Trigger points or muscle knots are painful spots in soft tissue that cause throbbing pain. If too many of these points are involved then this is called myofascial pain syndrome and it is a chronic pain disorder. There are certain characteristics of these trigger points:
- Jump sign: It is a behavioral response when pressure is applied on TrPs. It causes intense pain and tenderness. This is considered as a pathognomonic sign.
- Local twitch response: It is defined as a temporarily visible contraction of muscle because of the contraction of tense muscle fibres when pressure is applied
- Referred pain: Pain that is perceived at any side other than the site of a painful stimulus is referred pain. The pain is constant and distinct.
The following are the causes of TrPs:
- Injury; by a fall, stress, or birth trauma
- Lack of exercise
- Bad posture
- Muscle overuse
- Vitamin deficiencies; vitamin C, B, D
- Stressful conditions
- Sleep disturbance
- Joint problems
Classification of TrPs
1. Satellite trigger points
They cause pain locally at pressure usually around the centre of muscle belly with irradiation.
2. Active and inactive trigger points
They cause severe pain and referred pain as well on pain on palpation. Inactive TrPs can develop anywhere and can cause stiffness in muscles too.
3. Diffuse trigger points
It happens in several postural deformities.
4. Attachment trigger points:
This arises in tendon osseous junctions and are very tender.
Trigger point therapy
It refers to the treatment of trigger points found in muscle or fascia. This involves the application of pressure to sore muscle tissue for relieving pain. The goals of trigger point therapy are to:
- enhance blood circulation to the trigger zone
- stretching of the taut band
- release of the surrounding fascia
Trigger point therapy interrupts the neural signals that cause pain. In this way, stiffness and swelling are also reduced and the range of movements is increased. Trigger point therapy benefits certain conditions including arthritis, carpal tunnel syndrome menstrual cramps, multiple sclerosis, sciatica, etc.
There are several methods for trigger point therapy including manual trigger point therapy, dry needling, or a combination of these two. Check out this trigger point therapy in detail before choosing the best-suited one.
Manual trigger point therapy:
It is a manual technique to treat trigger points. In this method, strong manual pressure is applied to treat pain that can be uncomfortable or painful for the patient.
Dry needling technique:
It includes the use of sterile disposable acupuncture needles to enhance blood circulation and flow to affected areas. This helps in healing and reduce pain.
There are several trigger point techniques, some of them mainly focus on the trigger point and taut band while others focus on fascial release techniques. Each technique is numbered from I to VI the trigger point method I and II and the intermuscular mobilization IV include a strong pressure manually. That is why trigger pot therapy is painful. the trigger point technique I may be combined with a passive or active change in muscle length to hone the effect.
Trigger point techniques
- Technique I: local compression of trigger point
- Technique II: local manual stretching along with the taut band where several trigger points are located,
Fascial release technique:
- Technique III: the manual release of connective tissue and fascia around the trigger point
- Technique IV: the manual release of connective tissue and fascia between two muscles.
People with infectious diseases like open sores or recent injuries should wait for some time. Persons taking anti-coagulant drugs may experience bruising after TrPs.
To treat trigger point a health care professional refers a patient to a trigger point therapist. the therapist will ask the patient about pain its location severity in detail. Then the therapist will treat it accordingly with one of the best methods either manually or with a dry needle which will relieve the pain.