Trigger Points … Nasty little Things

February 12, 2019 | By | Reply READ MORE...

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We all have experienced Trigger points at one or the other point in our lives.Those little spots that make you feel stiff and nag you to the extent that you want to hold them “literally” to get riddance!!

Trigger points are the “knots” in soft tissue that are sensitive spots.
These sore spots are as common as pimples, often alarmingly fierce, and they seem to grow like weeds around injuries. They may be a major factor in back,buttocks and neck pain, as a cause and/or complication. A few trigger points here and there is usually just an annoyance, but many bad ones is myofascial pain syndrome

What exactly are muscle knots?

Trigger point is a small patch of tightly contracted muscle, a micro-cramp afflicting just a tiny patch of muscle tissue (as opposed to a whole-muscle spasm like a “charlie horse”) That small patch of muscle chokes off its own blood supply, which irritates it even more, a vicious cycle dubbed a “metabolic crisis.”
They can:

  • cause pain problems,
  • complicate pain problems,
  • mimic other pain problems.

What are the Types of Points?
ACTIVE…they are actively and currently causing pain.

LATENT…these are the dormant sleepers causing dysfunction to muscle, joint and movement, but have not yet fired up their pain zones. You don’t know they are there until you find the spot and apply pressure….PAIN.

SATELLITE…these points form in reaction to other points. These develop in the pain referral zone of the active or latent points. It’s the classic domino effect.

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Trigger points may explain many severe and strange aches and pains

Many people diagnosed with carpal tunnel syndrome are actually experiencing pain caused by a muscle in their armpit (subscapularis) .This odd phenomenon of pain spreading from a trigger point to another location is called “referred pain.” Here are some other examples of interesting referred pain leading to misdiagnosis

  • Sciatica (shooting pain in the buttocks and legs) is often caused by pain in the piriformis or other gluteal muscles, and not by irritation of the sciatic nerve. Many other trigger points are mistaken for “some kind of nerve problem.
  • Chronic jaw pain, toothaches, earaches, sinusitis, ringing in the ears (tinnitus), and dizziness may be symptoms of trigger points in the muscles around the jaw, face, head and neck.

However, the vast majority of symptoms caused by myofascial pain syndrome are simply the familiar aches and pains of humanity — millions of sore backs, shoulders and necks. Some of which can become quite serious.

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How do Trigger Points Form?
Trigger points develop with over use of muscle. They can form after sudden trauma or injury. Nutritional problems, sleep issues, organ dysfunction, disease, chronic infection and emotional factors can also contribute to the formation of trigger points. Inactivity and poor posture  can create them, too!

How Are They Treated?

Palliative care-
1. Manual Inactivation of Trigger Points by ischaemic compression
Light to moderate pressure is applied by pressing on the knot with a finger or by pinching the muscle having sore spots between two fingers for up to 30 seconds.
2. Electrical modalities like Ultrasound, Laser therapy
3. Invasive Treatment of Myofascial Trigger Points:

  • Dry needling
  • Injections with medications (e.g lidnocaine,corticosteroids)

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Curative Care-
Addressing the source of trigger point formation by strengthening of weak muscles that led to overuse of other muscles e.g triggers in thigh (vastus lateralis and ITB) resolve only after strengthening of Gluteal muscles

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