Trigger Points

22nd September 2007 at 20:58 BST by Dr C.A.Jenner MB BS, FRCA. Permalink.

This article explains the concept of trigger points in detail.

Trigger Points

Introduction

Trigger points are typically defined as hyperirritable spots present in the skeletal muscle. Also known as muscle knots, these points are like tight nodules located in skeletal muscles that produce sensations of tenderness, twitching or jumping when touched or pressured.

The muscles related to the posture are the ones most affected by the trigger points. These tender spots might actively occur in the affected muscle or produce additional tender spots in the body elsewhere.

Trigger points can usually occur in two forms, active and latent. Active trigger points are those that cause a strong sense of discomfort right away and can be diagnosed as soon as they are formed.

Meanwhile, latent trigger points do not present themselves in the beginning and continue getting worse with age and other causative factors.

Key Symptoms

Referred pain is the most characteristic symptom of a trigger point. This implies that trigger points usually send their pain to some other site. Generally, a trigger point feels like a hard 'lump', knot or band in the muscle.

Here, we list the most significant signs and symptoms indicating the presence of trigger points:

• Stiffness
• Muscle tightness and weakness
• Localized sweating
• Eye tearing
• Copious salivation
• Poor balance
• Dizziness
• Goose bumps
• Runny nose
• Headaches
• Muscle cramps

In some cases, trigger points can also manifest as tension headaches, tinnitus, temporomandibular joint pain, decreased range of motion in the legs and low back pain.

Causative Factors

Trigger points often develop due to muscular injuries, strains and trauma. In addition, structural imbalances, improper body mechanics, poor nutrition and stress are also the main precipitating factors. When the muscle fibers, fascia, ligaments or tendons become weak, overstretched or inflamed due to any of the above listed reasons, tiny tears occur in the associated soft tissue. When the healing of this tissue begins, it contracts, becoming twisted and knotted.

These knotted fibers further restrict the fresh blood supply required by the muscle cells. The muscle fiber also often shortens to protect itself from further injury.

This in turn can further result into a loss of range of motion of the joint. In most of the situations, such injuries and processes ultimately lead to the development of the trigger points in these muscles and associated structures.

Treatment Methods

There are a series of treatment methods available for the cure of trigger points.

The most common method adopted for the purpose is the massage therapy. In this method, static compression is applied and relieved alternatively in the affected area, in the form of a pumping action in order to flush out the toxins and calm the nerves.

In addition, a diet rich in anti-oxidants is also advised as a part of the treatment plan for relief from the pain associated with the trigger points.

Other treatment options available for the purpose include mechanical vibration, pulsed ultrasound, electrostimulation, ischemic compression, dry-needling and stretching techniques.

Lastly, trigger point injections are also often resorted to for immediate pain relief, especially when most of the other methods have failed to produce the desired result.

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