What I Know About Trigger Point Therapy
(in Plain English)
The information on this page is intended to educate the general public,
who often have little working knowledge of the details of how the human body works.
This is what I tell all my patients. It is meant to be simplistic.
If you want "the medical facts" please see the the Technical Terms page.
First: The Big Picture
Computer use can cause Trigger Point pain in the head, neck, back, arms, and hands.
What is a Trigger Point?
A Trigger Point is a spot in a muscle that is
making the muscle feel tight and causing pain.
It is the "Right There!" spot that
"Hurts So Good!" when it is massaged.
Sometimes the pain from a Trigger Point will be at the TP itself, but quite often the pain will present at a nearby joint. Occassionally a Trigger Point will "refer"
to a totally different area of the body.
Trigger points activate from several causes.
Most common causes are acute (recent) or chronic (long-term) muscular overload due to,
though not limited to:
> trauma (injury or surgery),
> overuse (strain or repetitive movement),
> poor posture,
> holding the same position long periods of time,
> chilling of a muscle,
> emotional stress.
Once a trigger point has activated, waste products begin to accumulate.
These waste products are nerve irritants which, in turn, both produce and perpetuate pain.
Although it may go back to being latent, once formed a Trigger Point does not go away by itself.
Instead, it starts recruiting. The pain itself causes other muscles to tighten,
and other Trigger Points to form.
The technical term is that Satellite Trigger Points develop.
I call the group of interactive Trigger Points a GANG, because it terrorizes you!
And like a gang, if you don't get them ALL, they don't go away!
The pain signals can be so strong to even make the brain decide to turn off the muscles involved, as in Frozen Shoulder.
IMPORTANT!
YOU MUST UNDERSTAND THIS:
Most of the time, the problem is NOT where the pain is!
Why does the pain occur away from the trigger point?
Our nerve pathways are similar to our road systems;
Each one often serves serveral locations.
A message traveling along the nerve
can give a message to any other place along its pathway.
Pain is often referred to another spot along the nerve's pathway.
Ex: TPs in the neck can be felt as pain in the elbow!
Most of the medical profession know nothing about Trigger Points.
Therefore Trigger Points are often mis-diagnosed as something else.
How can you tell if your problem is caused by Trigger Points?
Ask Katy Westbrook, LMT, a Trigger Point Therapy Specialist.
Trigger points can cause:
headaches,
neck and jaw pain,
back pain,
tennis elbow,
carpal tunnel syndrome,
thumb pain,
foot pain,
as well as MANY other problems.
They are the source of the pain in such joints as:
the shoulder,
wrist,
hip,
knee,
and ankle
Pain from Trigger Points is so often mistaken for:
arthritis,
plantar fasciitis,
tendinitis,
bursitis,
or ligament injury.
Trigger Points also cause symptoms as diverse as:
dizziness,
earaches,
toothaches,
sinusitis,
nausea,
heartburn,
false heart pain,
heart arrhythmia,
genital pain,
and numbness in the hands and feet.
Even fibromyalgia may have its beginnings with myofascial trigger points.
A Trigger Point is a spot in a muscle that is
making the muscle feel tight and causing pain.
It is the "Right There!" spot that
"Hurts So Good!" when it is massaged.
Sometimes the pain from a Trigger Point will be at the TP itself, but quite often the pain will present at a nearby joint. Occassionally a Trigger Point will "refer"
to a totally different area of the body.
Trigger points activate from several causes.
Most common causes are acute (recent) or chronic (long-term) muscular overload due to,
though not limited to:
> trauma (injury or surgery),
> overuse (strain or repetitive movement),
> poor posture,
> holding the same position long periods of time,
> chilling of a muscle,
> emotional stress.
Once a trigger point has activated, waste products begin to accumulate.
These waste products are nerve irritants which, in turn, both produce and perpetuate pain.
Although it may go back to being latent, once formed a Trigger Point does not go away by itself.
Instead, it starts recruiting. The pain itself causes other muscles to tighten,
and other Trigger Points to form.
The technical term is that Satellite Trigger Points develop.
I call the group of interactive Trigger Points a GANG, because it terrorizes you!
And like a gang, if you don't get them ALL, they don't go away!
The pain signals can be so strong to even make the brain decide to turn off the muscles involved, as in Frozen Shoulder.
IMPORTANT!
YOU MUST UNDERSTAND THIS:
Most of the time, the problem is NOT where the pain is!
Why does the pain occur away from the trigger point?
Our nerve pathways are similar to our road systems;
Each one often serves serveral locations.
