About Trigger Points
Muscle pain and tightness are often caused by something called "trigger points." These are small, sensitive areas in your muscles that can create pain, discomfort, and stiffness. Let’s break down what causes trigger points, why they hurt, and what recent research tells us about them.
This short video provides a nice visual understanding of trigger points:
Muscle pain and tightness are often caused by something called "trigger points." These are small, sensitive areas in your muscles that can create pain, discomfort, and stiffness. Let’s break down what causes trigger points, why they hurt, and what recent research tells us about them.
This short video provides a nice visual understanding of trigger points:
Trigger Point Research:
This video breaks down the latest research on how these painful areas develop, how they affect your body, and how treatments like needling can help relieve discomfort.
This video breaks down the latest research on how these painful areas develop, how they affect your body, and how treatments like needling can help relieve discomfort.
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Let's summarize the evidence talked about in the video:
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Understanding Trigger Points
A trigger point is an area within the muscle that shows abnormal electrical activity, which sets it apart from normal, healthy muscle. These areas are often linked to muscle pain, reduced flexibility, and tension. How Trigger Points Form Trigger points form when there is excessive release of a neurotransmitter called acetylcholine. This chemical is responsible for making your muscles contract. At trigger points, acetylcholine is released in higher amounts than normal, leading to excessive muscle contraction in that area, which can lead to pain and stiffness. |
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David Simons’ Research (2004)
In 2004, researcher David Simons conducted a study using fine-needle electromyography (a technique to measure muscle activity). He discovered that trigger points have significantly higher levels of electrical activity, which he called spontaneous electrical activity (SEA). This finding provided strong evidence that trigger points are real, measurable phenomena. The Cinderella Hypothesis A popular theory called the Cinderella Hypothesis helps explain why trigger points form, especially during repetitive activities or poor posture. It suggests that when we perform low-energy, repetitive activities (like typing or holding a posture), we overuse certain muscle fibers, known as type 1 fibers. These fibers are responsible for maintaining posture and slow movements, and when overused, they can form trigger points. The type 2 muscle fibers, responsible for powerful, fast movements, remain underused during these tasks. |
Scientific Imaging of Trigger Points
Researchers have used ultrasound technology to observe what’s happening inside the muscle at trigger points. These images show contraction knots—tiny areas where muscle fibers are tightly packed together, leading to increased tension. These knots also limit blood flow, which reduces the amount of oxygen that reaches the muscle, worsening the pain.
Researchers have used ultrasound technology to observe what’s happening inside the muscle at trigger points. These images show contraction knots—tiny areas where muscle fibers are tightly packed together, leading to increased tension. These knots also limit blood flow, which reduces the amount of oxygen that reaches the muscle, worsening the pain.
The Biochemical Evidence
In 2008, researchers Shah and Gilliam used a technique called microdialysis to analyze the chemical environment inside a trigger point. They found elevated levels of pain-causing substances like substance P, norepinephrine, and lactic acid. These chemicals are known to cause inflammation and pain, explaining why trigger points are often painful.
In 2008, researchers Shah and Gilliam used a technique called microdialysis to analyze the chemical environment inside a trigger point. They found elevated levels of pain-causing substances like substance P, norepinephrine, and lactic acid. These chemicals are known to cause inflammation and pain, explaining why trigger points are often painful.
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Can Needling Help?
The same 2008 study showed that treatments like dry needling, where fine needles are inserted into the trigger point, helped reduce the levels of these pain-causing chemicals. As the needles stayed in the muscle, the levels of substance P and other inflammatory markers dropped, leading to less pain and better muscle function. Additionally, the local twitch response—an involuntary contraction of the muscle when the trigger point is stimulated—can further release tension, promote blood flow, and enhance the therapeutic effects of needling. Learn more by watching the video below: The Role of Central Sensitization
Over time, trigger points can affect more than just the local muscle area. They can send pain signals to your spinal cord, which then "amplifies" the pain, making you feel it in other parts of your body. This is called central sensitization and is one reason why people with chronic trigger points often experience widespread pain. |
Difference Between Trigger Points and Motor Points A trigger point is a hyperirritable spot within a taut band of muscle that can cause referred pain and dysfunction, whereas a motor point is the location where the nerve enters the muscle (neuromuscular junction), allowing for optimal activation during needling or electrical stimulation. Generally, trigger points are treated to release tension and reduce pain, while motor points are targeted to enhance muscle function and coordination. |
Implications for Chronic Pain
Trigger points in the play a significant role in chronic myofascial pain. Understanding how they work—through chemical, electrical, and physical changes—helps us find more effective ways to treat and prevent them. Treatments like manual therapy, needling, and exercises that target these overactive muscle areas can help reduce pain and improve function.
Trigger points in the play a significant role in chronic myofascial pain. Understanding how they work—through chemical, electrical, and physical changes—helps us find more effective ways to treat and prevent them. Treatments like manual therapy, needling, and exercises that target these overactive muscle areas can help reduce pain and improve function.
Key Research & Resource:
Compiled by Joe Liguori
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