Question
QUESTION: Wife has been on disability for more than a year after suffering severe upper trapezius strain on both sides due to repetitive motion (she was an overworked accountant who had a bad workstation).

MRIs are negative, it's all soft tissue injury. She has seen several orthopedic doctors, chiros and physical therapists with mixed results. Usual chiro adjustments do nothing or actually make it worse. 2 trigger point injections seem to have done little although they may not have been in the exact right spot.

We finally figured out she has trigger points below the base of her neck on both sides, perhaps with scar tissue.  but the left is worse. We first used a golf ball massage, now I use my elbows to give her a deep tissue massage in those specific areas. I can feel clicking of her muscle fibers and this gives her temporary relief.

Is there anything else we can try?

ANSWER: great question.
  Did her chiropractor do trigger point therapy or myofascial release before the adjustment?
i would continue to do trigger point massage for her or have her go 2-3 times a week for about 6-8 weeks for accupressure massage. you can also add in chiropractic 1-2 times a week, Usually a multitude of therapies used together provide the best results. If that has not worked aftewr 8 weeks of consistent care then you can try accupuncture or cold laser therapy.
if all else fails then you need to look at her diet and ergonomics (ex: lapotops are bad) if she is top heavy (large breasted) that can exacerbate the problem.

---------- FOLLOW-UP ----------

QUESTION: Hi David,

Thanks for your fast reply. Will do. None of the chiros she's seen so far have seemed to be skilled in trigger point/myofascial release but she's going to see one this week who claims to be.
She tried accupuncture very briefly and might try that again. I've been unable to find a chiro or doctor in San Diego that offers cold laser therapy, any suggestions on how to find one?
What about trigger point injections, I've heard that botox injections in the right spot can be effective but expensive.

Answer
I know several great chiropractors in san diego. I just emailed a few to see if they have cold laser. I would do the trigger point injections as a last resort, because They don't typically get to the cause of the problem and tend to be temporary relief.
please email me direct tomorrow morning and i may have someone for you.
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