One of the most common causes of chronic pain is also one of the least understood.
Although discovered as early as the 1940s, myofascial trigger points are still often overlooked as a cause of chronic pain.
In many cases, chronic pain that does not respond to rest, medications and other treatments can be traced to the presence of a problem called myofascial trigger points.
Most people will experience trigger points at some point in their life. Many people have them chronically.
Trigger points are commonly felt in muscles that tend to become ropy or knotted. Whenever you have felt a knot in a muscle that is painful, you have been feeling a trigger point.
There is an entire science of detecting, mapping and treating myofascial trigger points.
Trigger points are unique in that they can cause pain locally; that is in the immediate area where they are located, as well as in a predictable pattern in tissues located some distance from the trigger point.
One of the most common examples is the knot that is often felt in the base of the neck or in the muscles across the tops of the shoulders.
When a knot is located here, the area will often be tender to the touch. The patient will usually be aware of tightness and dull achiness in the area. The patient will try to stretch the area or press and rub the area for relief.
Deep pressure will often help reduce the trigger point as will specific types of stretching.
Acupuncture is one of the most effective treatments for trigger points.
Gently inserting an acupuncture needle into the center of the trigger point will often have a dramatic effect. Surprisingly, this treatment is not painful. The finely made acupuncture needle is so small and so well polished to a smooth tip that insertion is usually painless.
In many cases, trigger points can cause chronic pain that is resistant to routine medical treatments.
As an example, consider a patient that came to see me last year.
The patient told me he had been having neck and back pain for years and that nothing helped long term. He had experienced temporary relief from massage, pain relievers, muscle relaxers and some other forms of therapy. The problem always returned.
When I examined him, I found muscle spasms affecting the neck and back.
The spasms were painful, and it would be easy to conclude that these spasms were the root of his problem. However, because the problem kept recurring, I realized that there must be an underlying problem that caused the muscle spasms to keep coming back.
Had the muscle spasm been the true cause of the pain, the problem would have been resolved the first time he took muscle relaxer medication. Something was causing the neck and back muscles to spasm, and that underlying problem would need to be corrected to accomplish long term relief.
Further examination revealed muscular trigger points in a number of muscles situated close to the spine, as well as in the legs. These trigger points had likely been present for years.
We began to treat the patient with a combination of joint manipulation and acupuncture. Although he had tried chiropractic manipulation at a different clinic previously with only temporary results, the combination of manipulation with acupuncture this time was dramatically effective.
Within a few weeks he was telling me that he was able to enjoy exercise more than he had in years. His movements became more fluid and pain-free. He made several trips and told me that travel was no longer an excruciating experience.
Trigger points can be caused by many circumstances. Prolonged sitting, using a computer, tablet or smart phone for extended periods, odd postures at work, carrying a purse or backpack, driving and many other activities are likely to cause trigger points.
Frequent exercise can actually be preventative.
The cycle of relax-contract-relax repeated numerous times helps keep trigger points from forming. Sustained contraction can increase the chances of trigger points.
For chronic pain related to trigger points, relief may be as simple as acupuncture treatment combined with joint manipulation and appropriate exercise. To prevent trigger points, keep moving.