The Trigger Point Manual.
She reported in her autobiography that she could touch spots in the muscle that reproduced and intensified the pain that radiated from the trigger area. Travell’s interest in myofascial pain stemmed from a painful muscle strain that she suffered in the course of her work. In 1942, Travell, with coauthors Ringler and Herman, 7 first reported on her many studies on trigger points. He described the treatment of chronic pain by injection of trigger points with procaine. Steindler, 6 in 1940, used the phrase “trigger point” to describe areas from which pain was referred. As early as 1936, Edeiken and Wolferth 5 used the term “trigger zone” to describe pain reported by coronary thrombosis patients referred to the shoulder and down the left arm in response to pressure over the upper part of the left scapula. The terms “trigger point” and “myofascial pain” permeate the American literature that describes muscle pain syndromes. 4 Schmidt, in 1914, implicated muscle spindles as responsible for the painfulness of the muscle hardenings, because of the anatomical location and known sensory function of spindles. 3 Muller pointed out that they were liable to be overlooked because doctors tend not to search for them in a systematic and skillful manner. He noted that these hardenings were predictably found in specific locations in specific muscles. He reported that with pressure, some hardenings radiated pain to far-reaching areas, while others were even spontaneously painful. His unique contribution to the early German literature was the identification of insertion nodules, which he described as pressure sensitive. In 1912, Muller discussed fiber hardenings and insertion nodules on palpation of injured muscles. The phenomenon of pain spreading from nodules in muscles was also reported by German students of the Dutch masseur Mezger. 2 In 1876, Helleday described a myalgic condition characterized by nodules near the origin of muscles that were tender on palpation. 2 As early as 1843, the German literature referred to tendinous cords or wide bands in muscle as “muskelschwiele” (muscle callus). Prior to the 20th century, references to muscle pain syndromes appeared most extensively in the German literature.