Trigger Points – Part 1
The “gift” that keeps on giving
Have a nagging ache that seems to come and go? Or won’t go away? You can feel fine for weeks, even months and then BAM!, the pain returns with a vengeance. You take a couple of aspirin or ibuprofen, rest it and it feels better for a while. Then, for no reason at all it seems to return “all of a sudden” out of nowhere. It could be your low back, a stiff neck, tension headache, painful wrist or tingling foot – you name it – you know what I mean.
Sometimes the pain lingers for days and finally prompts a doctor visit. The doctor ran some tests and told you there was nothing showing up that could be causing it. Nerves seem alright, circulation is good and there is no structural damage to the joints. Could be muscle tension – a prescription for muscle relaxants helps, but again only temporarily.
As massage therapists we have seen this many times with our clients. While tight muscles can explain the symptoms, often there are myofascial trigger points at the root of the problem.
Trigger point pain is nothing new in the history of humankind, it was just called something different before Dr. Janet Travell, MD. coined the phrase in the 1970s and published her first of two medical books on the subject in 1983 entitled Myofascial Pain and Dysfunction: The Trigger Point Manual.
Dr. Travell did her clinical research over many years working with patients that suffered from all kinds of pain. She even worked with United States President John F. Kennedy, who suffered debilitating back pain from them. Dr. Travell would inject trigger points with medications or use ice and stretch to release them. Massage therapists use fingertip/thumb pressure on the trigger point to release them.
So can you!
What are they?
A trigger point is a localized area of extreme tenderness within a muscle or its surrounding connective tissue (fascia). It is believed to be sensitive from deposits of cellular wastes that accumulate and irritate surrounding sensory nerve receptors. They are felt as tight nodules (like small beans), or stringy or ropey fibers within a muscle (like thin speed bumps).
How do you get them?
Sometimes we use our muscles too much for a day or two – cleaning the house, weeding the garden, painting the ceiling, weekend sports, you get the idea. Many trigger points develop because of too much activity (overuse, repetitive stress syndromes), but not all of them.
Sometimes we overstretch a muscle and sometimes we shorten them for long periods. Have you ever fallen asleep on the couch in a weird position or stared at a computer screen (or cell phone screen) for hours on end; days on end? Then chances are you developed a trigger point in a muscle or two. What can happen is that you wear a pathway between a muscles stretch receptors and the spinal nerve that it connects to. Sort of like wearing a pathway through a field of grass from taking a shortcut too often. The longer and more often you take the shortcut the barer the grass. It becomes habitual. Trigger point patterns get established the same way. In times of emotional stress or when performing some activity you tend to hold a posture, use a muscle or your joints the same way and that can cause the pain to return.
Another way we get trigger points is from traumas like car accidents, falls, roller coaster incidents – you get the picture. When muscles and joints are suddenly stretched or twisted beyond normal limits they recoil or spasm. The constant firing of nerve impulses wears a pathway in the nervous system that establishes a pain pattern. (The technical term is a facilitated spinal cord segment).
And once you get them it can be hard to get rid of them!