Myofascial Trigger points cause PAIN,
Sometimes severe and debilitating.
Trigger points are one of the most overlooked and misdiagnosed causes of pain, joint problems and muscle weakness.
This information in intended to answer the many questions often asked about trigger points.
Sometimes severe and debilitating.
Trigger points are one of the most overlooked and misdiagnosed causes of pain, joint problems and muscle weakness.
This information in intended to answer the many questions often asked about trigger points.
- Getting Help
- Background
- What Are Trigger Points
- Trigger Point Patterns
- Why Chiropractic
Myofascial Trigger Points is a fancy term to describe extremely painful conditions that develop in muscles. Because of how extremely common they are, and how important the proper diagnosis and treatment of trigger points is, I felt this deserved special attention.
More detailed information and diagrams can be found on the adjacent tabs, but let me get right to the point!
Trigger points are extremely common and the source of pain in nearly everyone’s life at some time. They are often misdiagnosed because of being commonly overlooked as the cause of such severe pain and dysfunction that other, more serious conditions are often considered instead.
The proper identification and treatment of the cause of pain is what’s most important to you!
Proper treatment and relief of trigger points is much more than just helping to stop the hurt. It requires identification of, most often multiple causes, and the means to correct the cause. That's what we do!
More detailed information and diagrams can be found on the adjacent tabs, but let me get right to the point!
Trigger points are extremely common and the source of pain in nearly everyone’s life at some time. They are often misdiagnosed because of being commonly overlooked as the cause of such severe pain and dysfunction that other, more serious conditions are often considered instead.
The proper identification and treatment of the cause of pain is what’s most important to you!
Proper treatment and relief of trigger points is much more than just helping to stop the hurt. It requires identification of, most often multiple causes, and the means to correct the cause. That's what we do!
These conditions are such a significant problem and have such a great impact on the pain that most all people experience that I felt it necessary to dedicate an entire page to the subject. You will see that there is a great amount of misguided care for many conditions when these causes are not properly diagnosed and treated effectively.
While there is a good amount of clinical literature and manuals on the subject, there is little available to the laymen reader. The primary reference for this content is “Myofascial Pain and Dysfunction: The Trigger Point Manual” by Janet Travell, MD and David Simons, MD. Although deceased, Dr. Travell was the foremost expert on the subject and published over 40 papers and the two volumes of this book.
I have attempted to briefly present the most relevant information to provide a better understanding of what trigger points are and how they can contribute in such a large way to much of the typical painful conditions from which many people suffer. It is my professional experience that many painful musculoskeletal conditions become more chronic problems that are not accurately identified and properly treated because they are comprised of difficult to understand trigger points.
Once again, this information is not for the diagnosis of any conditions, but for a better understanding of a common problem most everyone experiences at some time. For specific care, consult your healthcare provider, but please find encouragement in knowing that I readily treat these conditions and would be happy to discuss any questions in person.
While there is a good amount of clinical literature and manuals on the subject, there is little available to the laymen reader. The primary reference for this content is “Myofascial Pain and Dysfunction: The Trigger Point Manual” by Janet Travell, MD and David Simons, MD. Although deceased, Dr. Travell was the foremost expert on the subject and published over 40 papers and the two volumes of this book.
I have attempted to briefly present the most relevant information to provide a better understanding of what trigger points are and how they can contribute in such a large way to much of the typical painful conditions from which many people suffer. It is my professional experience that many painful musculoskeletal conditions become more chronic problems that are not accurately identified and properly treated because they are comprised of difficult to understand trigger points.
Once again, this information is not for the diagnosis of any conditions, but for a better understanding of a common problem most everyone experiences at some time. For specific care, consult your healthcare provider, but please find encouragement in knowing that I readily treat these conditions and would be happy to discuss any questions in person.
