Forget the famous line, No pain, no gain. It does not apply in fibromyalgia or Myofascial Pain Syndrome, or even in simple TrPs. In FMS clients, exercise causes a reduction in temperature and cerebral blood flow. They often can t think clearly enough during exercise to set limits. Tell them to set a timer, or to exercise with a friend who can keep track of the time.
Cramps can also result from cooler temperatures, sometimes immediately.
Hotter temperatures may bring nausea and extreme fatigue, if toxins flood the system. Hot tubs and hot baths should be limited to fifteen minutes or less, at least at first. Watch for chlorine sensitivity. Many of these clients will have multiple chemical sensitivities. You can use galvanic electrical stimulation or ultrasound with electrostim as a search and destroy method, as both modalities cause pain in the immediate area of the TrP until it s broken up.