Research into myofascial trigger point pain therapy began as early as 1843, but the one person that pioneered and documented trigger point therapy was Dr. Janet Travell. Dr. Travell was a cardiologist, and personal physician to Presidents John F Kennedy and Lyndon B. Johnson. Her research stands out and has stood the test of time, becoming the mainstay for all information and treatment.
Her work was published in 1983 with the Trigger Point Manual, then a second volume in 1992. Early in her career she practiced in pulmonary, cardiology, and general medical services. The major complaint she found among patients was pain.
In all three categories of her practice she would ask patients how they were feeling. They would often respond with something like, “Okay, but I’ve got this pain in my shoulder and I can’t sleep.” In many cases there was no objective evidence of disease to account for the patient’s pain. Dr. Travell began to research the unexplained pains that her patients complained about so often.
Trigger point pain and its release through trigger point therapy is the result of that research.
Myofascial trigger points are extremely common and can become a problem for anyone at some time or another throughout life. Skeletal muscles are the largest single organ of the body. Our muscles account for around 50% of our body weight. With hundreds of muscles, any one of them can develop trigger points. Trigger points, in general, have received little medical attention, especially as a source of pain and dysfunction in medical school and teachings.
As we use our muscles for every activity in our daily lives they are a big target for wear and tear, injury and dysfunction. Although trigger point pain is not life threatening, it can be extremely painful and hinder our quality of life and movement.
Disabling chronic pain costs the US population billions of dollars annually. A significant amount of chronic pain due to myofascial trigger points could be prevented by proper diagnosis and treatment. Trigger points respond very well to massage therapy.
One way of defining a trigger point is to rule out what they are not. Trigger point pain can mimic many other conditions. Many people go to their doctor thinking they have a medical condition, only to find out with testing that it is not what they think it is. So, the source of their pain and dysfunction remains a mystery to them.
What is a myofascial trigger point? Our massage therapy school textbook definition explained it well: “A firm, palpable, highly irritable spot in a taut band of muscle fibers or fascia characterized by exquisite tenderness, referred pain and loss of range of motion. “ (Trigger Point Therapy, Steiner Education Group, ©2008 FCNH, Inc.) Research has clarified that trigger points and, therefore, trigger point pain are caused by dysfunction of the “motor endplates” of skeletal muscle fibers.
People who experience trigger point pain usually complain of localized, regional, aching pain in subcutaneous (under the skin) tissues, including muscles and joints. Sometimes symptoms will also include numbness or “pins and needles” sensation, loss of range of motion, referred pain to other areas of the body, weakness without muscle atrophy (getting smaller), and inflammation.
Muscles with trigger points will have a decline in strength, greater fatigue, and longer recovery times than muscles that are pain free, without trigger points. The involved muscle shows a fatigue pattern at the beginning of a repetitive task and accelerated fatigue-ability with delayed recovery. The trigger point is like a nest of hornets in a muscle that contains multiple sources of intense trouble and dysfunction.
There are several things that can activate a trigger and bring about trigger point pain and dysfunction. Trauma to a muscle, such as an automobile or sports injury, an acute illness, emotionally charged events such as a death or tragedy, overworked or strained muscles, postural imbalances, repetitive work postures, overload, overuse or straining of muscles in the workplace.
Sickness, which might include excessive coughing can bring about a trigger point in surrounding muscles. Tension and stress in our lives can cause trigger points. Sometimes we can get a trigger point that will go away in time. Then certain stressors or activities perpetuate the trigger point, so that it repeatedly returns every time we repeat that same activity. If not taken care of and relieved, the trigger point pain can return time and time again.
There are both active and latent (inactive) trigger points. An active trigger point starts due to a one-time trauma, and might become inactive when the soft tissue heals. However, it is still there, asleep until triggered by something to set it off again. Eventually, something will set it off. For instance, a calf muscle with a latent trigger point that gets cold might develop a knot and trigger point pain will occur again, long after the injury is gone.
Trigger points are also identified as “key” and “satellite” trigger points. A key trigger is directly caused by the original stress or trauma to the muscle. A satellite trigger is a spin off of a key trigger point. Several satellites could form.
The satellite trigger point could develop in the “pain referral zone”, a synergist (complementing) muscle or an antagonist (opposing) muscle of the key trigger point. Releasing or inactivating a key trigger from the trigger point will also release the satellite trigger points. The pain referral zone is an area of pain that is felt at a distance from the original sight of the trigger point. So ,the “trigger point pain” might be felt away from the original trigger point.
Trigger point pain can be treated with medical massage. Click here for specific information about trigger point therapy through massage.
Have questions? Do you have pains that are caused by trigger points? Ask questions about your symptoms.
Gained Relief? Share how you gained relief through trigger point therapy.
Therapist? If you are bodyworker, how have you helped clients with trigger point therapy?
Read what others have shared or asked below:
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I have found this type of therapy to be very helpful. Brenda has done a great job of relieving my aches and pains with it.
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