Physiopedia describes a Trigger Point as “a hyperirritable spot, a palpable nodule in the taut bands of the skeletal muscles’ fascia”. They are sensitive ‘knots’ in soft tissues which can be activated by inflammation, infections, electrolyte imbalances, muscle overuse, etc. All human beings have trigger points in their body, but that doesn’t necessarily mean they are painful. Pain arises under sudden muscle contraction or direct compression of the skeletal muscle belly. Such pain is felt in the affected muscle, or gets radiated to other areas due to pain reference. Musculoskeletal pain syndrome is commonly caused by myofascial trigger points.
When the trigger point pain or strain persists, it gets acknowledged as myofascial pain syndrome. Trigger points can be active or latent. An active trigger point is felt painful at rest, of which the pain is radiated to another area. Latent trigger points can cause restriction of movement or muscle weakness, and pain can only be felt on the application of pressure over the affected area. The trigger knots are not limited to specific areas, but can be found in any skeletal muscle. Such knots or lumps may even lead to the limiting of blood supply in the area, and thereby irritating it even more. Trigger points begin by mimicking other problems, and make the patient feel that he/she is suffering from some other health issue.
One of the most efficient methods of treatment of trigger points is physical therapy. Since these knots are activated by muscle overuse, underuse, or inflammation, it’s easier to treat them physically without the use of medicines. Since trigger point pain also causes difficulty in mobility of the affected area, the other muscles are strained to perform the function of that muscle, which may lead to the formation of lumps on them as well due to overexertion. Various kinds of treatment are provided for back, neck, shoulder, knee, and joint pains; headaches and migraines, etc.
Different people with different levels of injury require specific treatment. Chronic conditions may require intense treatment over a longer period of time to see improvement. Training is given for the maintenance of a good body posture and balancing the body mechanisms while lifting heavy objects. Regular sessions of exercise are given by the therapist, along with the encouragement of stretching and remaining physically active in daily life activities as well. There are various techniques of massage, like Deep Stroking Massage which is done rhythmically in only one direction. Such massaging over the tense muscles strengthens muscles’ flexibility and endurance, along with easing the pain.
Ischemic Compression Technique involves applying a substantial amount of pressure on the trigger point to help the contracted muscle gain relaxation without causing pain. The Spray and Stretch technique of treatment uses ethyl chloride spray over the stretched painful area. Methods that employ the rhythmic contraction and relaxation of the muscles are Reciprocal Inhibition, Contract-Relax/Hold-Relax, Post-Isometric Relaxation, etc. These physiotherapy treatments maintain the joint range, and allow muscles to exert their maximum power without causing fatigue. Other specific techniques include Ultrasonography, Myotherapy, Muscle Energy Technique, and Neuromuscular Technique.