Trigger Point Therapy
A TP is a hyper-irritable spot or palpable nodule in the bands of a skeletal muscle’s fascia. Direct compression or muscle contraction can elicit a jump sign, local tenderness, a local twitch response and referred pain which is usually distant from the spot.
The referral patterns have been described extensively over the years and correlate heavily in location with the body’s meridian system as described in Eastern Medicine. Research into such points is often conflicting and can feel much like going down a rabbit hole.
We don’t necessarily form hyper irritable points for any particular reason. Sometimes sleeping on the cold ground or carrying a heavy backpack is enough. Poor posture, vitamin deficiencies, and repetitive stress activities have also been suggested as culprits. Sometimes there is no apparent reason other than being alive.
To make things worse, trigger points can be notoriously hard to find and don’t always present with the same symptoms. In the head and neck region, myofascial pain syndrome with trigger points can manifest as tension headache, tinnitus, temporomandibular joint pain, eye symptoms, and torticollis.
Similar to the controversy around cause is the controversy around treatment. Non pharmacologic treatment modalities include acupuncture, osteopathic manual medicine techniques, massage, acupressure, ultrasonography, application of heat or ice, diathermy, transcutaneous electrical nerve stimulation, ethyl chloride Spray and Stretch technique, dry needling, and trigger-point injections with local anesthetic, saline, or steroid. The long-term clinical efficacy of various therapies is not clear.
That being said, we have a very good track record of both locating and treating trigger points. Just as not every client is the same, not every trigger point requires the same treatment regimen. We incorporate joint manipulation, deep tissue massage, compressive massage, assisted stretching, cryotherapy, various electrical modalities, energy work and sometimes supplementation to address trigger points depending on the patient’s needs.
The key to treating these little monsters is finding the therapy that is right for you.