The hidden menace of Trigger Point Pain

with Tim Wright - Gower Acupuncture (Swansea)

Ever suffer from a muscular pain where you can’t quite locate its origin and where massaging or pressing on the site of pain doesn’t relieve the pain at all? If so you may well have fallen victim to trigger point pain.

What are trigger points?
Trigger points are areas of tightly contracted irritable muscles. They can occur in muscle, fascia or skin. Research by National Institute of Health has shown that the taut bands contain many pro-inflammatory substances. They typically refer pain or discomfort away from the area that is contracted. For example; pushing on the side of the neck can refer pain into the upper chest and down the arm in the case of a dysfunction in a group of muscles called the scalenes. You’ll find that massaging the arm and chest in this case gives no relief. You have to go to the source of the pain in the neck to resolve the issue.

How do trigger points form?
Within each muscle there are millions of tiny “mini muscles” called sarcomeres. When you want to contract a muscle a nerve impulse is sent to the muscle. On receiving this impulse, the sarcomeres contract. If the muscle is overloaded, tightened for sustained periods of time, repetitively used or affected through trauma it can remain in the contracted state. Once affected the sarcomeres can’t release – they remain contracted. This restricts blood flow and leaves the cells of the muscle in an energy crisis. Unfortunately, blood flow and the energy (in the form of ATP) that it brings are exactly what the sarcomere needs to get itself unstuck. Without blood supply, waste products accumulate and cause local irritation, pain and hypersensitivity otherwise known as a trigger point. Trigger points don’t just cause pain though. Sternocleidomastoid (a muscle on the side of the neck) trigger points can even affect hearing, balance and cause nausea.

So, who discovered trigger points?
Dr Janet Travel was one of many physicians working on trigger points from the 1950’s onwards.
Her work on John F Kennedy’s back earned her the honour of being the President’s physician during his time in the White House. The depth of her life-time’s research is staggering and can be found in two huge (and very expensive) volumes on trigger points.

So where would you get trigger points?
You can get trigger points almost anywhere in the body. There are certain muscles that are more susceptible though. Postural muscles – those that are used to maintain an erect posture – often spend prolonged periods under contraction and so are especially prone to trigger points.

The most stressed of these tend to be the muscles of the neck. Prolonged periods of neck craning from reading, texting, being on the computer over-stress the muscles in the back of the neck and shorten the muscles in the front of the neck.

How do you get rid of trigger points
Find the trigger point and massage it. Finding the trigger point isn’t always easy though. A skilled massage therapist or acupuncturist can locate and work these trigger points/knots out. I particularly like acupuncture as the needle penetrates directly into the affected muscle fibre.

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