Advice Pool - Health and Fitness

Muscle tension, joint flexibility, and the feeling of being tied up in knots can all be caused by a phenomenon called trigger points. Have you ever had a pain in one area and when a massage therapist rubbed a differe

According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product

nt place on your body you felt the pain melt away? If so, you’ve experienced the result of “trigger point therapy.”

Trigger points are also called muscle spasms. Technically they are areas of hyper-irritability in

; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

Examples of combination products may in

a muscle that may refer pain &/or numbness to another area. In other words, a trigger point is a “knot” in the muscle fibers which prevents the muscle fibers from lengthening to their longest length. Since muscles g

lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

nerally insert at a joint, when the shortened fibers are pulling on the insertion they are causing tension, limiting range of motion, and weakening the entire muscle because these fibers are basically out of commissio

here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe

n.

Trigger Points and Stretching

A muscle originates on a bone, crosses over a joint, and inserts onto a bone that will move when the muscle contracts. This is the way the body moves, and it functions p

d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

Combination pro

erfectly until a trigger point forms in the muscle. As the muscle shortens it is pulling on the insertion point and when you try to move in the opposite direction you feel stiff, inflexible. You may decide to stretch

ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc

however, people sometimes complain about feeling worse after stretching than they did before doing the stretch. To stretch a muscle, while it still has an active trigger point, could cause tiny tears to occur in the

easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi

fibers, and could cause even more pain.

Consider this analogy. If you tied a rope onto a strong tree and then went straight across and tied the other end of the rope onto a flexible tree, the smaller tree would con

nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically

tinue to stand straight. If you then tugged on the rope the flexible tree would bend. However, if you tied a knot, or two, or three, into the rope, the flexible tree would be leaning over. If you then pushed the be

and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ

t tree so it was again standing up straight, you would only cause the knot in the rope to tighten, and you would be overstretching the fibers on either side of the knot. This is exactly what happens when you try to s

ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi

tretch a muscle that is shortened by knots in the fibers, without first releasing the trigger points.

Five Tips to Effectively Treat Trigger Points

As mentioned, the trigger points caused knots to form i

ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

Following aspects would a

n the muscle and the shortening of the fibers put a strain on the insertion point on the other side of the joint. You can reverse this situation by doing the following steps:

1. Treat. Hold the pressure on ea

dd to the challenges in developing combination products:

Which markets to tap where the combination products can do fairly well?
Which combination prod

h trigger point. In order to effectively stretch a muscle you need to first press on each trigger point, holding the pressure for 30-60 seconds.
2. Understand the Muscle Movement. Look at the muscle that

cts are meaningful and rational?
Which therapeutic categories to select?
Which Combinations can address unmet needs of the patients?
Do combin

you will be treating. To best treat and stretch a trigger point, you need to know what movement the muscle makes. For example, the muscles in the back of your neck will pull your head back so you can look up at the

tions increase the patient compliance?
What would be the developing cost?
How to tackle the risks encountered during combination product developmen

ceiling, and the muscle on your shoulder blade raises your arm. To stretch, you need to go in exactly the opposite direction as the movement of the muscle.
3. Stretch. Move so the muscle needs to stretc

t?

As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel

. For example, the trapezius muscle will raise your shoulder, so to stretch it you want to move your head away from your shoulder. You can accomplish this by dropping your head in the opposite direction while pulling

ping new procedures for reviewing their safety, efficacy and quality.

Professional from academic institutions, pharmaceutical industries, health care indust

your shoulder down toward the floor.
4. Press and Stretch for Optimal Benefit. To optimize the treatment, whenever possible, continue the pressure on the deactivated trigger point and then move your body

y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products

so the muscle is forced to lengthen.
5. Slowly Move the Joint in a Smooth Circle. Slowly rotate your shoulder in a circle, move your leg so your hip joint loosens, curl and open your fingers fully, circl

.

As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de

your neck, and arch your back like a cat. Finally, stop pressing on the trigger points but continue the slow, relaxed movement of your joints.

The more often you limber up your joints, the more flexible you will fe

elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

Companies that provide selfless information through particip

el. Always go only to the point of “this feels great,” never trying to overstretch or make a movement that is beyond your comfort level. Stretching feels great when you have untied the knots that have held you bound

tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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