The following is a list of commonly asked questions about
Trigger Point Therapy. Click on a question to view its answer.

Frequently Asked Questions

What is Trigger Point Therapy?

     The term Trigger Point was first utilized by Dr. Janet Travell M.D. to describe nodules in muscle tissue that “triggered” pain when physically manipulated. Along with Dr. David Simons M.D., Dr. Travell spent most of a lifetime researching and developing a field of manual medicine that she termed Myofascial Pain. Drs.Travell and Simons authored two medical textbooks on the subject titled Myofascial Pain and Dysfunction : The Trigger Point Manual Vol.I and II . These two volumes represent probably the most complete and scientifically valid clinical understanding of musculoskeletal pain and dysfunction.
     Though their work goes largely ignored in medical school curriculums, there is a growing number of physicians, chiropractors, physical therapists, athletic trainers, and massage therapists employing trigger point work in their daily practice. Dr. Travell is now deceased, but Dr. Simons, now in his eighties, continues his outstanding research.
     Clinical Trigger Point Therapy is a bodywork system that is based on the research of Drs. Travell and Simons. It utilizes a combination of physical (hands-on) techniques to locate and release trigger points that produce many varieties of musculoskeletal pain and dysfunction. Clinical Trigger Point Therapy incorporates many clinically oriented techniques, but also contains many self-applied techniques as well. This comprehensive design empowers people to take control of the physical pain in their lives, to understand it and address it on their own terms.

So what exactly is a trigger point?

     A trigger point is a small area of muscle that remains tightly contracted all the time, even if the muscle itself is relaxed. It is found in the muscle belly, where the nerve that controls that muscle attaches to it. The trigger point is not actually a problem with the muscle itself, but rather is a problem with the structure that connects the nerve and the muscle. Physically, a trigger point feels like a knot about the size of a pea in the muscle.

How does a trigger point affect the muscle?

The presence of a trigger point in a muscle affects its function in the following ways;

• It weakens the muscle by preventing a strong contraction.
• It prevents the muscle from completely relaxing.
• It increases muscle tension.
• It greatly increases the likelihood that the muscle will spasm.

How does a trigger point affect the nerve?

     A trigger point affects the nerve primarily by producing referred pain, but it may also produce other symptoms such as numbness, tingling, dizziness, and other neurological symptoms.

What is referred pain?

     Referred pain is a type of pain that is experienced by a person in a region of their body that does not contain the source of that pain. For example, its common knowledge that a person having a heart attack will often experience pain in the left arm or shoulder. The source of the pain is actually the heart muscle, but the pain is “referred” or projected to the left arm or shoulder.
     In general, about 75 percent of all trigger points produce referred pain that is felt in an adjacent region of the body. The other 25 percent of trigger points produce pain that is felt only on or directly around the trigger point.

Why is pain “referred” to another region of the body?

     This is still a bit of a mystery. Perhaps its best to examine the function of pain itself for an answer to that question. In general, pain is a message from the body to the brain that serves to protect an injured body part or tissue. For example, the pain from a cut on your foot serves to prevent you from walking on it and doing additional damage.
     Likewise, referred pain from a trigger point serves to prevent you from using the muscle that harbors the trigger point. For instance, trigger points in the neck and shoulders often refer pain to the head. Now if you have a headache, your naturally going to want to keep your aching head as still as possible and probably lie down if you can. The muscles of the neck and shoulders function to move the head, so lying down and immobilizing your head serves to rest these muscles and prevent further damage to them.

What is the best way to treat trigger points?

     There are many different methods for treating trigger points. Probably the easiest and one of the most effective is simple physical pressure applied to the trigger point itself. The drawback to this method is that it produces or increases the referred pain from the trigger point. If done gently and within a person's pain tolerance however, this method has one important benefit; it proves to both the patient and therapist, that this is indeed the source of the pain. If done properly, pressure release treatment methods produce a “good” type of pain, or rather pain that both hurts and feels good at the same time. More advanced treatment methods often employ special stretching techniques and sometimes combine pressure release methods with special stretching techniques.

What causes trigger points?

     Many factors can cause trigger points, but generally muscle overuse or overloading is the primary cause. Any activity or posture that requires a long, sustained contraction of a muscle can create trigger points in that muscle. In addition any posture or body position that puts a muscle in a shortened position for an extended period of time can cause trigger points to form and/or worsen. Mental stress and emotional exhaustion contribute greatly to trigger point activation. Other causes include physical trauma, improper exercising, and work related overuse activities.