‘Myotherapy is the evidence-based assessment treatment and rehabilitation of musculoskeletal pain and associated conditions’, Myotherapy Association Australia
Persistent Pain
Some pain relates quite simply to overworking a muscle or tendon. Other pains last longer than three months and we call them persistent or, more technically, ‘nociplastic’.
This pain comes from neuro-immune assemblages relating to biological, psychological and social affects in the body: hence the ‘biopsychosocial paradigm’. These pains will resemble or mimic musculoskeletal pain but when scientists study them they find there is no activation going on in the danger receptors where it hurts.
With discoveries in neuroscience and plasticity in recent years we know have a much better idea how to work with these tricky persistent pains. We now work to alter the way these neural assemblages emerge as a pain experience by:
- designifying out of date cognitions,
- using mindfulness techniques to learn to combat cognitions and their affects on the body,
- encouraging life affirming and vitality producing activities,
- learning movement patterns that enhance your ability to be in ‘the dance of life’, however that may look,
- doing affective massage that nourishes your sensory nervous system with new stimulus,
- working with medical practitioners for pharmacological supports where needed.
If you are a Micah Projects participant we also have crisis, housing, health and social services to form an eco-system of support to deal with your persistent pain holistically.
A note on dry-needling
Dry-needling (the use of acupuncture type needles in a western musculoskeletal paradigm) has become synonymous with Myotherapy. Today dry-needling has reasonable evidence for the short-term alleviation of pain, but very marginal evidence for longer-term pain reduction and no evidence for the rehabilitation of an underlying tissue deficiency. See a useful review of the JOSPT systematic review last year by Body in Mind researchers,
Although I have double the industry training in dry needling, and employ what I feel to be a precise and sensitive approach, I use needling sparingly. I only use needles with those who are very comfortable, informed and consent to dry needling.
In almost all cases I can use ischemic compression, gentle neuromodulation and positional techniques to soften muscle tone.
Pain science shows we need to build safety and strength messages in the body and for many people I believe needling is not supportive of this aim.
More importantly, having clients become dependent on a treatment with low evidence, when there are approaches with much better long-term efficacy for persistent pain (such as movement, strength and pain education) it is not clinically responsible.
What to expect in a Myotherapy Session with Dave:
- Pain and functional movement assessment
- For pain modulation and hypertonic muscles: Ischemic pressure (Shiatsu), Myofascial release (MFR), dermoneuromodulation (DNM), dry-needling. Please wear suitable sports underwear
- Tendinopathies and motor control challenges: Progressive loading / isometric exercises and functional movement training. Bring exercise clothes
- Neurodynamic mobilisations for nerve movement restrictions
- Joint mobilisation and active stretching for joint restriction
- Pain science education and mindfulness for persistent pain
- Other techniques if appropriate including ultrasound shockwave therapy and heart rate variance (HRV) monitoring and education.
“A supportive space to build safety in the body so as to reduce reactivity to everyday stressors”
Private Clients
Price $115/hr, $165/90 mins, hicaps available for Myotherapy in your extras cover
Please book online as David Monson Private Client or call Dave on 0415 731 400
Book a Myotherapy Session Here
Micah Projects Participants and Concession Cards
No fee for eligible Micah Project referrals
Health Care Concession cards, $20 /60 mins
Please book through Inclusive Health reception: 3013 6050