Trigger Points

Trigger points are small knots that form in one of the muscles of your body, as a result of muscle strain, overstretching of the muscle, or injury. A trigger point is an area in the muscle or connective tissue (fascia) that becomes sensitive or painful upon being touched. These small areas of tightness usually build up due to repeat injury to that muscle, strain from repetitive overuse, or repetitive overstretching of that muscle. These trigger points may be small enough that patients are not aware of their precise locations, and may feel an elevated level of pain or discomfort in an already sore muscle, when an expert diagnostic clinician presses upon it. these trigger points may cause pain in the muscle they are contained in, or they may cause referred pain. Referred pain is pain caused by an injury to a structure on another part of the body. Other sources of referred pain are pinched nerve roots, usually caused by degenerative disc disease.



Diagnosis: Before a diagnosis of muscle tension or trigger points can be made, a careful examination must be done to distinguish trigger points from other orthopedic injuries that have similar symptoms. Upon pressing on trigger points, they may become painful and trigger immediate pain in another region of the body. This referred pain may be due to a nerve branch that is connected to both that pressed trigger point and the other location of the body that is painful. Trigger points may also cause continuous tension in the muscle and the connective tissue lining of the muscles in a disorder known as myofascial pain syndrome.

Treatment: Treatment of trigger points usually involves the same type of therapies as muscle strains, and other orthopedic problems such as arthritis. Treatments for muscle strains usually include building up strength in atrophied muscles and tendons, increasing the muscle length to normal, reduction of muscle tension, and exercises to make the muscles and body more flexible.

The sooner the better is the rule for treating trigger points and relieving tension in injured muscles to prevent the muscle from atrophy or the buildup of scar tissue known as adhesions. Simple, nonaggressive movement during the healing process can help prevent scar tissue adhesions from building up on affected muscles. Doctors may first try muscle relaxants to ease the strain involved with back spasms and muscle spasms. When muscle relaxants are not sufficient alone, physical therapy may be attempted to reduce muscle spasms and to increase the length of the muscle.

Chiropractors and osteopaths are both trained in hands on manual manipulation of stubbornly tight muscles that won't relax on their own. One technique used by these professionals is known as the strain-counter technique. With this technique, the chiropractors or osteopaths use their hands or traction device to stretch the muscle, and hold it at that length over several timed intervals, with the goal of reeducating the muscle to find its proper position. This technique, if successful, may lengthen the length of muscle, and break up adhesion and other scar tissue that has formed around muscle and connective tissue coating (fascia) of the muscle.

Other treatments for trigger points may include ultrasound, electrical stimulation, and trigger point myotherapy.