Trigger points are a common problem seen by massage therapists. Trigger points were defined in 1942 by Dr Janet Travell, personal physician to President John F. Kennedy.
She identified four defining characteristics of myofascial trigger points:
- Discrete, well defined point of pain in the skeletal muscle or it’s fascia, the connective tissue enclosure of the muscle. The pain does not have to be caused by trauma, inflammation, osteoarthritis, or other pathological processes.
- The trigger point is identified as a nodule within the muscle. Pressure placed upon the trigger point may cause a twitching in the muscle.
- Pressure on the trigger point causes pain and may create pain in another part of the body. This is known as referred pain. The location of the referred pain is specific to the muscle that has the trigger point. For example, trigger points in the trapezius muscle refer pain to the side of the neck and head.
- The referred pain does not have a neurological explanation. Unlike sciatica, where nerve compression results in pain referred along the length on the nerve, the referral patterns for trigger points do not follow nerve distribution and are not fully understood.
Trigger points are only found in muscles. They are a small nodule of muscle contraction within a larger muscle. You can think of them as “knots” in the muscle. Sustained contraction at the nodule can compress blood flow, restricting the supply of nutrients and oxygen to the muscle. Pain and weakness are often found in the affected muscle. They are often caused by overuse.
Treatment is done with trigger point therapy. With this, the massage therapist applies pressure to the affected area with thumbs or fingers. As the muscle fibres release their contraction, pressure is increased. You will feel some discomfort during this process. As the areas are hyper-irritable, it is important that you provide feedback to the massage therapist. Over a course of several treatments with your RMT, the therapy will re-educate the muscle. Your pain and swelling will be reduced and you will see an improved range of motion and coordination.