Dr. Alyssa Musgrove
Did you know there are over 600 muscles in the human body? When muscle tissue is healthy, full range of motion can be achieved without discomfort, and daily activities can be performed with ease. However, being the most abundant tissue in the body, muscles can also be a common source of pain.
A trigger point is an area of the muscle or myofascial system sensitive to touch. Trigger points commonly feel like a lump or tightly stretched muscle fiber – like a pea buried deep in the muscle. A trigger point in a muscle could be actively painful or it could manifest no pain unless touched. The small “knot” can be highly irritable when being pressed on in that exact location or cause referred pain elsewhere in the body. Left untreated, trigger points can cause muscle tension, stiffness, weakness, edema, and limited range of motion. Muscles affected by trigger points can also compress the nerves running through, or nearby, the affected muscle. This muscle compression can cause sensations of tingling, numbness, burning and hypersensitivity.
Trigger points can form in a variety of ways. Some causes are obvious, such as trauma, accidents, falls, injuries, muscle strains, and episodes of “overdoing it.” Everyone occasionally lifts or carries unreasonable loads, ambitiously exercises when out of condition, or overexerts during sporting activities to get the win. However, congenital irregularities in bone structure, repetitive work posture, and lack of exercise can contribute to trigger points, as well.
Furthermore, poor posture can cause trigger points by keeping some muscles in a shortened position, while other muscles are lengthened. Muscles of the neck, back and hips can be severely stressed in the poor posture dictated by car seats, chairs, mattresses and other furniture without good support. Carrying or lifting heavy items, wearing heavy clothing, and carrying bulky handbags, backpacks or suitcases can irritate trigger points in the upper back and shoulders. In older adults, we often see poor posture being used to avoid feeling pain from an injury or ache associated with a degenerative joint. This type of “muscle guarding” can also cause trigger points.
Less obvious causes of trigger points include poor nutrition, non-restorative sleep, emotional distress, and exposure to cold temperatures. For example, anxiety and emotional stress can form significant tension in the neck and shoulder muscles creating trigger point activity. Vitamins and minerals could play a part in the creation of trigger points due to the physiological role they play in muscle activity and function.
Often people seeking relief of pain, tenderness or lack of proper motion might have trigger points that are over-looked, and the pain is never resolved. Many of the common conditions we see in our office, such as tension headaches, shoulder pain, jaw pain (TMJ), plantar fasciitis, carpal tunnel syndrome, disc pain and tendinitis, can actually be linked to trigger points.
Lifestyle changes can go a long way in preventing the development of trigger points. Correct posture, balanced diet, stress reduction and staying active are all important factors. Stretching and strengthening exercises will help achieve and maintain full range of motion, as well as optimal muscle function.
At home, self-applied massage can help relieve trigger point pain. Pressure can be applied directly to the point with the fingers, knuckles, and/or elbow. For hard-to-reach muscles, a tennis ball, golf ball, lacrosse ball, foam roller or Thera Cane can be used. When using a ball, place it between your body and something else: usually the floor, sometimes a wall, or another body part. The goal is to achieve a release of the trigger point by applying just the right amount of pressure. The pressure typically produces initial soreness, sometimes called the “good pain”, but relax as much as possible, use deep breathing and wait for the sensation to fade to about 80% of the original intensity. Release has been achieved when the tenderness diminishes. This can take anywhere from 10 seconds to several minutes.
Trigger point therapy can also be performed by a qualified professional. In our office, we utilize a highly-targeted approach that combines soft tissue therapies and chiropractic adjustments to help alleviate the factors that have caused the trigger points. As the underlying biomechanics improve, the trigger points begin to resolve — without the need for injections or medications. Trigger point therapy, whether self-applied or administered by a professional, has the potential to relieve chronic pain and greatly improve a patient’s overall quality of life.