January 12, 2010

What is a trigger point?

Trigger points are discrete, hyper-irritable spots located in a taut band of skeletal muscle. They produce pain locally but that's not all! Unlike a more simple adhesion, when addressed - trigger points activate pain in a different area of the body. This is called referred pain. The pattern of referred pain, while not identical from person to person, is extremely consistent across each one of us. Trigger points can be the result of many things, a physical trauma (like an injury or accident) or by an unhealthy repetitive use of muscles that cause great stress in the body. Such as improper sleeping positions, carrying a purse on the same shoulder every day, even muscles used to maintain our every day posture! (muscles in the back, neck, shoulder and hips for example) Certain kinds of visceral diseases or even emotional distress can leave the individual more prone to have trigger points.


When a trigger point is located it has a few characteristics to let you know what you are dealing with. Even at first touch the therapist will feel a bundle or nodule of muscle fibers that are harder than normal consistency. The client will feel hypersensitive in that spot (maybe even having a 'jump' in reaction) as well as a radiation of pain toward that trigger points referred pain pattern.  There may also local twitch response. Defined: a brief, contractile response of a skeletal muscle elicited by a single maximal volley of impulses in the neurons supplying it.

There are two trigger point categories:
Active: Causes pain at rest. Pain is often described as shooting or radiating.
Latent: Does not cause spontaneous pain, but pain is present when palpated. May restrict movement or cause muscle weakness.


Trigger point symptoms can manifest in many ways:
Pain: Persistent, Aching, Stinging, Burning,Throbbing
Decreased Range of Motion
Weakness
Reduced Stamina
Tension Headache
Pain Behind the Eyes
Unprovoked Sweating
Insomnia
Muscle Spasms
Dizziness or Vertigo
Ringing in the Ears 
Persistent Tearing
Tinnitus

There are some great ways to treat trigger points:
Deep massage designed for trigger points can work wonders! A trained therapist can be specific and attentive to the point - feeling the tissue soften and dissipate under their touch. In more extreme situations ultrasonical and injections have been used to deactivate these troubled areas.

For self care - stretches can definitely help! Talk to you massage therapist about what stretches will target the exact muscles affected by the trigger point. Also, like so many body issues - being mindful about how you use your body in your daily life can be preventative as well as corrective.

Possible Prevention Aids:
Good body mechenics
Regular full body activity followed by a resting period
Stretching of high-risk muscles
Appropriate Vitamin intake of B1, B6, B12, C,  Folic Acid
Appropriate Mineral intake of Calcium, Magnesium, Potassium, Iron



Research Links:
http://www.aafp.org/afp/2002/0215/p653.html
http://triggerpoints.net/
http://www.easyvigour.net.nz/trigger_points/h_triggerpoint5.htm
http://www.drlowe.com/myofascial/generalinfo/globalization.htm
http://saveyourself.ca/tutorials/trigger-points.php

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