A message traveling along the nerve
can give a message to any other place along its pathway.
Pain is often referred to another spot along the nerve's pathway.
Ex: TPs in the neck can be felt as pain in the elbow!
Most of the medical profession know nothing about Trigger Points.
Therefore Trigger Points are often mis-diagnosed as something else.
How can you tell if your problem is caused by Trigger Points?
Ask Katy Westbrook, LMT, a Trigger Point Therapy Specialist.
Trigger points can cause:
headaches,
neck and jaw pain,
back pain,
tennis elbow,
carpal tunnel syndrome,
thumb pain,
foot pain,
as well as MANY other problems.
They are the source of the pain in such joints as:
the shoulder,
wrist,
hip,
knee,
and ankle
Pain from Trigger Points is so often mistaken for:
arthritis,
plantar fasciitis,
tendinitis,
bursitis,
or ligament injury.
Trigger Points also cause symptoms as diverse as:
dizziness,
earaches,
toothaches,
sinusitis,
nausea,
heartburn,
false heart pain,
heart arrhythmia,
genital pain,
and numbness in the hands and feet.
Even fibromyalgia may have its beginnings with myofascial trigger points.
Now a More Detailed Explanation
(but still in Plain English)
X marks the spots that could be causing the pain.
How do Trigger Points form?
When your body wants to move,
your brain sends a message to specific muscles, telling them to contract and shorten, thereby moving a body part across a joint.
This message is first carried along the nerve fiber as an electrical impulse.
However, when the message reaches the end of the nerve, the impulse causes a chemical to be released that washes over the muscle fiber and causes it to contract. (See the Technical Page for details.)
When the muscle does the work of contracting,
it burns calories, and then releases by-products of muscle metabolism.
These are toxins that the body needs to get rid of,
much like carbon dioxide is a toxin produced by the lungs.
One of the muscles' toxins is lactic acid.
Lactic acid is what makes you sore when you begin exercising.
Normally, under regular muscle movement, the blood immediately removes these toxins from the area. The toxins are then carried to the kidneys, which filter them out. The process is automatic and very efficient, and usually causes you no problems.
However, sometimes the nerve can get over-stimulated in some way,
and a Trigger Point can be formed.
When your body wants to move,
your brain sends a message to specific muscles, telling them to contract and shorten, thereby moving a body part across a joint.
This message is first carried along the nerve fiber as an electrical impulse.
However, when the message reaches the end of the nerve, the impulse causes a chemical to be released that washes over the muscle fiber and causes it to contract. (See the Technical Page for details.)
When the muscle does the work of contracting,
it burns calories, and then releases by-products of muscle metabolism.
These are toxins that the body needs to get rid of,
much like carbon dioxide is a toxin produced by the lungs.
One of the muscles' toxins is lactic acid.
Lactic acid is what makes you sore when you begin exercising.
Normally, under regular muscle movement, the blood immediately removes these toxins from the area. The toxins are then carried to the kidneys, which filter them out. The process is automatic and very efficient, and usually causes you no problems.
However, sometimes the nerve can get over-stimulated in some way,
and a Trigger Point can be formed.
There are OVER 200 places where Trigger Points can be found!
What causes Trigger Points?
There are over 200 places
on the human body where
Trigger Points have been found.
(More may be discovered...)
The spots are predictable and
can be located by simply probing the right places.
Trigger Points have many causes.
The most common causes are:
> Overuse, as in repetitive movements
> Strain, as in one-time heavy lifting
> Holding the same position for long periods of time, as in computer work or driving
> An accident, or near-accident,
where the muscles suddenly over-contract
> Injury or surgery
where the body's pain level causes
the nearby muscles to tighten
> Exposure to cold (causes muscle tightness)
> Holding muscles involuntarily tight due to stress
There's a reason why "pain-in-the-neck"
(or back) (or butt) are all cliches
for situations or people who cause stress.
When the nerve is over-stimulated, it then dumps too much
of the contracting chemical onto the muscle.
A Trigger Point forms when a tiny part of that muscle fiber gets "stuck"
and goes into a state of constant contraction.
At first the "knot" is really tiny, only microscopic.
It seems to cause you no problems whatsoever.
In fact, unless I come along and push on it,
you don't even know that it's there.
But, unless it is treated and released, it does not go away.
It just keeps contracting and keeps giving off toxins 24/7,
rather than its normal occasional cyclical contraction.
And the toxins just keep building up.
But even worse than the fact that the toxins are continuing to be produced,
something worse also starts to happen.
