Trigger Points – The Possible Source of Pain
After a hard day at work, do you ever blame your throbbing headache on the sheer effort of intense concentration? You’ve literally given yourself a “brain ache”! Whilst I’ve no doubt that you’ve been concentrating hard and haven’t once been distracted by Facebook, a more likely reason for that headache is the presence of trigger points in your neck and shoulders. These unpleasant little knots of tension can be the cause of many an unexplained ache or pain anywhere in the body.
A trigger point is a small area of muscle where the muscle fibres have adhered together due to repeated mechanical stress, emotional stress, poor posture, or trauma (e.g. a fall or collision) amongst other things. The resulting contraction or ‘knot’ inhibits the supply of blood and oxygen to that area, impeding the ability of the muscle to eliminate metabolic waste, which builds up and stimulates nearby nerve endings leading to trigger point pain.
This small knot of contracted muscle fibres renders the entire muscle dysfunctional. The muscle’s strength is impaired since it is unable to contract fully, but neither can it relax fully, leaving it feeling tense and stiff. This means the rest of the muscle fibres must work harder to compensate for the dysfunctional ones, resulting in the whole muscle being fatigued and at risk of spasm.
When pressure is applied to a trigger point, it causes an almost exquisite pain sometimes accompanied by a light flickering of the muscle. But the oddest thing about trigger points is that because they affect the nervous system, they can produce referred pain that radiates from the adhesion to another location, sometimes quite far from the trigger point itself. The referred pain is usually an almost constant dull ache, but may become acute and debilitating.
Let’s start with your headache; trigger points in the upper trapezius and other muscles of the neck, can be the cause of pain in the front, sides and top of the head and even in the jaw.
A more extreme example of referred pain is when a person having a heart attack feels pain in the left arm, shoulder or even the jaw, instead of deep in the chest where the heart lies.
Further examples include: –
- Trigger points in the muscles of the lower leg cause pain in the sole of the foot, which is sometimes mistaken for plantar fasciitis, a common problem amongst runners.
- Trigger points in the calf muscles may cause cramping of the calf muscles during the night.
- Trigger points in the pectoralis minor muscle of the chest cause pain in the shoulder that might radiate down the inside of the arm.
- Trigger points in the wrist flexor muscles of the forearm cause pain in the wrist, sometimes misdiagnosed as carpal tunnel syndrome.
The list goes on…
So, the source of at least some of the aches and pains you’ve been feeling probably isn’t the area where you feel the pain, and treatment that focusses on the area of referred pain obviously isn’t going to be effective – it is the source that must be treated.
Fortunately trigger points are an ongoing subject of study in the science of pain and recognised pathways of referred pain have been mapped out across the body; patterns which associate pain in one location with trigger points elsewhere.
So, how do we treat trigger points?
Massage is an effective treatment that increases the blood circulation to the knot, allowing oxygen to enter, and elongating and breaking apart the adhered muscle fibres. Of course, I recommend booking an appointment to see me, but you can try treating yourself.
The trick is to find the trigger point in the first place, and here’s a website that can help you do just that:
Once you find a trigger point, use fingers, thumbs or even an elbow to press on it directly (not too hard – say a pain level of 6 – 8 out of 10) and hold for a while (up to 90 seconds) until the pain subsides. You can then increase the pressure, causing the level of pain to increase and hold until the pain subsides once more.
Alternatively, you could apply small kneading strokes to the trigger point in a circle or back and forth. If the direction of the muscle fibres is obvious (like down the length of your thigh for example), try massaging parallel to the fibres as though you are trying to elongate them.
If none of these methods helps and the pain persists, give me a call.