Spray and Stretch

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

1. Indications
   1. Myofascial Pain Syndrome
2. Mechanism
   1. Anesthetic spray distracts patient
   2. Clinician passively stretches Trigger Point muscle
3. 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
4. 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
5. Precautions
   1. Hyperirritable Trigger Points may be exacerbated
   2. Fluori-Methane is potential biohazard for ozone loss
      1. Safer alternative than ethyl chloride (explosive)
6. References
   1. Sola in Roberts (1998) Procedures, Saunders, p. 890-901
   2. Alvarez (2002) Am Fam Physician 65(4):653-60
   3. Fomby (1997) Phys Sportsmed 25(2):67-75