The following is a
list of commonly asked questions about
Trigger Point Therapy. Click on a question to view its
What is Trigger Point
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
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.
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
So what exactly is a trigger
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
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
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?
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
Why is pain “referred” to another
region of the body?
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.
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
What is the best way to treat
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
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?
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.