Every muscle fiber is serviced by blood capillaries,
blood vessels so tiny that they are only one blood cell wide.
That is where the osmosis between the muscle and the blood takes place.
The blood:
>Feeds the cell with glycogen for fuel;
>Gives the cell oxygen so that it can burn (metabolize) its fuel;
>Removes the by-products of muscle metabolism (those toxins mentioned above).
Due to the latent Trigger Point, part of the muscle is tight all the time.
So tight, in fact, that it squeezes the capillary and basically shuts it down.
Now, not only do you have a muscle constantly giving off toxins,
but the blood, that's supposed to remove the toxins, can't get through!
And so the Trigger Point continues to build.
There are over 200 places
on the human body where
Trigger Points have been found.
(More may be discovered...)
The spots are predictable and
can be located by simply probing the right places.
Trigger Points have many causes.
The most common causes are:
> Overuse, as in repetitive movements
> Strain, as in one-time heavy lifting
> Holding the same position for long periods of time, as in computer work or driving
> An accident, or near-accident,
where the muscles suddenly over-contract
> Injury or surgery
where the body's pain level causes
the nearby muscles to tighten
> Exposure to cold (causes muscle tightness)
> Holding muscles involuntarily tight due to stress
There's a reason why "pain-in-the-neck"
(or back) (or butt) are all cliches
for situations or people who cause stress.
When the nerve is over-stimulated, it then dumps too much
of the contracting chemical onto the muscle.
A Trigger Point forms when a tiny part of that muscle fiber gets "stuck"
and goes into a state of constant contraction.
At first the "knot" is really tiny, only microscopic.
It seems to cause you no problems whatsoever.
In fact, unless I come along and push on it,
you don't even know that it's there.
But, unless it is treated and released, it does not go away.
It just keeps contracting and keeps giving off toxins 24/7,
rather than its normal occasional cyclical contraction.
And the toxins just keep building up.
But even worse than the fact that the toxins are continuing to be produced,
something worse also starts to happen.
Every muscle fiber is serviced by blood capillaries,
blood vessels so tiny that they are only one blood cell wide.
That is where the osmosis between the muscle and the blood takes place.
The blood:
>Feeds the cell with glycogen for fuel;
>Gives the cell oxygen so that it can burn (metabolize) its fuel;
>Removes the by-products of muscle metabolism (those toxins mentioned above).
Due to the latent Trigger Point, part of the muscle is tight all the time.
So tight, in fact, that it squeezes the capillary and basically shuts it down.
Now, not only do you have a muscle constantly giving off toxins,
but the blood, that's supposed to remove the toxins, can't get through!
And so the Trigger Point continues to build.
How Do Trigger Points Cause Pain?
A Trigger Point has 2 Phases:
(1) Latent (hidden; waiting; no apparent problems)
(2) Active (something starts aching or hurting)
As long as the Trigger Point is in the latent (hidden) stage,
you don't even know there's a problem.
You probably think that's good.
But while it's hidden, you might keep right on doing whatever it is that's causing it.
And the toxins continue to build up...
As long as it stays latent, you still don't know anything's wrong.
UNTIL IT GOES INTO THE ACTIVE PHASE
THAT'S WHEN THE PAIN STARTS GETTING YOUR ATTENTION
Each Trigger Point has a threshold point that varies with muscle and person.
This point is "the straw that breaks the camel's back."
Once the threshold of toxin build-up is reached, the Trigger Point goes ACTIVE.
At this point the toxins begin to irritate the nerve that tells the muscle to contract.
THAT'S when the pain starts!
The pain from an active Trigger Point is felt in different ways:
Often the area starts to ache somewhat non-specifically.
It's not too terrible, feels good to rub it, but it doesn't go away for long.
Trigger Points can also cause an area to feel burning, tingling, or numb.
Or, there can be pain felt in a nearby joint.
This is because the muscle is very tight from the Trigger Points (there can be many)
and extreme pressure is put on the muscle's attachments.
Most people will now attempt to circumvent the whole process by taking
PAIN-KILLERS.
That's like putting duct tape over the red light flashing on your dashboard.
To complicate things even further,
one Trigger Point, when not released with TPT,
will cause other TPs to form, what are known as satellites.
This is possibly the body's way of trying to convince you to STOP doing whatever you're doing to cause the TPs to form in the first place.
(I call them "gang members" because they will terrorize you,
and you have to get rid of them ALL to get the problems to go away.)
A couple of more things complicate matters with Trigger Point pain.
Trigger Points have the unique ability to "refer pain."
