Trigger Point Massage Therapy and Referred Pain

Trigger Point Therapy is a highly effective technique commonly used to alleviate chronic pain and dysfunction. It is a technique that can be used alone or integrated with other modalities in a session. A trigger point is a firm, palpable, highly irritable spot found in a tight band of muscle fibers that is generally characterized by extreme tenderness. Commonly referred to as “knots,” trigger points are worked by applying direct pressure, deep gliding pressure, and stretching the effected area.

 According to  Doctors Janet Travell and David Simons in their set of medical textbooks, Myofascial Pain and Dysfunction: The Trigger Point Manual Vol 1 & 2, myofascial trigger points are tiny contraction knots that  can develop in a muscle.  These are very small areas of normally low neurological activity within muscle fibers that have become irritated and locked into a contraction, becoming very highly irritable and which refer pain into another area. When this contraction persists, the blood flow is restricted in this fiber and it becomes ischemic. It is generally thought that this state is the result of an irregular amount of the neurotransmitter Acetylcholine being released from the nerve which stimulates that muscle. Trigger points often occur when the soft tissue is injured, overloaded, or strained.

When trigger points are present in muscles there is often pain and weakness in the associated structures.  But any paresthesia: itch, tingle, twitch, pain, etc. can be the result of trigger point activity. These pain patterns  are common and predictible and have been readily mapped to allow for identification of the causative sources. Many trigger points have pain patterns that overlap, and some create reciprocal cyclic relationships that need to be treated extensively to remove them. A skilled trigger point therapist can quickly trace the pain back to its source and deactivate those trigger points with specific pressure techniques.

 The misdiagnosis of pain is one of the most important issue taken up by Travell and Simons. Referred pain from trigger points often mimics the symptoms of other maladies and causes of discomfort. Travell and Simons suggest that most of the common everyday pain is in fact caused by myofascial trigger points and that ignoring this concept often leads to false diagnoses and the ultimate failure to deal effectively with pain.

The  Trigger Point Therapists at Nashville Neuromuscular Center always do a thorough assessment and listen to medical history including accidents and injuries to determine the likelihood of trigger points being the actual source of myofascial pain syndromes. We frequently refer to appropriate medical professionals to rule out any other more serious causes before just assuming that trigger point massage will be the cure-all for what ails you.