Trigger points are lumpy spots in your muscle that are tender and irritable
Pressing on a trigger point can cause pain over an area or somewhere else
Symptoms tend to be consistent i.e. pressing on the same trigger point should lead to the same site and type of pain
What is myofascial pain syndrome?
This happens when someone has 2 or more trigger points in the muscle and the covering over the muscle, known as the ‘fascia’
What is the cause of trigger points?
Nerve impingement
A herniated disc or bony spur presses on the nerve, leading to trigger points in the area controlled by that nerve
Prolonged pain
Pain in a certain area that is not treated causes changes in the nerves that carry the signal to the brain, leading to extreme sensitivity over the area
Muscle overuse
The frequency of the muscle usage and small tears results in insufficient time for the muscle to heal up
There is inflammation and less oxygen and nutrients; the muscle fibres shorten and need even more nutrients, leading to a vicious cycle
There are ‘polymodal’ nerve receptors inside the muscle that can turn them into trigger points
Poor physical fitness
Ageing
Middle aged people between 30-60 are more likely to get it
Poor posture
Stress and mental illness like anxiety, depression, PTSD
Lack of vitamins and iron
Poor sleep
Trauma and accidents
How do we treat trigger points?
Medications
Paracetmaol and NSAIDs and COX 2 inhibitors
Muscle relaxants
Weak opioids like tramadol for a short time
Strong opioids are not recommended
Physiotherapy
Cold packs to reduce inflammation
Hot packs to increase blood flow and circulation
Stretching and strengthening
Posture training and changes in office ergonomics
Massage
Laser light therapy
TENS machine
Acupuncture
Pain procedures
What pain procedures are available for treatment of trigger points?
Trigger point injections with:
Dry needling
Steroid
Concentrated Glucose
Local anaesthetic
Biologics like PRP (under research)
Ultrasound guided nerve blocks to target the underlying nerve responsible
Radiofrequency procedure to target the joint that is in pain that is causing the trigger point
Nucleoplasty to treat the disc herniation and relieve pressure on the irritated nerve
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