The following article first appeared in the Tribune-Review

Magicians use misdirection to create illusions. Look here and you don't see what's happening there. The human body can do the same thing with less enjoyable results. A pain here might actually be caused by an injury there. Pittsburgh's only certified trigger point myotherapists operate the Center for Pain Treatment at 1312 Carson Street, South Side, where the hunt for elusive pain is ongoing. Trigger point myotherapy is a relatively new field with a very famous patient. Before his election to the presidency, the late John F. Kennedy suffered from back pain so debilitating that as a freshman senator he missed almost three-fourths of the votes on the Senate floor. Dr. Janet Travell, now in her 90s, treated him by finding his trigger points, or "the tender spot in the muscle that sends pain to another place in the body," said therapist Richard Finn of Washington, Washington County. Dr. Kathleen Clarkin Henning of Dormont, a chiropractor who works with the South Side myotherapists said, "We try to abort the signal to the brain by pressing on the trigger point and stretching the muscle out. You can have a trigger point in your upper shoulder or in your back area, but the pain may not be perceived in that area; it might be perceived in the upper head area, like a headache." Trigger point therapy has been used successfully to treat tennis elbow, carpal tunnel syndrome, migraine headaches, trick knee, bursitis, sciatica, TMJ (temporomandibular joint) syndrome and other ailments. "Things have been misdiagnosed so often," therapist Mark Spanos of Carnegie said. "A patient visits the doctor with a headache. Doctors think that since there's no physical cause - there's no tumor, the blood vessels are working fine, the nerves are functioning fine - therefore it has to be something else, like a migraine." But maybe it's not. New clients at the center first see Clarkin Henning, who takes a history and does a chiropractic exam. Then she sends them to one of the myotherapists or refers them to a physician. "I don't accept every case that comes in the door," Clarkin Henning said. Patients will see her again after their trigger point myotherapy for a chiropractic treatment. If the patient is to stay at the center, a trigger point myotherapist will then begin treatment. "We don't use oils," Spanos said. "We don't do a typical massage. We'll palpate a little bit, which is mostly searching through the muscles to find the tight areas, and then we'll use compression. "We'll compress on the muscle until that trigger point starts to deactivate and uncontract. The muscle will start to relax." A chart hanging on the treatment room wall shows the connecting points between muscles and various points of pain in the body. "A woman came in and was shown her pain pattern on the chart and she said, 'You mean someone has know about this before? It's actually charted out and I'm not crazy?'" Finn said. Finn said that while 30 percent of the treatment is done in the office, the rest is up to the client. "Stretching exercises are a big part of our program," said therapist Nancy Shapiro of Carnegie. Patients are taught to incorporate stretches into their daily routine, a departure from the stretching programs assigned by physical therapists, whose exercises often require clients to set time aside daily for exercise. "Most therapists have a terrible time getting their patients to do their exercise, but we don't have that problem," Finn said. A stretching exercise may be as simple as extending the arm while hanging up the phone. Trigger point myotherapy is often the court of last resort for pain sufferers. Spanos said, "We see a lot of people who have given up on physical therapy after a year or two years. Sometimes they've gotten slightly better, sometimes they've exacerbated the problem with physical therapy. Tasso G. Spanos of the South Side, father of Mark Spanos, who was unavailable to be interviewed, was a pioneer in the field of trigger point myotherapy in Pittsburgh. "My mother, when she was very young, had polio," said Mark Spanos. "We were very lucky in the fact that she had no permanent disability. But when she turned 40, she got post-polio syndrome with muscle contractions, weakness and pain." Tasso Spanos was walking through Kaufmann's department store several years ago when he noticed a TV program about the benefits of exercise and myotherapy presented by a former patient of Dr. Travell's, according to his son. "He was on his way to work, but he stayed there for an hour and watched the show," Spanos said. From that TV program, Tasso Spanos embarked on a voyage of self-education. He studied Travell's work and the work done by the late Hans Kraus, who was called "the father of sports medicine" in his obituary in a recent issue of Sports Illustrated.

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