Trigger points, technically known as myofascial trigger points are the cause of myofascial pain syndromes. They are categorized into two types, active trigger points and latent trigger points. By definition, an ‘active’ trigger point causes a clinical pain complaint. It is always tender, whether being pressed on or not. It prevents full lengthening of a given muscle, weakens the muscle and when compressed, produces a referred pain pattern in a fairly specific pain reference zone (see the adjacent tab). ‘Latent’ trigger points are the same but do not give off active or spontaneous pain, they only hurt when palpated, but still generate the same referred pain syndromes. Latent trigger points are more responsible for the muscle becoming more tense and even shortened causing restricted movement.
Active trigger points are very common; in fact they may be the source of as much as 85 – 90% of all musculoskeletal pain and dysfunction. Trigger points may become more ‘active’ or turn ‘latent’ and go back and forth depending on causative factors and aggravations. As people age and become less active, latent trigger points are likely the cause of the stiffness and restricted range of motion that develops after the more constant pain of active trigger points decreases.
Trigger points can develop from a variety of causes including an acute injury or a trauma such as a fall, or more often, from over-use syndromes or the prolonged activation of a muscle group such as from overdoing a sporting event. Whatever the cause, you can think of it as the muscle simply becoming permanently “turned on” or contracting for a prolonged period of time. The time period may be days or weeks long, but is more often months and may persist for years. It is for this reason that trigger points most often result in more chronic pain conditions, sometimes debilitating, that can also interfere with full range of motion and strength of a muscle or muscle group.
The primary sight of a trigger point is usually fairly small and typically located in the belly of a muscle. The resulting effect is a painful syndrome that is most often felt nearby but away from the actual trigger point in a referred pain zone. The resulting pain patterns and even areas of numbness are very characteristic and are mapped out fairly accurately for every muscle that has been studied. (see the example on the adjacent tab)
The severity of symptoms caused by trigger points can range from agonizing and even incapacitating pain of active trigger points to less painful, but nagging restriction of movement and distortion of posture caused by latent trigger points. Reports from various studies describe patients who have suffered from other kinds of severe pain such as heart attack, broken bones or renal colic, say that trigger point pain can be just as severe.
The resulting pain of an active trigger point has little to do with the size of the muscle. Many severe conditions can be brought about from very small muscles. For instance, a trigger point of a small muscle under the ear and near the jaw can cause intense jaw pain, inability to chew food and even chronic debilitating headaches.
Left untreated or ineffectively treated, trigger points become more involved with multiple locations that often eventually develop. This typically occurs within the referred pain pattern where the occurrence of additional ‘satellite’ trigger points become stimulated due to the pain zone. When a body area develops multiple trigger points the resulting referred pain patterns can become even more painful and involve more areas. They become more chronic, as is their nature and much more complicated to treat as they involve greater referred pain zones. They also often take on the other neurological symptoms such as numbness and muscle weakness.
This is a significant source of much of the muscle and joint pain that the majority of us experience. Furthermore, it may contribute to such overwhelming pain and disability, that more serious conditions are sought out thus overlooking the proper treatment of such a basic, yet compounding problem. The proper identification, diagnosis and treatment is paramount to effective relief and, most importantly, long term resolution of the condition.
Active trigger points are very common; in fact they may be the source of as much as 85 – 90% of all musculoskeletal pain and dysfunction. Trigger points may become more ‘active’ or turn ‘latent’ and go back and forth depending on causative factors and aggravations. As people age and become less active, latent trigger points are likely the cause of the stiffness and restricted range of motion that develops after the more constant pain of active trigger points decreases.
Trigger points can develop from a variety of causes including an acute injury or a trauma such as a fall, or more often, from over-use syndromes or the prolonged activation of a muscle group such as from overdoing a sporting event. Whatever the cause, you can think of it as the muscle simply becoming permanently “turned on” or contracting for a prolonged period of time. The time period may be days or weeks long, but is more often months and may persist for years. It is for this reason that trigger points most often result in more chronic pain conditions, sometimes debilitating, that can also interfere with full range of motion and strength of a muscle or muscle group.
