Active Trigger Points
Trigger points are effectively muscle knots that can send a signal to your brain that causes pain to occur, either where the “knot” is, or referred pain elsewhere. Trigger points 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.
In spite of this, trigger points have been treated and studied for the past 70 years. Treating your trigger points can result in massive pain relief for you, if your trigger points are the cause of your pain condition.
The causes of trigger point pain
- Trigger points can be caused by a number of factors, including:
- Prolonged or repetitive postures
- Lack of strength in muscles
- Sensitisation of a nerve pathway, or
- As your body’s protective mechanism to ensure that a muscle can’t be torn or damaged.
You may have had treatment to try releasing trigger points and not had success, despite the fact the trigger point is causing the pain response from your brain. Correct, careful and accurate treatment from the Headache and Pain Management Centre team will address these “knots” in your muscles, and give you enormous pain relief.
How we diagnose and treat your trigger point pain
The key to treating trigger points is to do it correctly. Because everyone is built slightly differently, we will precisely identify the location of your trigger points, and then treat them carefully and correctly to obtain the best results. Our trigger point treatment techniques can include a contraction and stretch with a coolant spray, acupressure, or dry needling – coupled with postural correction or strengthening program.
The science behind the exact pathology of trigger points is hotly debated in the literature, but products such as back balls and foam rollers are advocated and sold by the Australian Physiotherapy Association as trigger point treatment staples for professional athletes and everyday people alike.
What are trigger points?
A 2002 paper defines trigger points 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 fibres 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 fibre 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 your trigger points.
Why we treat trigger points
Trigger points can cause you pain either at the site of the trigger point, 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 Headache and Pain Management Centre clinicians have been treating trigger points since they graduated from university. They have thousands of hours of clinical experience in diagnosing and treating trigger points, to obtain the best relief possible for you.
For more information on how active trigger points may be causing your chronic pain condition, please call us on 1300 16 55 33 or use the contact form above.
Information thanks to Travell and Simons’ wonderful textbooks, and Alvarez and Rockwell.