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.