| Human Physiology versus Modern Living | | | | deactivated by acupuncture, electric stimulation, or |
| Human bodies have not changed much in the past | | | | injections. Fortunately, trigger points also respond |
| 10,000 years; however, during the last 150 years, | | | | to manual therapy. |
| we have greatly changed our lifestyles. Our bodies | | | | Trigger Point History |
| deal with new chemicals, sleep habits, physical | | | | Some researchers think that many trigger points |
| tasks, indoor lighting, noise, and other unnatural | | | | and acupuncture points overlap. Hence trigger |
| stimulation. The increase of psychological stress, | | | | point therapy was accomplished by acupuncture |
| repetitive tasks, and decrease of physical activity | | | | thousands of years ago in China and other parts |
| in modern lives has contributed to chronic pain. It | | | | of the world. In the seventh-century book A |
| is difficult to change a lifestyle, but trigger point | | | | Thousand Golden Remedies, Sun Su-Miao (Si miao) |
| therapy can be used to reduce or eliminate the | | | | described "ah-shi" tender points - most probably |
| source of various types of pain, without drugs or | | | | trigger points. In the 1940s, trigger points were |
| surgery. | | | | first clearly described and mapped by Janet |
| Pain Can Be Tricky | | | | G.Travell, MD, who eased John F. Kennedy's pain in |
| The Centers for Disease Control and Prevention | | | | 1955, allowing him to run for president. Dr. Travell |
| reported in 2006 that over 25 percent of | | | | then served as the personal physician for both |
| Americans aged twenty and older report pain | | | | presidents Kennedy and Johnson. Drs. Travell and |
| lasting over twenty-four hours. The Annals of | | | | David Simons later wrote the seminal text on |
| Internal Medicine reported that twenty-five billion | | | | Trigger Point Therapy: Myofascial Pain and |
| dollars per year was spent in search of low back | | | | Dysfunction: The Trigger Point Manual. Although |
| pain relief in 2003. Typical allopathic treatments for | | | | sixty years of medical research has shown that |
| pain are medications, cortisone, and surgery. For | | | | trigger point therapy relieves pain, the medical |
| many patients, surgery provides welcome relief, | | | | community has been slow to promote this |
| at least temporarily, from sciatica, carpal tunnel | | | | therapy. Doctors who do treat trigger points |
| syndrome, and other mechanical and | | | | inject steroids, local anesthetics, carbon dioxide, |
| pathophysiologic problems. However, symptoms | | | | dextrose, Botox(R), MyoX(TM), and even muscle |
| mimicking such problems can be caused by trigger | | | | relaxants to disarm trigger points, and such |
| points, which surgery does not improve. In | | | | injections have been covered by U.S. medical |
| general, trigger points frequently remain | | | | insurance since 2005. |
| overlooked, unrecognized, and untreated. After a | | | | Manual Trigger Point Therapy |
| back injury, medication was prescribed for me for | | | | In Europe, manual approaches are used by |
| a year with little relief. Then I visited another | | | | myoskeletal medical doctors and practitioners. In |
| medical doctor who, in one session, removed my | | | | the United States, physical therapists use spray |
| pain using manual therapy. He explained that my | | | | and stretch techniques, which numb the skin, |
| pain was referred from the actual problem areas. | | | | interfering with pain conduction, allowing stretching |
| Referred Pain | | | | to release trigger points. Also, massage therapists |
| Referred pain is sensed in an area away from the | | | | use direct pressure by hand, foot, or tool. The |
| actual pain source. Examples of referred pain are | | | | simplest and least invasive method of trigger point |
| headaches, phantom limb pain in amputated limbs, | | | | therapy involves manually locating the trigger |
| pain down the left arm during a heart attack, and | | | | point, which may feel like a pea or knot, and |
| the infamous so-called brain freeze caused by | | | | pressing or holding firmly, using thumb and finger, |
| drinking cold liquid, which cools the vagus nerve | | | | for fifteen seconds or more. Elbows and feet |
