Spray and Stretch

Aka: Spray and Stretch, Stretch and Spray, Fluori-Methane, Vapocoolant Spray

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II. Indications

  1. Myofascial Pain Syndrome
  2. Trigger Point

III. Mechanism

  1. Anesthetic spray distracts patient
  2. Clinician passively stretches Trigger PointMuscle

IV. Equipment: Vapocoolant Spray

  1. Fluori-Methane Spray (by Gebauer Co. in Cleveland)
  2. Contents of Vapocoolant Spray
    1. Dichlorodifluoromethane 15%
    2. Trichloromonofluoromethane 85%
  3. Spray kept at 10 to 12 degrees celsius

V. Technique

  1. Patient positioned comfortably
  2. Fluori-Methane sprayed over involved Muscle
    1. Direct spray at 30 to 60 degree angle
      1. Sweep spray parallel to Muscle fibers
      2. Sweep spray toward Trigger Point
    2. Spray 2-3 times, each covering 10 cm/sec
  3. Muscle involving Trigger Point is stretched
  4. After Stretch and Spray
    1. Apply moist heat to involved Muscle for 10-20 min
    2. Full active range of motion of involved Muscle
  5. Repeat up to daily for 1-2 weeks
  6. Suspend treatments for 2-3 days if soreness develops

VI. Precautions

  1. Hyperirritable Trigger Points may be exacerbated
  2. Fluori-Methane is potential biohazard for ozone loss
    1. Safer alternative than ethyl chloride (explosive)

VII. References

  1. Sola in Roberts (1998) Procedures, Saunders, p. 890-901
  2. Alvarez (2002) Am Fam Physician 65(4):653-60 [PubMed]
  3. Fomby (1997) Phys Sportsmed 25(2):67-75 [PubMed]

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