How Trigger Points Can Torture Your Body

Date:Posted By:Mike Salvatore

If you have a painful knot or taut band in a particular muscle, you may be suffering from the all-too-common myofascial trigger point. Active trigger points are the consistently painful ones, while latent trigger points are those that only cause pain when you apply pressure to them. Both types can lead to more severe issues down the line, although you can take action to help halt their development or eliminate them.

What They Are

Myofascial trigger points are hypersensitive areas in your body brought about by a variety of direct and indirect causes. Those with direct causes are known as primary trigger points. Direct causes involve some type of trauma in your muscles, tendons or ligaments, often due to overuse, injury, repetitive motions or activity that excessively strains or stretches the same areas.¹ ² ³

Chronic poor posture or holding a certain posture for an extended period can also lead to primary trigger points, as can aging, genetics and an accumulation of micro-traumas over an extended period of time.⁴

Trapezius muscle trigger points

Unlike primary trigger points, secondary trigger points develop in areas that have not been subjected to trauma. They can crop up in areas that are subjected to referral pain from issues going on with other bodily structures.¹

What They Do

Suffer from a collection of trigger points and you can end up with a condition known as myofascial pain syndrome (MPS). As one of the most common reasons people seek out manual therapy treatments, MPS typically brings on muscular dysfunction and a deep, intense pain from your muscles and their fascia.⁵ ⁶ The low back, hips, head, neck and shoulders are typically the hardest hit by the pain, since they’re consistently subjected to the pull of gravity and repetitive daily activities.⁷

Both active and latent trigger points can lead to muscle weakness, imbalance as well as decreased, altered and dysfunctional movements in the affected muscle and other muscles that rely on it for proper functioning.¹ ⁶ ⁸ Muscle cramps, tension-type headaches, migraines, dizziness and sensory disturbances are other potential side effects, as are limited joint movement and joint dysfunction.⁹⁻¹³

Those suffering from fibromyalgia seem to have a higher number of trigger points than the general population.¹ Trigger points have also been linked to plantar heel pain, non-specific low back pain and even depression.¹⁴⁻¹⁷

What You Can Do

One of the most effective ways to treat trigger points is with a two-part plan that addresses the trigger points as well as the underlying factors that led to their development. Studies on trigger point and myofascial pain syndrome treatments have found a number of techniques to be effective.

Two of the most helpful are massage therapy and manual therapy, which includes various forms of stretching and ischemic compression.¹ ¹⁸⁻²⁰ Addressing the underlying cause involves changing the detrimental habits that led to trigger point development, such as chronic poor posture.

A comprehensive trigger point treatment program would generally consist of a combination of techniques, such as:

  • Heat therapy through infrared sauna use

  • Clinical orthopedic manual therapy and advanced stretching techniques

  • A form of ischemic compression known as mashing

  • Resistance flexibility and strength training (RFST) which targets the fascia where trigger points can live

  • Pilates and Foundation Training to help correct postural issues contributing to trigger point development

  • Changing any detrimental habits that could be contributing to trigger points is a wise move to avoid new trigger point development. Habits may include things like consistently craning your neck to read in bed, cradling the phone on your shoulder and repetitive movements that constantly strain and overload the same muscles.

REFERENCES

  1. Giamberardino MA, Affaitati G, Fabrizio A, Costantini R. Myofascial pain syndromes and their evaluation. Best Pract Res Clin Rheumatol. 2011; 25(2):185-98.

  2. Alvarez DJ, Rockwell PG. Trigger points: diagnosis and management. American Family Physician. 2002;65:653-60.

  3. Malanga GA, Cruz Colon EJ. Myofascial low back pain: a review. Phys Med Rehabil Clin N Am. 2010;21(4):711-24.

  4. Cheng, R., 1987 (Mar). Combination laser/electrotherapy in pain management. In: Second Canadian Low Power Laser Conference, Ontario, Canada.

  5. Blanco CR, Fernandez de lasPenas CF, Xumet JE, Algaba CP, Rabadan MF, de la Quintana MC. Changes in active mouth opening following a single treatment of latent myofascial trigger points in the masseter muscle involving post-isometric relaxation or strain/counterstrain. Journal of Bodywork and Movement Therapies. 2006;10(3):197-205.

  6. Oliveira-Campelo NM, de Melo CA, Alburquerque-Sendín F, Machado JP. Short- and medium-term effects of manual therapy on cervical active range of motion and pressure pain sensitivity in latent myofascial pain of the upper trapezius muscle: a randomized controlled trial. J Manipulative Physiol Ther. 2013;36(5):300-9.

  7. Han SC, Harrison P. Myofascial pain syndrome and trigger point management. Regional Anesthesia. 1997;22:89–101.

  8. Fernández-de-Las-Peñas C. Interaction between Trigger Points and Joint Hypomobility: A Clinical Perspective. J Man Manip Ther. 2009;17(2):74-7.

  9. Gerwin R. Myofascial pain syndrome: here we are, where must we go? Journal of Musculoskeletal Pain. 2010;18(4):329-47.

  10. Ge HY, Arendt-Nielsen L. Latent myofascial trigger points. Curr Pain Headache Rep. 2011;5(5):386-92.

  11. Fernández-de-Las-Peñas C. Interaction between Trigger Points and Joint Hypomobility: A Clinical Perspective. J Man Manip Ther. 2009;17(2):74-7.

  12. Ghanbari A, Rahimijaberi A, Mohamadi M, Abbasi L, Sarvestani FK. The effect of trigger point management by positional release therapy on tension type headache. NeuroRehabilitation. 2012;30(4):333-9.

  13. Hubbard JE. Myofascial trigger points. What physicians should know about these neurological imitators. Minn Med. 2010;93(5):42-5.

  14. Renan-Ordine R, Alburquerque-Sendín F, de Souza DP, Cleland JA, Fernández-de-Las-Peñas C. Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for themanagement of plantar heel pain: a randomized controlled trial. J Orthop Sports Phys Ther. 2011 Feb;41(2):43-50.

  15. Celik D, Kaya Mutlu E. The relationship between latent trigger points and depression levels in healthy subjects. Clin Rheumatol. 2012;31(6):907-11.

  16. Ramsook RR, Malanga GA. Myofascial low back pain. Curr Pain Headache Rep. 2012;6(5):423-32.

  17. Iglesias-González JJ, Muñoz-García MT, Rodrigues-de-Souza DP, Alburquerque-Sendín F, Fernández-de-Las-Peñas C. Myofascial trigger points, pain, disability, and sleep quality in patients with chronic nonspecific low back pain. Pain Med. 2013;14(12):1964-70.

  18. Grieve R, Barnett S, Coghill N, Cramp F. Myofascial trigger point therapy for triceps surae dysfunction: a case series. Man Ther. 2013 Dec;18(6):519-25.

  19. Takamoto K, Sakai S, Hori E, Urakawa S, Umeno K, Ono T, Nishijo H. Compression on trigger points in the leg muscle increases parasympathetic nervous activitiy based on heart rate variability. J Physiol Sci. 2009;59(3):191-7.

  20. Trampas A, Kitsios A, Sykaras E, Symeonidis S, Lazarou L. Clinical massage and modified Proprioceptive Neuromuscular Fasciliation stretching in males with latent myfascial trigger points. Phys Ther Sport. 2010;11(3):91-8.

 

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