| running along the throat. During a brain freeze, one | | | | may also be used, as in barefoot deep tissue |
| may feel it in the head, when the cause may be | | | | therapy. Best of all, this modality can be |
| down the throat. Pain referral is also common in | | | | incorporated into a Swedish, barefoot, deep |
| myofascial pain syndromes, which are caused by | | | | tissue, or other type of massage, whether the |
| trigger points in muscle, fascia (fibrous tissue that | | | | client is clothed or not. Trigger point referral |
| connects, separates, and supports muscles, | | | | patterns in muscles have been thoroughly |
| bones, skin, and other organs), tendon, and | | | | mapped; for example, temple headaches are |
| ligament tissue. These trigger points are among | | | | most often caused by trigger points in the |
| the most common causes of chronic pain. | | | | temporalis or upper trapezius. So when a patient |
| Trigger Points | | | | complains of a temple headache, the therapist |
| A trigger point can be thought of as a muscle | | | | knows, or looks up, which points on which |
| protection mechanism, which stiffens the muscle | | | | muscles harbor this referred pain. When manual |
| in order to limit range of motion, triggered by | | | | pressure is applied to the correct point, the pain |
| injury, overuse, and adrenaline - all phenomena in | | | | will temporarily increase,and then fade. Many |
| which modern humans excel. Resultant stiffening | | | | massage schools now teach manual trigger point |
| or spasms of muscles cause blood stagnation, | | | | therapy, and popular laybooks have been written |
| nutrient loss, and buildup of toxins. Such protection | | | | that can prove extremely useful for self-help. |
| can become chronic and painful and can activate | | | | Self-Massage |
| other trigger points, spreading pain and disability | | | | For self-treatment, a tennis ball may be placed |
| like an infection. Postural muscles, as in the neck, | | | | inside a sock and dropped over the shoulder |
| shoulders, back, and pelvic girdle, and others, such | | | | between the shoulder blades and pressed against |
| as forearms, hands, calves, and face, that are | | | | a wall into tender spots for fifteen seconds or so, |
| used in repetitive actions are most vulnerable to | | | | whether or not "good" pain decreases. This can |
| trigger points. Trigger points may cause | | | | be done several times a day. For more force, or |
| headaches (tension and migraine), | | | | for gluteal areas, one can lie on the floor or use a |
| temporomandibular joint pain, sciatica, and | | | | harder ball. Several tools are available to aid |
| apparent carpal tunnel syndrome and can be | | | | self-treatment. Not all pain is caused by trigger |
| associated with burning, numbness, weakness, | | | | points, so if one to three therapy visits do not |
| temperature, sweating, dryness, dizziness, nausea, | | | | produce relief, then referral to a licensed health |
| tinnitus, vision, decreased range of motion, and | | | | specialist is recommended. |
| other problems. Since trigger point syndromes are | | | | Conclusion |
| unfamiliar to many physicians, these familiar | | | | Over the last hundred years, Western medicine |
| symptoms can make diagnosis difficult. Sedentary | | | | has been straying from manual therapies to |
| people and those, such as computer operators, | | | | drugs, surgery, and other invasive treatments. |
| dentists, drivers, and specialized athletes, who hold | | | | Manual trigger point therapy is a noninvasive |
| unnatural positions or perform repetitive tasks are | | | | method for relieving many types of pain. It may |
| at high risk of developing active trigger points. | | | | be used by doctors as well as massage |
| After sitting at a desk, running or a gym workout | | | | therapists, and even by patients themselves, to |
| may seem to make up for the sedentary time, | | | | help reach the goal of a pain-free body. To find a |
| but it actually may promote the pain and | | | | trigger point therapist near you, ask your doctor, |
| dysfunction. Rigid use then overuse is not the | | | | physical therapist, or local massage school. |
| best. Most trigger points are reduced or | | | | |