Trigger Points

Travell and Simons (1999) cited in Davies (2004) describe a trigger point as a small contraction knot in muscle tissue. It often feels like a partly cooked piece of macaroni, or like a pea buried deep in the muscle. A trigger point affects a muscle by keeping it both tight and weak. At the same time, a trigger point maintains a hard contraction on the muscle fibers that it is a part of. In turn, these taut bands of muscles fibers keep constant tension on the muscle’s attachments, often producing symptoms in adjacent joints. The constant tension in the fibers of the trigger points itself restricts circulation in its immediate area.

Trigger points are known to cause headache, neck and jaw pain, lower back pain, the symptoms of carpal tunnel syndrome, and many kinds of joint pain mistakenly ascribed to arthritis, tendinitis, bursitis or ligament injury. Trigger points cause can cause problems which may be as diverse as ear aches, dizziness, nausea, heartburn, false heart pain, heart arrhythmia, tennis elbow and genital pain.

Trigger points can also cause colic in babies and bed-wetting in older children and may be a contributing causes of scoliosis .They can be a cause of sinus pain and congestion .They may play a part in chronic fatigue and lowered resistance to infection. Because trigger points can be responsible for long–term pain and disability, people can believe that there seems to be no means of relief.

Referred Pain

The difficulty in treating trigger points is that they typically send pain to another site in the body. Most conventional treatment of pain is based on the assumption that the cause of the pain will be found at the site of the pain. But trigger points almost always send the pain else where. This referred pain has always confused healthcare providers, including most doctors and allied health professionals.

Conventional treatments for pain often fail because they focus on the pain itself, treating the site of the pain while overlooking and failing to treat the cause, which may be some distance away. Even worse than routinely treating the site of the pain is the pharmaceutical treatment of the whole body for what is usually a local problem. Painkilling drugs, the increasingly expensive treatment of choice these days, give us the illusion that something is good is happening, when in reality they only mask the problem.

Most common pain, like headaches, muscle aches, and joint pain, is a warning - a protective response to muscle overuse or trauma. Pain is telling you that something is wrong and needs attention. It’s not good practice to kill the messenger and ignore the message. When pain is seen in its true role as the messenger and not the affliction itself, treatment can be directed to the cause of pain. Luckily, referred pain is now known to occur in predictable patterns. This valuable medical advance has been valuable in delineating these patterns.

Trigger points massage works by accomplishing three things: it breaks into the chemical and neurological feedback loop that maintains the muscle contraction; it increases circulation that has been restricted by the contraction tissue; and it directly stretches the trigger point’s knotted muscle fibres. (Davies 2004 p.3-4).

 

References:

  • Travell J.G , and D C . Simon " 1992 Myofasical Pain and Dysfunction.
    Baltimor : Lippincott, Williams and Wilkins.

  • Clair Davies and Amber Davies 2004 The Trigger Point Therapy Workshop, 2nd ed.
    New Harbinger, United States of America.