That means that the pain can be felt somewhere else rather than where the TP is.
Sometimes this referred pain is very logical.
There are different theories: one in very simple terms is analogous to peripheral neuropathy, where nerves for the toe are wired to the "toe" area of your brain, and no matter where the 3 foot long "toe" nerve is affected along its length, pain is felt in the toe. Other examples of referred pain are arm pain for heart attacks, "brain freeze" after drinking a cold liquid, scratching your ear to relieve the tickle in your throat and "phantom pain" in an amputated limb.
The pain can be referred to another spot along the nerve's pathway.
Ex: TPs in the neck can be felt as pain in the elbow!
There are hundreds of other examples,
some of which seem to make no logical sense at all.
Why Massage Therapy is the Best Treatment for Trigger Points
Trigger Points are NOT visible on X-rays or MRIs.
Most medical professionals (including the vast majority of doctors)
know NOTHING about them.
Because the only way to SEE a TP is on a microscope,
they have NOT received much study.
(Who would volunteer for that one?)
Add that with the fact that they weren't discovered until the 1960s.
They were not published in medical text books until 1999.
Most of the doctors who do know about them
treat TPs with an injection of a Botox-like chemical!
Maybe you're like me:
You DON'T WANT to take pain-killers or injections of any kind!
Now you don't have to.
You can get NATURAL PAIN RELIEF with Trigger Point Therapy.
(1) Latent (hidden; waiting; no apparent problems)
(2) Active (something starts aching or hurting)
As long as the Trigger Point is in the latent (hidden) stage,
you don't even know there's a problem.
You probably think that's good.
But while it's hidden, you might keep right on doing whatever it is that's causing it.
And the toxins continue to build up...
As long as it stays latent, you still don't know anything's wrong.
UNTIL IT GOES INTO THE ACTIVE PHASE
THAT'S WHEN THE PAIN STARTS GETTING YOUR ATTENTION
Each Trigger Point has a threshold point that varies with muscle and person.
This point is "the straw that breaks the camel's back."
Once the threshold of toxin build-up is reached, the Trigger Point goes ACTIVE.
At this point the toxins begin to irritate the nerve that tells the muscle to contract.
THAT'S when the pain starts!
The pain from an active Trigger Point is felt in different ways:
Often the area starts to ache somewhat non-specifically.
It's not too terrible, feels good to rub it, but it doesn't go away for long.
Trigger Points can also cause an area to feel burning, tingling, or numb.
Or, there can be pain felt in a nearby joint.
This is because the muscle is very tight from the Trigger Points (there can be many)
and extreme pressure is put on the muscle's attachments.
Most people will now attempt to circumvent the whole process by taking
PAIN-KILLERS.
That's like putting duct tape over the red light flashing on your dashboard.
To complicate things even further,
one Trigger Point, when not released with TPT,
will cause other TPs to form, what are known as satellites.
This is possibly the body's way of trying to convince you to STOP doing whatever you're doing to cause the TPs to form in the first place.
(I call them "gang members" because they will terrorize you,
and you have to get rid of them ALL to get the problems to go away.)
A couple of more things complicate matters with Trigger Point pain.
Trigger Points have the unique ability to "refer pain."
That means that the pain can be felt somewhere else rather than where the TP is.
Sometimes this referred pain is very logical.
There are different theories: one in very simple terms is analogous to peripheral neuropathy, where nerves for the toe are wired to the "toe" area of your brain, and no matter where the 3 foot long "toe" nerve is affected along its length, pain is felt in the toe. Other examples of referred pain are arm pain for heart attacks, "brain freeze" after drinking a cold liquid, scratching your ear to relieve the tickle in your throat and "phantom pain" in an amputated limb.
The pain can be referred to another spot along the nerve's pathway.
Ex: TPs in the neck can be felt as pain in the elbow!
There are hundreds of other examples,
some of which seem to make no logical sense at all.
Why Massage Therapy is the Best Treatment for Trigger Points
Trigger Points are NOT visible on X-rays or MRIs.
Most medical professionals (including the vast majority of doctors)
know NOTHING about them.
Because the only way to SEE a TP is on a microscope,
they have NOT received much study.
(Who would volunteer for that one?)
Add that with the fact that they weren't discovered until the 1960s.
They were not published in medical text books until 1999.
Most of the doctors who do know about them
treat TPs with an injection of a Botox-like chemical!
Maybe you're like me:
You DON'T WANT to take pain-killers or injections of any kind!
Now you don't have to.
You can get NATURAL PAIN RELIEF with Trigger Point Therapy.
