Myofascial Pain and Trigger Points

What is myofascial pain?

Myofascial pain is pain generated in the muscles ("myo") and connective tissue ("fascial") of the body. The hallmark feature of myofascial pain is the trigger point. A trigger point is a hyperirritable spot located in a taut band of skeletal muscle (a "knot").

Trigger points can be responsible for prolonged pain and dysfunction and are associated with many painful conditions including neck, back, or shoulder pain, and headaches. Trigger points cannot be seen on conventional MRI's and ultrasounds.
Your trigger point therapist must have a thorough knowledge of muscle anatomy and use good palpation skills to identify the troubled areas.

Why are trigger points a problem?

Trigger points are responsible for both motor and sensory problems. Muscles with trigger points can have poor firing patterns, weakness, stiffness and decreased range of motion. Trigger points make your muscles work in an inefficient manner and can cause overload to other muscles that function biomechanically with the problematic tissue. Additionally, trigger points are often a key source of pain. They are associated with local tenderness and referral of pain to distant locations. Trigger points can alter the sensitivity of the peripheral and central nervous system resulting in increased firing of nerve receptors which transmit pain signals.

Do all trigger points cause pain?

Trigger points can be active or latent. Active trigger points generate pain within your pain awareness threshold. Latent trigger points are below your pain awareness threshold, but can trigger local tenderness when directly palpated by your therapist. Both types of trigger points can cause the poor motor patterns described above and should be treated.

How do trigger points form?

Trigger points are very common and can form in many different ways including sustained loading and repetitive overuse from work, recreational and athletic activities; muscle overload from poor posture; muscle tension due to mental and emotional stress and direct injury to the tissue from a fall, strain, break, twist or tear.

What conditions are associated with trigger points?

Trigger points can "stand alone" causing pain and dysfunction and can mimic other musculoskeletal pathology. Additionally, trigger points are often present when an underlying pathology exists and the body works to protect and stabilize an area. Examples of conditions often associated with trigger points include facet joint dysfunction, disc herniation, osteoarthritis, rotator cuff impingement, neck pain, back pain, tennis elbow, headaches, TMJ dysfunction, sciatica, hamstring strains, calf tightness and plantar faciitis.

How are trigger points identified?

Trigger points cannot be seen on conventional MRI's and ultrasounds. Your trigger point therapist must have a thorough knowledge of muscle anatomy and referral patterns and use good palpation skills to identify the troubled areas.

How do you treat trigger points?

Once identified, your therapist can treat trigger points with manual techniques such as trigger point pressure release or with trigger point dry needling.

For additional information please visit the following websites:

www.triggerpointnc.com

www.myofascialtherapy.org