What is... a trigger point and why does it cause pain?

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What are... trigger points?

Trigger points are often referred to as knots. They are defined as sensitive (hyperirritable) areas of the body. Pressure, stimulation or irritation of trigger points can cause a specific effect in another part of the body. They can be a tender area in a muscle which causes generalised pain when overstimulated. 

Trigger points mean there is unexplained pain that radiates from these points of local tenderness to broader areas, sometimes distant from the trigger point itself. This is often called ‘referred pain’.

What causes trigger points?

Trigger points are an extremely common cause of pain.

Myofascial means muscle tissue (myo) and the connective tissue in and around it (the fascia). Myofascial pain often results from muscle trauma, injury or repetitive strain and also from poor posture and stress.

 The body will naturally try to protect itself when under stress, but this may cause strength and flexibility imbalances in the body. So, when stressed or injured, muscles will often form trigger points, like contracted knots, that cause pain and tightness. Trigger points can also restrict blood flow and nerve signals, hence the referred pain.

Trigger points are painful when pressed on, cause a shortening of the muscle fibres and have referred pain. For example, when the trapezius (see picture) has a trigger point it will refer pain up the side of your neck and head, causing a headache.  

Symptoms

Everyone has trigger points, but to different degrees. Symptoms can range from intolerable agonising pain caused by active trigger points to decreased range of movement with poor posture and weakness from latent trigger points.

Treatment

Massage will help treat and remove trigger points and improve posture, flexibility and strength.

When trigger points are present, part of the muscle fibre is contracted into a small, thickened area (a knot) and the rest of the muscle fibre is stretched thin.

Deep and slow, sustained pressure to the knotted-up area is required for the best results. The pressure should be maintained until there is a change in pain or the discomfort eases. This helps the body to undergo soft tissue release, allowing for increased blood flow, a reduction in muscle spasm, and the break-up of scar tissue. It will also help remove any build up of toxic metabolic waste in the body.

 After applying pressure to trigger points, the relaxed muscle should be stretched.  If the muscles are not returned to normal length, there is greater chance that the trigger points will reoccur.  Stretching is safer and less painful after the trigger points have been treated.  

How long does it take to get rid of a trigger point?

This depends on the severity of the trigger point (or points) and the length of time they have been present. Your therapist will be able to advise you on this, but it is likely that repeat appointments may be required. The underlying cause of the trigger point(s) will also need to be determined, or it is likely that they will simply return. This may involve a postural assessment.

Benefits of treating trigger points

Benefits include increased mobility and flexibility, but also a decrease in symptoms of back, neck and shoulder pain, and also in knee pain, muscle and joint pain, sciatica and headaches.

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