During the course of your treatment, trigger point (TP) therapy may be recommended as an important part of restoring spinal and nerve system balance. This explanation will help you understand why this form of muscle work is being suggested to you.
What Is A Trigger Point?
A TP is a hypersensitive area in a muscle that causes local pain, referred pain (to other areas) and often a noticeable twitch response when it is compressed. Some of the discomfort of a trigger point is thought to be due to the presence of specific body chemicals: histamine, serotonin, bradykinin plus others. TPs are either called “active” (they are causing you pain now) or “latent” (they are not currently causing you pain.)
According to Dr. Janet Travell (author of the landmark book, Myofascial Pain and Dysfunction)* “latent TPs may persist for years after apparent recovery from injury; it predisposes to acute attacks of pain since minor overstretching, overuse or chilling of the muscle may suffice to reactivate it. Both latent and active TPs cause dysfunction; only active TPs cause pain.” However, latents may become active again.
How Do I Get Trigger Points?
TPs are usually the result of injury, poor posture, body strain or dehydration. They may remain as focal points of irritation long after the event that caused them is past.
How Do Trigger Points Interfere With Function?
Trigger points interfere with function in the following ways:
- TPs cause pain when you try to stretch the muscle. Pain is a chemical event and the chemistry stimulates a protective spasm in the muscle. This perpetuates the pain-spasm cycle.
- The length of muscle stretch is reduced making you tight and stiff.
- There is pain when you try to contract the muscle strongly and pain leads to spasm.
- Muscle contraction is weakened. Often other muscles attempt to compensate for this which begins to strain them. It’s like doing someone else’s job plus yours!
- Muscle fatigues more easily with normal activity.
- TPs may be reactivated by other triggers, arthritic joints, visceral (organ) disease and emotional stress.
How Do You Treat A Trigger Point?
The medical profession treats TPs with anesthetic injection into the TP and a method called “stretch and spray” using an agent called fluoromethane.
We will treat your TPs using a manual method called “ischemic compression” in which pressure is applied with the fingers to the TP. This alternately forces blood away from the TP (ischemia, or lack of blood) and upon release, allows blood to flood the TP, acting as a wash. The compression may be tender due to the pain-stimulating chemicals associated with the TP. Tenderness is NOT a sign that damage is occuring during compression. Generally the tenderness decreases as treatment continues.
We will also ask you to do stretching at home to encourage blood flow through the muscle. THIS STRETCHING IS CRITICAL and may be the deciding factor in the ultimate success of your treatment.
Do Trigger Points Go Away Forever?
Yes, they can. The degree to which they do depends on completeness of your treatment, self-care and lifestyle stresses. You may have to change some habits! Some TPs are more persistent than others, especially when they are associated with fibrotic (scar-like) change in the muscle.
A cleaner muscular system will help you maintain the balance created by your spinal adjustments as well as making your body a more comfortable place to live.
*Travell, JG, Simonds DG: Myofascial Pain and Dysfunction: The Trigger Point Manual. Baltimore, Williams and Wilkins, 1983.