The human body has over 400 muscles, and each one of them is susceptible to trigger points! Known informally as “knots”, I’ve found in my practice that trigger points are a major contributor to muscle dysfunction and back pain. It is not uncommon to ask a friend or loved one to poke a sore spot in your back, little did you both know you are attempting trigger point therapy.
What is a Trigger Point?
A trigger point is a band or “knot” of disorganized muscle that causes muscle tension and limits the function, strength, stretch and range of motion of a muscle. When compressed, trigger points are tender and pain usually radiates, or is felt in another area of the body. They are often hard, banded or “ropey” to the touch. When active, a painful trigger point can be mistaken for a muscle strain. Many of the muscles in your back, such as the quadratus lumborum, are especially susceptible to trigger points and can result in back pain. Trigger points in the muscles of the jaw may also contribute to headaches.
How Trigger Points Form
They are formed from repetitive or incorrect muscle use, either from poor posture, or repetitive straining required for occupation or sport. Stress, poor sleep, improper diet and nutrient deficiencies are other common factors in trigger point formation.
Some trigger points in one muscle can activate satellite trigger points in other muscles, which go away when the source trigger point is treated. Additionally, trigger points in one muscle can inhibit function of another muscle, which can create more imbalance, pain and dysfunction. Latent trigger points are silent and cause muscle dysfunction, while active trigger points cause acute pain.
Trigger Point Diagnosis
Proper assessment by a qualified professional is essential, as other causes of pain must also be ruled out. Trigger points will have pain when pressure is applied to the area affected that mimics the pain experienced by the patient; the pain may also travel to another body part. The clinician will also notice a taught band of muscle that may twitch when manipulated.
Therapy for Trigger Points
There are four ways that most clinicians deal with trigger points:
- Spray and stretch: the therapist sprays a cooling solution onto the affected body part and stretches the muscle
- Injection: a therapist may inject a substance into a trigger point.
- Massage: a massage therapist will add strong pressure on top of a trigger point to temporarily cut off blood supply
- Acupuncture: an acupuncturist will insert a needle into the trigger point to cause a twitch and release of the muscle.
I often treat trigger points in my athletes in practice with acupuncture and have seen wonderful results including pain reduction and increased athletic performance. However, it is important to know that most trigger point therapies can result in temporary tenderness after the treatment; this tenderness usually subsides within hours.
Factors that contribute to trigger points must be addressed or else those pesky knots will continue to form. On the plus side, folks who exercise regularly have fewer trigger points than sporadic exercisers, so be sure to move to keep blood flowing through those muscles! Although not dangerous, if left too long trigger points can become a source of constant pain and can limit the function and range of motion of the muscle, so it is important to have trigger points address by an experienced health care provider.