• Trigger points are muscle knots leading to increased muscle stiffness, tenderness and decreased range of motion

• The pain can be experienced away from the source (referred pain)

How Trigger Points can be formed?

• Repetitive movements from activities such as mouse and keyboard use, mobile phones, gardening, DIY projects

• Heavy lifting, carrying babies, briefcases or boxes, wearing body armour

• Habitually poor posture due to a sedentary lifestyle or prolonged bed rest

• Muscle tensing due to mental / emotional stress

• Direct injury such as a blow, strain, break, twist or tear (car accidents, sports injuries, falling down stairs, etc.)

Treatment

• Myotherapy (deep pressure massage), mechanical vibration, pulsed ultrasound, electrostimulation, ischemic compression, trigger-point-injection, dry-needling, "spray-and-stretch" using a cooling (biofreeze) gel

• Stretching techniques, combinations of passive, active, active isolated (AIS), muscle energy techniques (MET), and proprioceptive neuromuscular facilitation (PNF) stretching.  

• I also aim to elongate the soft tissue surrounding muscles as I often feel that this helps to resolve strain patterns, otherwise muscles will simply return to positions where trigger points are likely to re-develop.

What to expect from treatment

• Based on my experience, patients usually report relief from pain during the first treatment. For others, several treatments are needed before an improvement is noticed

• You may experience fatigue as the chronically held musculature is allowed to relax and return to a normal tone, however some patients experience an increase in energy

• Possible relief from other symptoms, such as chronic hand and forearm pain improving after being treated for painful neck and shoulder

After treatment

• It is common for patients to experience some soreness for one to two days after treatment. This usually resolves after the first few treatments

• Minimising stress, pacing your activities and avoidance of overexertion (as well as focusing on what you can do instead of your limitations) are of prime importance.

References

Mosby's Medical Dictionary (2009), 8th edition, Elsevier.

National Association of Myofacial Trigger (2016) “Myofascial Trigger Point Therapy - What Is It?”