Trigger points describe taut skeletal muscle bands located within larger muscle groups. Trigger points are soft to the touch and can transmit pain to distant parts of the body. Patients may experience localized persistent pain that reduces the range of motion of the affected muscles.Massage, sprays and stretches, and injections are some techniques for reducing trigger point pain.
What is a trigger point?
Trigger points feel like little marbles or knots under your skin. Many people experience no pain or discomfort when a trigger point is pressed. Sometimes trigger points become very sensitive, and some people experience significant pain in the area where they have trigger points.
Have you ever had a muscular Charlie horse? If so, then you know what it’s like: the whole muscle is in a painful spasm, and the only thing that seems to help is to gently lengthen and stretch the muscle. Now, think of trigger points as little Charlie horses in your muscles. These nasty spots don’t cause the whole muscle to cramp, just a small part of it. However, if you have enough trigger points, you may start to experience severe pain and limited muscle movement.
Where do people get their triggers from?
Trigger points and muscle knots can appear anywhere on your body. Wherever there is muscle tissue, there may be small areas of tissue tension.This could be a trigger point. Body areas where trigger points are more common may include:
- The upper trapezius muscles on the sides of your neck are just above the shoulders
- your quadratus lumborum
- your hamstrings
- your calf muscles
- along your iliotibial band
You can get trigger points anywhere in your body, and if they happen in excess, you can develop chronic pain and myofascial pain syndrome.
Myofascial Pain Syndrome and Trigger Points
Imagine a small cut on your finger. One knife, one finger. It can be a little painful, especially if something hits the small cut or if you move your finger the right way. But the cut isn’t serious, just a temporary nuisance.
Now imagine small cuts on your entire hand and all your fingers. These wounds are so numerous that they are hurt, and badly injured. And because there are so many cuts, every movement (and some resting positions) causes pain. This is myofascial pain syndrome. You have so many tiny muscle and fascial trigger points that your body muscles are in constant pain.
Myofascial pain syndrome can be difficult to treat; the pain is so widespread that it can be difficult to know where to start.
Does Science Support Trigger Points and Trigger Point Therapy?
Research shows that no one really knows what the exact tissue is that makes you feel your triggers. It’s also unclear why some people experience pain when touching a muscle knot and others don’t.
Science today can’t explain why some trigger points are injured, while others are just muscle knots. In theory, trigger points, tight bands of muscle and fascial tissue, become so tight that they restrict blood flow to the muscle tissue. This creates a metabolic crisis in the muscle tissue; there is pain and tightness, and oxygen and nutrients are needed to help heal, but due to the tightness resulting in reduced blood circulation, these nutrients cannot reach the muscles. Cycle of Pain Reduction The pain cycle begins, and this cycle is difficult to interrupt.
Active and passive trigger points
There are two types of trigger points for physical therapist therapy: active trigger points and passive trigger points.Passive trigger points only take damage at their exact location. If you have a painful muscle knot in your hamstring and someone presses on it, the pain will be felt at the pressure at the knot.
Active trigger points refer to pain in another part of the body. You may experience pain in your shoulder and symptoms in your chest or arm if someone presses on the activity trigger points in your shoulder.
No matter what type of trigger point you have, or we don’t fully understand what happens when a trigger point forms, you can benefit from physical therapy to help manage your problem.
How can physical therapy help?
If you seek care from a physical therapist for trigger point therapy, don’t aim to eliminate the trigger point. Instead, focus on learning strategies to help manage painful trigger points. Physical therapy for muscle knots can help you manage your pain and help identify underlying physical mechanisms that may be making your muscle knots sore.
There are many different physical therapies for trigger points.These may include:
- Exercises that help change your posture and the way your body moves
- Ergonomic tape
- Treatment modalities such as ultrasound and electrical stimulation
- dry needling
Myofascial release techniques and trigger point therapy may be helpful for your muscle knots and trigger points.Myofascial release is thought to help properly align the fascia surrounding the muscle. This can help improve blood circulation and normal muscle movement.
Trigger point therapy is performed by having your PT hold the tops of muscle trigger points. This temporarily cuts off circulation to the tissue. The cut-off of this circulation increases a chemical called nitric oxide in the tissue. Nitric oxide signals your body to open microcapillaries, which bring more blood flow and break the pain-spasm-pain cycle.
Trigger point therapy at home
One of the best things you can do for trigger points is learn to self-manage your condition. This may include performing a self-massage trigger point technique. These may include:
- Press the trigger point with Back-Nobber
- Roll a tennis ball to press into your trigger point
- Foam rolls over your muscles to help smooth fascial tissue
Research shows that there is no single best treatment for muscle knots. One thing is for sure – an active treatment program involving postural correction and exercise is superior to passive treatment of trigger points.Connect with your physical therapist for a comprehensive assessment of your condition and learn about self-care strategies for managing trigger points.
If you’re dealing with painful muscle knots and trigger points, first, don’t panic. Trigger points are benign and do not pose a significant danger to you or your health. They only cause pain, which may limit your normal mobility.
To manage your painful muscle knots, talk to your healthcare provider to make sure your pain doesn’t have an underlying sinister cause. Ask about physical therapy to help treat your trigger points, and start participating in an active treatment program to positively impact your trigger points. By learning strategies for self-management of pain, you can take control of your condition.
Frequently Asked Questions
Are trigger points the same as muscle knots?
Yes, the trigger point is a tight band of skeletal muscle that feels like a marble under the skin. Trigger points are often referred to as nodes.
Do trigger points hurt?
Yes, but not always. Trigger points are often very sensitive to touch and can transmit pain to other parts of the body. There are several trigger points that cause widespread pain, sometimes called myofascial pain syndrome.
How does trigger point therapy work?
Trigger point therapy involves applying direct pressure to trigger points. This temporarily cuts off circulation to the tissue, causing a buildup of nitric oxide in the tissue. Nitric oxide signals the opening of microcapillaries, increasing blood flow to break down muscle knots.
Does trigger point therapy hurt?
Yes, trigger point therapy can be painful, but only when pressure is applied to the tender area. Temporary pain with trigger point therapy can help relieve persistent pain and muscle spasms.
You may not feel immediate relief from your session, but you should feel an improvement the next day. It may take several sessions to fully resolve the trigger point. Be sure to drink plenty of water after each workout to help flush waste from your muscles.