Trigger Points

Trigger Points

Trigger points are found in muscles. They are small hypersensitive areas that are tender to touch and can cause both local and referred pain.

They can be activated by trauma, overload (eg from repetitive work, sport or leisure activities) or lack of use. They can be influenced by emotional stress and tension.

The actual cause of Trigger Points is still unknown but there are several theories including :
-Increased stiffness in the muscle tissue
-Increased excitatory chemicals in the region
-Decreased energy supply due to blood vessel compression and increased demand for energy that causes a vicious cycle with nerve sensitisation and muscle fibres unable to relax.

Trigger Points can be active or latent. Active Trigger Points cause symptoms but latent Trigger Points don’t produce symptoms unless they become activated. Additional Trigger Points can develop in the pain referral area of the initial Trigger Point eg a trigger point in the lower back can cause pain in the buttocks. A second Trigger Point can then develop in the buttocks that can cause pain in the calf. A third Trigger Point can then develop in the calf etc…

Studies have demonstrated that Trigger Points are associated with several pain conditions, including migraine, tension-type headache, temporomandibular disorder, neck pain, shoulder pain, epicondylalgia, carpal tunnel syndrome, low back pain, pelvic pain, and whiplash syndrome.

Clinical Features may include :
- Tenderness on palpation
- Taut bands in the muscle
- Referred pain described as deep, aching +/- burning, (can be perceived as being superficial) and can last seconds, hours or days
- Muscle weakness and/or muscle tightness
- Pain with stretching or contraction of the affected muscle

Treatment options :
- Soft tissue techniques such as massage or deep pressure
-Dry Needling
-Laser therapy shows strong research evidence of effectiveness for pain relief.
-TENS has shown moderate evidence for immediate effects over trigger points.
-Exercise has shown moderate benefit and can include stretching and range of motion, strengthening, endurance, or coordination exercises.
-Exercise is important in preventing recurrence.
-Ultrasound therapy has weak evidence for effectiveness in the management of trigger points.