Active Trigger PointsTrigger Points are effectively muscle knots that can result in a pain signal sent to the brain, and result in either pain where the “knot” is, or referred pain elsewhere.  They are an underestimated and under-recognised cause of pain, and are very commonly missed by other clinicians, due to the lack of education about them at universities and medical schools.  This is despite the fact they have been treated and studied for the past 70 years, and treating them causes massive pain relief for those whose trigger points are the cause of their pain condition.

They are caused by a number of factors:

  • Prolonged or repetitive postures
  • Lack of strength in muscles
  • Sensitisation of a nerve pathway, or
  • As a protective mechanism to ensure that a muscle can’t be torn or damaged.

The science behind the exact pathology of trigger points is hotly debated in the literature, but products like back balls, foam rollers are advocated by and sold by the Australian Physiotherapy Association, and are staples in the lockers and kit bags of professional athletes and everyday people alike. People who live with those “knots” in muscles, when treated well and with care, can have enormous relief with correct and accurate treatment.

Some may have tried releasing trigger points and not had success, despite the fact the trigger point is causing the pain response by the brain.  The key to treating trigger points is to do it correctly. Their location needs to be identified precisely on the individual patient (everyone is built slightly differently), and then treated carefully and correctly in order to obtain the best results. Techniques can include a contraction and stretch with a coolant spray, acupressure, or dry needling – coupled with postural correction or strengthening program.

A paper published in 2002 explains the definition of a trigger point in very clear terms:

Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders. Acute trauma or repetitive microtrauma may lead to the development of stress on muscle fibers and the formation of trigger points. Patients may have regional, persistent pain resulting in a decreased range of motion in the affected muscles. These include muscles used to maintain body posture, such as those in the neck, shoulders, and pelvic girdle. Trigger points may also manifest as tension headache, tinnitus, temporomandibular joint pain, decreased range of motion in the legs, and low back pain. Palpation of a hypersensitive bundle or nodule of muscle fiber of harder than normal consistency is the physical finding typically associated with a trigger point. Palpation of the trigger point will elicit pain directly over the affected area and/or cause radiation of pain toward a zone of reference and a local twitch response. Various modalities, such as the Spray and Stretch technique, ultrasonography, manipulative therapy and injection, are used to inactivate trigger points. 

Trigger points can cause pain either at the site of where the trigger point is, or quite often refer pain to places that you may not have thought possible. For example, trigger points from behind your shoulder blade are the most common cause of front of shoulder pain and restriction, and trigger points in your buttock muscles are often the cause of the pain associated with sciatica.

Trigger points can also cause muscle weakness, muscle tightness or movement restriction. If you have undertaken a strengthening program in the past and your pain or strength showed either minimal or no improvement, it is very likely that trigger points are the cause of that lack of improvement.

Our clinicians have been treating trigger points since they graduated from University – and have thousands of hours of clinical experience in diagnosing and treating them, to obtain the best relief possible for all of their patients.

Contact us if you would like more information on how Active Trigger Points may be causing your chronic pain condition.