One of the perpetuating factors in myofascial syndromes that is often underestimated, is the deficiency of some vitamins and minerals.
Often, in order to achieve a lasting remission of the problems related to trigger points, manual therapy alone is not sufficient, but one must eliminate all perpetuating factors as well. In this article I will focus on the very important category of perpetuating factors constituted by inadequate nutrition.
First, you must understand the connection between nutritional deficiences and inadequacies and Trigger Points. This can be explained mainly on two fronts, the energy crisis linked to the trigger points on the one hand, and neurological disorders on the other hand.
Now it happens that certain vitamins act as coenzymes that are part of enzyme systems, without which the enzymes can not carry out essential metabolic functions. This can cause disturbances of the energy cycle that will tend to exacerbate the irritability of trigger points, which themselves are ultimately caused by an energy crisis at the local level of muscle sarcomeres. In addition, the deficiency of certain vitamins causes neurological disorders that will accentuate this irritability by the nervous system malfunction
There are particular groups especially at risk of vitamin and mineral deficiencies, particularly the elderly, pregnant and lactating women, heavy consumers of alcohol and drugs, those who follow long-term diets very restricted and totally devoid of food of animal origin (unless supplemented very carefully), the chronically ill and people taking certain medications.
In all these, the vitamin and / or mineral deficiency is associated with a high susceptibility to myofascial syndromes and increased difficulty of complete success in their cure.
Outside of the myofascial scope, I would like to stress that vitamin deficiencies in the modern diet are also associated with serious diseases such as cancer.
Janet Travell discovered that often, a subclinical vitamin deficiency causes myofascial problems long before the onset of a clinical deficiency proper. The 5 vitamins that have proven essential to complete the treatment of trigger points are as follows:
- Thiamine (Vitamin B1). The B1 deficiency causes beriberi. Its deficiency worsens myofascial syndromes, because on the one hand it takes part in the metabolism of glucose (the fuel of muscles), and because on the other it is essential in the functioning of the nerves. The Thiamine is present in eg pork, legumes, nuts and whole grains, but is easily destroyed by heat above 100 degrees (eg in a pressure cooker) and is lost in water being water-soluble. Its toxicity is very low or none.
- Pyridoxine (vitamin B6). Water-soluble vitamin, it is essential in energy metabolism and lipid metabolism, and its deficiency causes degeneration of nerve myelin. Although B6 is well preserved by the body, demand increases with age and with the ingestion of protein. Rich sources of B6 are meat, liver, kidney, chicken, tuna, soybeans, nuts and some vegetables, bananas and avocados.
- Cobalamin (vitamin B12) and folic acid. These two vitamins are closely linked and are essential in protein synthesis, production of red blood cells, and in the synthesis of fatty acids and the production of nerve myelin. The sources of B12, which is also water soluble, are essentially animal, so those who follow a strictly vegan diet are at high risk of failure, but it usually will begin to occur after many months of strict diet and it will not be immediately apparent . It will be therefore proper for those who follow this diet to add some animal food such as eggs or fish periodically to avoid running out of stocks of B12. Folic acid is found in leafy vegetables instead (hence the name, from the Latin word folium, which means "leaf"), fruits, and liver.
- Ascorbic acid (Vitamin C). Its deficiency causes scurvy. Vitamin C also helps prevent muscle soreness after exercise, and strengthens the capillaries and the production of collagen, which is useful in cases of bedsores. According to some researchers is also useful in cancer because it seems to lengthen the life expectancy of patients, although it does not seem sufficient to cure it, although there are proponents of vitamin C megadose therapy who believe the opposite. However, megadoses of C above 1000 mg might also pose a risk of kidney stones. An excellent source of C is citrus fruits, raw vegetables such as raw broccoli, and a good fresh orange juice from 4-5 fruits should be sufficient for the daily needs of the healthy person. Smokers are at high risk of deficiency of Vitamin C.
In addition, some minerals have proved important to protect against relapse in myofascial syndromes, and the main ones are Iron, Calcium, Potassium and Magnesium.
It is expensive and complicated to establish vitamin deficienciesby laboratory investigations. These often subclinical deficiencies, unlike obvious ones, do not give rise to real diseases but to ambiguous symptomsare difficult to identify, including iperirritabilita of myofascial trigger points. The most sensible approach is to have a diet rich in fresh and raw vegetables and take a balanced multivitamin and mineral supplement, avoiding megadoses unless in specific cases and under the supervision of the doctor.
Furthermore, one is at higher risk for deficiencies if belonging to the following groups: the elderly, pregnant and lactating women, alcoholics, drug addicts, extreme vegetarians, smokers, and chronically ill. In these cases it may be appropriate to assume a greater amount of vitamins, but always taking care to remain within the acceptable doses and not exaggerate especially for vitamins A, D and E where the toxic risks are greater.