The primary sight of a trigger point is usually fairly small and typically located in the belly of a muscle. The resulting effect is a painful syndrome that is most often felt nearby but away from the actual trigger point in a referred pain zone. The resulting pain patterns and even areas of numbness are very characteristic and are mapped out fairly accurately for every muscle that has been studied. (see the example on the adjacent tab)
The severity of symptoms caused by trigger points can range from agonizing and even incapacitating pain of active trigger points to less painful, but nagging restriction of movement and distortion of posture caused by latent trigger points. Reports from various studies describe patients who have suffered from other kinds of severe pain such as heart attack, broken bones or renal colic, say that trigger point pain can be just as severe.
The resulting pain of an active trigger point has little to do with the size of the muscle. Many severe conditions can be brought about from very small muscles. For instance, a trigger point of a small muscle under the ear and near the jaw can cause intense jaw pain, inability to chew food and even chronic debilitating headaches.
Left untreated or ineffectively treated, trigger points become more involved with multiple locations that often eventually develop. This typically occurs within the referred pain pattern where the occurrence of additional ‘satellite’ trigger points become stimulated due to the pain zone. When a body area develops multiple trigger points the resulting referred pain patterns can become even more painful and involve more areas. They become more chronic, as is their nature and much more complicated to treat as they involve greater referred pain zones. They also often take on the other neurological symptoms such as numbness and muscle weakness.
This is a significant source of much of the muscle and joint pain that the majority of us experience. Furthermore, it may contribute to such overwhelming pain and disability, that more serious conditions are sought out thus overlooking the proper treatment of such a basic, yet compounding problem. The proper identification, diagnosis and treatment is paramount to effective relief and, most importantly, long term resolution of the condition.
The black X's are the location of the actual trigger point. The red pattern indicates the zone where pain is typically felt, but may also be areas of tingling or numb sensations.
While there may be noticable pain at the trigger point site (black X), the most prominent discomfort is felt through the referred areas especially when pressure is applied to the trigger point site. One may feel pain at the top/back of the shoulder while at rest or when moving the arm through simple movements. However when laying down on the affected side for instance with bedding or a pillow pressing onto the trigger point, there may be a more intense radiating ache and even tingling that is felt through the referred pattern.
As the condition worsens with more trigger points developing, it becomes obvious how overwhelming and debilitating these problems can be.
Once again, the nature of trigger points is complex. In order to properly identify and treat these conditions, they require a comprehensive clinical understanding of muscle physiology, biomechanics, muscle retraining and rehabilitation, and neurology. Chiropractors are experts in these fields and in fact acquire as many or more curriculum hours in each of these areas as do doctors of medical degrees.
As Dr. Travell describes in her text book;
“The clinical importance of myofascial trigger points to practitioners has been described in the literature for [essentially all practitioners].
Yet the muscles in general and trigger points in particular receive little attention as a major source of pain and dysfunction in modern medical school teaching and in medical textbooks. This manual describes a neglected, major cause of pain and dysfunction in the largest organ of the body. The contractile muscle tissues are a primary target of the wear and tear of daily activities, but it is the bones, joints, bursae and nerves on which physicians usually concentrate their attention.”
A chiropractor’s focus is again on these exact tissues and the neurology that determines their actions.
As Dr. Travell describes in her text book;
“The clinical importance of myofascial trigger points to practitioners has been described in the literature for [essentially all practitioners].
Yet the muscles in general and trigger points in particular receive little attention as a major source of pain and dysfunction in modern medical school teaching and in medical textbooks. This manual describes a neglected, major cause of pain and dysfunction in the largest organ of the body. The contractile muscle tissues are a primary target of the wear and tear of daily activities, but it is the bones, joints, bursae and nerves on which physicians usually concentrate their attention.”
A chiropractor’s focus is again on these exact tissues and the neurology that determines their actions.