A Guide to Trigger Points in Physical Therapy

A man gets physical therapy for his back pain trigger points.

Trigger points — commonly known as muscle knots — are sore spots or tight bands of muscle tissue. They can be painful to touch and can limit the range of motion in the muscle area, and they can even send “referred” pain to other, seemingly unrelated areas of the body. About everybody gets trigger points now and then, but some get them more than others — and some get them so much that they can result in the debilitating myofascial pain syndrome.

 

Trigger Points Are Not Well Understood

As a condition that is most often considered a minor inconvenience, there has not been much investigation into the cause and nature of trigger points. Trigger points are most commonly assumed to be small patches of contracted muscle. One hypothesis suggests that this contracted muscle cuts off its own blood supply, making it even more irritated. Others wonder if trigger points are simple sensory disturbances of irritated peripheral nerves.

 

Diagnosis of Trigger Points Can Be Difficult

Sometimes a trigger point is obvious. You can feel a painful knot in your muscles. But trigger points can come and go in active and latent phases, and sometimes referred pain is the major complaint while the trigger point goes unnoticed. Headaches, eye pain, sciatica, toothache, carpal tunnel pain, and even pain mimicking appendicitis can all be caused by trigger points. Myofascial pain syndrome (caused by trigger points) is sometimes confused with fibromyalgia (which is not) and vice versa.

You can find trigger points anywhere there is muscle tissue. They are commonly located in the upper trapezius muscles above the shoulders, in the quadratus lumborum of the lower back, the hamstrings, the calves, and along the iliotibial band.

Myofascial Pain Syndrome

Myofascial pain syndrome is a chronic condition that can result when multiple trigger points work to simultaneously cause pain to a region of soft tissue rather than a single spot. Suspected potential causes include aging, injury, lack of exercise, bad posture, chronic stress, sleep disturbances, joint problems, and vitamin deficiency.

 

Trigger Points in Physical Therapy

If your pain is great or persistent, you may wish to receive professional treatment for relief. The goal of trigger point therapy is simply to relax the muscle, and there are a number of ways this is done. There has been little research into finding truly effective treatments, but the following treatments have shown promise:

  • Massage is often the first thing people try. A massage from a professional is best, but a massage from a friend can also help. Try a massage cream and follow these self-massage tips.
  • Dry needling, which looks something like acupuncture, has shown success with some people but has not been confirmed by research as a widely accepted treatment.
  • Ultrasound and electrical stimulation are sometimes helpful.
  • Kinesiology taping and postural exercises may work as preventative measures.

There is no single best treatment. Whatever works for you is what works for you. But an active program of postural correction exercises guided by a physical therapist can go a long way toward preventing future flare-ups.

 

Trigger Point Therapy at Home with PrePak Products

If trigger points are a regular occurrence for you, you’ll want to develop your own methods of treatment that you can use whenever the problem flares up. Self-massage will probably be a big part of that, and a few tools may be helpful to have on hand. First, a curved back nobber can make it much easier to reach and press into hard-to-reach trigger points on your back. You can also roll over a tennis ball (either on the floor or pressed between your back and a wall. Foam rollers can also be very helpful, and if you have a partner with strong hands you might want to pick up a massage cream for trigger points to make it easier on them and more effective for you.