Myofascial Trigger Points can entrap the nerves, blood, and lymph vessels, causing a variety of symptoms that confuse doctors and patients alike. Often nerve damage is erroneously suspected, and many expensive, unnecessary (and often painful) tests are ordered.

Trigger Points are formed of multiple microscopic areas called active loci (pronounced low-sigh). These loci cause the segments of the muscle fibers, called sarcomeres, to become distorted. Eventually, a contraction knot forms, as well as a taut band. When you have Trigger Points, your muscle strength becomes unreliable. You may also notice that when one part of your body is supported by another part while you are sleeping, the part being compressed goes numb.

Some other symptoms of Trigger Points include the following:

• Stiffness
• muscle tightness and weakness
• localized sweating
• eye tearing
• copious salivation
• poor balance
• dizziness
• nausea
• tinnitus
• goose bumps
• runny nose
• buckling knees
• weak ankles
• illegible handwriting
• staggering gait
• headaches
• muscle cramps

Most specific pains called fibromyalgia are actually caused by Trigger Points. Trigger Points seem to form throughout life as a response to the many things that happen to our bodies. They can be caused by a variety of events ranging from a surgical incision, overuse, repetitive motion trauma, bruises, strains, joint problems, and so forth. Many of the aches and pains attributed to “old age” may actually be due to Trigger Points, and may be reversible.

Dizziness, ringing of the ears, loss of balance, and other symptoms can all be caused by Trigger Points in the side of the neck, in the muscle group called the sternocleidomastoid (SCM) complex. This muscle group performs many functions, one of which is to hold up the head. Receptors in the SCM complex transmit nerve impulses to inform the brain of the position of the head and body in the surrounding space. When there are Trigger Points present, the receptors lie. What they tell the brain is not what the eyes tell the brain. When head movement changes the SCM message (when you turn around or look up or down) you get dizzy. This, coupled with poor balance, can make it seem as if the walls are tilting. When people with SCM Trigger Points drive, we get the impression that we “bank” our turns at a steep angle, as if we were driving a motorcycle. Also, Trigger Points associated with the SCM muscle group can cause patterns of light and dark, such as tree shadows on a road, to create an almost seizure-like phenomenon. Looking at certain printed fabrics, such as plaids, stripes, and polka dots, can make us dizzy.

Trigger Points often form as a result of other medical conditions. For example, a case of arthritis might be otherwise well managed, but the accompanying Trigger Points might be completely overlooked. That patient’s pain load could be substantially lessened if the secondary Trigger Points were treated successfully. Diagnosis really becomes challenging when body wide Trigger Points develop with overlapping referral zones. This “spread” of Trigger Points gives the impression that the condition is progressive, but it isn’t. It may be getting steadily worse, but with proper attention to perpetuating factors and appropriate treatment, the “progression” can be reversed.

Sometimes the Trigger Point is inside the pain pattern, and sometimes the pain pattern occurs elsewhere. Each specific Trigger Point on the body has a referred pain or other symptom pattern that has been carefully observed and documented in many patients. This pain pattern is similar from patient to patient. Active Trigger Points often produce other symptoms, also usually in their referred pain zones. Such a Trigger Point hurts whenever you use the muscle involved. When the point becomes very active, pain and other symptoms result, even when the muscle is at rest. A latent Trigger Point doesn’t hurt at all unless it is pressed. It restricts movement, and weakens and prevents full lengthening of the affected muscle. If you press on a latent Trigger Point, it will refer pain in its characteristic pattern. A latent Trigger Point may be activated by overstretching, overuse, or chilling the muscle.

If Trigger Points are treated immediately and vigorously, and perpetuating factors (conditions that aggravate and perpetuate the Trigger Points) are avoided or remedied, the Trigger Points can be eliminated. If the muscle is pushed to work in spite of the pain, especially if perpetuating factors exist, active Trigger Points may develop secondary and satellite Trigger Points.

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.

The difficulty with trigger points is that they refer pain. This displacement of pain is what throws everybody off, including most doctors. It’s why pain is so often misdiagnosed and so often treated with painkillers–the shotgun approach. Pain is a message that something’s wrong and needs your attention. Is it good medicine to kill the messenger and ignore the message?

Trigger Point Therapy was pioneered and developed in this country by Dr. Janet Travell, President John F. Kennedy’s personal physician during his years of persistent back pain. Today it is commonly referred to as Neuromuscular Therapy.

Trigger points are accumulations of waste products around a nerve receptor. Often times they feel like nodules or taut bands of fibers within the soft tissues. Trigger points form in muscles which have been overused or injured due to an accident or surgery. Common characteristics are increased muscle tension and muscle shortening. Increased muscle tension is the primary side-effect of trigger points and pain is the most common secondary effect. Trigger points can present themselves as referred patterns of sensation such as sharp pain, dull ache, tingling, pins and needles, hot or cold, as well as can create symptoms such as nausea, ear ache, equilibrium disturbance, or blurred vision.

