Trigger Point Therapy


What is Trigger Point Therapy? (Neuromuscular Therapy)


A trigger point can be thought of as a knot in a muscle. The defining symptom of a trigger point is referred pain. The result is you can have a knot in a muscle, but you feel pain or discomfort elsewhere. Some common examples of referred pain are tension headaches, migraine, sinus pain, and a stiff neck that won’t let you turn your head.

Back pain very often is nothing but referred pain from trigger points. Low back pain can come from trigger points in surprising places, such as your buttocks, your stomach muscles, or even your calf muscles or hamstrings. Treatment for back pain often fails when trigger points are not identified as a possible cause.

Jaw pain, earache, and sore throat can also be caused by a trigger point. Stiffness and pain in a joint, sore legs, sore feet, or painful ankles may all be caused by trigger points. Muscles that have been shortened, stiffened, or enlarged by a trigger point will frequently squeeze a nearby nerve. Sensations such as numbness, tingling, burning, or hypersensitivity, especially in the arms and hands can be due to trigger points. Trigger points can also cause a muscle to clamp down on the blood supply especially to the extremities causing cold hands or feet.

Trigger points are often the major source of pain in whiplash, yet many times they go undiagnosed. Tears, sprains, and dislocations may be diagnosed, yet the accompanying trigger points are not. Failure to recognize and treat trigger points as a part of any physical injury delays complete healing and causes needless pain.

Trigger points can also be caused by accidents, falls, strains, or any kind of trauma including a onetime episode of overdoing it. Emotional stress, food sensitivities, food allergies, how one sleeps at night, how one sits in front of a computer, can all be suspect. A sedentary lifestyle is a great perpetuator of trigger points. Muscles need to work in order to stay healthy. That being said the "weekend warrior" who over does it in short bursts will most likely find aches and pains on Monday morning that are the result of trigger points.

Trigger points don’t respond to positive thinking, biofeedback, meditation, and progressive relaxation or topical ointments. Applications of heat or cold may temporarily reduce pain but they won’t deactivate trigger points. Likewise, electrical stimulation can give temporary relief of pain but not affect a trigger point long term. Swedish massage, therapeutic touch, craniosacral therapy all have their place in therapeutic bodywork, yet they are not specific enough to deactivate trigger points.

Even death doesn’t get rid of trigger points! Autopsies have been performed where trigger points have been identified. Very specific trigger point therapy needs to be applied directly to the affected area to bring results. Chronic pain from long-standing trigger points may require multiple treatments, as with any other therapy. Time is of the essence in treating a newly acquired trigger point because they can be relieved more quickly and hopefully not return.

Resources for this article:
Myofascial Pain and Dysfunction: The Trigger Point Manual
Janet G Travell, MD., David G. Simons, M.D.
The Trigger Point Therapy Workbook by Clair Davies