Daily headaches kept Sara either popping aspirin at work or on the couch at home. She didn’t like the side effects of the prescription from her family physician and the referral to a neurologist for more testing was still 3 months away.
She showed up to our office unsure as to whether or not a physical therapist could help. She did know she was desperate for some relief. As she put it “to hold her over”.
It turned out Sara’s headaches were caused by trigger points in her neck. And that is absolutely an area where we can use our specialized skills to help.
In fact, Sara left the clinic that day headache free (without aspirin) and after a few weeks the headaches weren’t coming back.
Her prescription meds were flushed and her neurologist appointment was cancelled. A lot of time and money was saved in the process.
What is a trigger point?
A tight area or “knot” within a muscle is a trigger point. It is different from a muscle spasm, which occurs when the entire muscle is contracting. Also different from a muscle strain where there is damage to the muscle tissue.
A trigger point causes a shortening of the muscle fibers and causes pain with pressure. In addition, they cause referred pain. This means that a trigger point in one muscle can create pain in another area, often very distant, from the pain point.
Do I have trigger points?
If you feel like you have problem with daily stubborn and unexplained aching and stiffness, then trigger points may be to blame. In fact, they can accompany and complicate other injures of the muscles and joints.They can make the original problem, such as muscle strain or arthritis, worse and in many cases actually overshadow the original pain.
Why do I have trigger points?
When a muscle has been contracted repetitively, a trigger point most often occurs. This can occur in several ways:
- Repetitive movements
- Heavy lifting or carrying
- Habitually poor posture
- Muscle tensing due to stress
- Prolonged bed rest or sitting
In Sara’s case, chronic poor posture at her desk all day caused the trigger points in her neck, which referred pain to her head.
Treating Trigger Points
The good news is that trigger points respond well to physical therapy and can solve many pain problems. The trick is often in diagnosis due to referred pain that attempts to throw us off course.
For example, some people diagnosed with carpal tunnel syndrome actually have wrist pain due to a trigger point in a muscle under their armpit.
As orthopedic physical therapists, we are skilled at diagnosing and managing trigger points. However, we frequently see patients when they find us as a last resort.
They commonly arrive with a list of diagnostic procedures, none of which was able to explain or relieve their pain. Luckily for Sara, she came to us before costly tests and procedures were performed.
We treat many orthopedic conditions where trigger points are involved including shoulder impingement, neck and jaw pain, low back problems, and tennis elbow to list a few. If you have a diagnosis of arthritis, tendinitis, bursitis, or ligament injury treating trigger points may significantly reduce your pain.
So, what do WE do about them?
Trigger points and the related muscle tightness or damage will not resolve with rest. In fact, if pain does subside the trigger point is likely dormant but will resurface when activity is resumed. This is not the answer for long term relief.
We have a tool bag full of techniques including manual therapy, soft tissue mobilization, and most effectively dry needling to release and relax the trigger points.
The goal is to release the contracted fibers and increase circulation to the muscle enabling oxygen and nutrients to return to the area.
Ultimately, we must also work to correct the muscle imbalances, poor postures, or modify repetitive activities that caused the trigger point in the first place.
If you can relate to Sara’s story, even if other physical therapy or medical interventions have failed, trigger point therapy may be the answer you have been looking for.
Identify if trigger points are contributing to your pain even before you sign up for treatment sessions by meeting with a physical therapist for a discovery visit.