Trigger points can exist in two states, either active or latent. Active trigger points are those which cause discomfort. Latent trigger points wait silently in the muscle for a future stress to activate them. Aches and pains which began in the past become more frequent and severe in intensity as we age. It is common to attribute this discomfort to arthritis instead of our tight muscles which harbor trigger points.

Trigger points are not visible with traditional medical testing such as MRI or X-ray. 80 % of the trigger point locations are common with acupuncture treatment locations. When trigger points are not treated, they will create satellite trigger points in the affected area. For instance, a trigger point in the trapezius may cause a trigger point to appear in the temple. The trigger point in the temple then may cause a trigger point to appear in the jaw. And, voilà! - a case of TMJ.

To diffuse a trigger point, static compression (pressure) is applied for 10 seconds, released, then pressure applied for 10 more seconds in a pumping action while the client breathes deeply. This action flushes the toxins and calms the nerves. (see pictures on right showing treatment of a stiff neck and as part of a Sports Massage for a runner). Releasing trigger points releases endorphins so the result is elimination of discomfort as well as being energized.

Trigger point massage is not a relaxing, “fluff and buff” technique. It requires the participation of the client to communicate the presence and intensity of pain and discomfort. The therapist and client work together as a team to maximize the effectiveness of the treatment.

It is common to find great improvement after one treatment. Repeated treatment may be necessary for those with chronic trigger points. Stretching should be done as “home work” to encourage the muscles that have been treated to stay in a lengthened position.

Trigger point research lists nutritional deficiencies or inadequacies as “perpetuating factors.” A good multi-vitamin supplement that is high in anti-oxidants and is in an encapsulated form can help ensure that once treated, trigger points do not reform. Robb* recommends Twinlab’s MaxiLife or for those over 40, MaxiLife CoQ10 formula to be taken: one capsule up to four times per day, since the water-soluble nutrients which are critical to normal muscle function (e.g. Vitamin C and B-Complex) can only stay at a peak level in the blood stream from 4 to 6 hours.

Trigger Point Therapy is a subset of neuromuscular therapy which examines and treats muscles and muscle attachments in layers from superficial to deep, ligaments and connective tissues. More about neuromuscular therapy will be presented in a future article.

Trigger Point Therapy may be the answer.  it is a type of massage therapy which examines and treats muscles and muscle attachments in layers.  It addresses surface muscles  and connective tissues and deeper ligaments and connective tissues. It is closely aligned with the eastern technique of acupressure massage. The treatment techniques are very similar, the guidelines for applying acupressure apply to most Trigger Point Release applications.

Trigger point is a pain-relief techniques to alleviate muscle spasms and cramping. The therapist locates and deactivates `trigger points’, which are often tender areas where muscles have been damaged or acquired a re-occurring spasm or `kink’ that worsens painfully when aggravated. The major goals are to reduce spasm inducing new blood flow into the affected area. The spasms are partly maintained by nervous system feedback (pain-spasm-pain) cycle.

Spasms also physically reduce blood flow to the trigger point area (ischemia), reducing oxygen supplied to the tissues and increasing the spasm. Pressure is applied to trigger points, for a short time (between about 7 to 10 seconds per point), which can be momentarily painful but is greatly relieving.

It is common to hit the same trigger points several times during a session, but you won’t be leaning into a sore spot for several minutes. Often ice or another cooling agent is used to reduce nervous system response, making the area easier and more comfortable to work. Then the muscles are gently stretched to complete the relaxation process.

Trigger points are clustered areas of pain in or around muscles that usually radiate pain in a predictable pattern. When a muscle, or group of muscles, incurs injury, it automatically contracts around the painful site to support and protect the area. If pain is resolved quickly, the muscles can relax. If pain persists, muscles can become habitually contracted. Sometimes contractions press on nerves causing tingling, numbness, and more pain. Like a sponge that is squeezed, a contracted muscle can’t hold much blood. Blood transports oxygen and nutrients to the muscles and carries away waste products. When a muscle is deprived of healthy circulation, it doesn’t receive enough oxygen and nutrients, and waste products accumulate. This can result in fatigue and soreness. It can also irritate nerves in the area, causing pain to spread beyond the congested area.

Trigger point therapy is a bodywork technique that involves the applying of pressure to tender muscle tissue in order to relieve pain and dysfunction in other parts of the body. Sometimes massage and trigger point therapy are performed together.

Trigger point therapy is also called myofascial trigger point therapy. It was developed by Dr. Janet Travell in the United States in the 1940s.

Trigger points have several causes. Some common causes are: birth trauma, an injury sustained in a fall or accident, poor posture, or overexertion.

The purpose of trigger point therapy is to eliminate pain and to re-educate the muscles into pain-free habits. After several treatments, the swelling and stiffness of neuromuscular pain is reduced, range of motion is increased, tension is relieved, and circulation, flexibility and coordination are improved.