Myofascial Trigger Points
What is a Myofascial Trigger Point?
Do you have pain that has been unexplained and has not responded to treatment by other medical providers or perceived by any interpretation of diagnostic testing? Do you have these signs in any combination?
- Unexplained weakness and wasting of muscles
- Super-Hypersensitive spots that hurt when someone presses on it.
- Muscle tightness that you can’t stretch out no matter how hard you stretch that produces changes in normal muscle activation patterns causing you to perform normal activities differently.
- Pain with stretching or use of the sore muscle.
- Spontaneous pain: super-hypersensitive spots that you can feel all the time, even at rest.
- Muscle knots that refer pain to a distant site away from where you are pushing?
- Taut bands of muscle that produce a twitch response with pressing on it reproducing your symptoms?
- A hypersensitive scar that is immobile and/or extremely painful when I bump it, or touch it or rest it on something.
If you do, you may have Myofascial Trigger Points or Scar Tissue Adhesions!
Why are you not needling the “sore spot?” Repeated noxious input to the same area causes decreases in local, but increases in referred pain away from the original site of pain. Over time areas of repeated pain stimuli at the same site decrease and referred pain increases with stimulation of the original site of pain. This indicates that pain stimuli over a long period of time causes changes in the central nervous system and how it processes pain. The more the pain goes on, the more changes that happen in the brain. The magnitude of the perceived pain is correlated to the intensity of the on-going pain.
Pain relieving strategies such as Dry Needling, myofascial release, muscle rebalancing (stretching the tight and strengthening the weak muscles), postural education and exercise, activity modification can reverse most or at least part of the pain-related processing changes in the brain within minutes by deactivating hypersensitive connections.
Myofascial Trigger Points are:
- Spontaneous pain: “I have this spot that hurts even when I am not doing anything.”
- Latent pain: “I have this spot that hurts only when I or someone else pushes on it.”
- Allodynia: a pain that happens from stimulation that normally would not cause pain such as “Boy, when I roll over onto my back there is a really sore spot I can feel.” “When someone rubs over that spot, I can really feel that.” “I did not know that spot was so sore until you rubbed over it.”
- Taut band within a muscle: Indurated (hardened) bundle of muscle fibers within a muscle. “I have this bump on my neck, back, arm, leg, foot, hand, hip that is really quite painful.” “Do you feel that bump?…it hurts!”
- Spot Tenderness: an area of focal hypersensitivity. “Ahhh! That really hurts when you push on that bump.”
- Referred Pain: pain distant to the site of mechanical stimulation. “You’re pushing on my thigh, but I can feel that in my knee.” “You’re pushing on my shoulder, but I can feel that in my hand.”
- Local Twitch Response: a twitching of the involved muscle with snapping palpation of a taut band. “I can feel the muscle ‘jump’ when you snap that lump back and forth.”
- Familiar Pain: patient recognition of familiar pain. “Yeah, those are my symptoms, that’s where my pain is. You’ve got it right on the money.”
- Physical therapist or physician by the location and name of the painful structure can predict where the patient will feel the pain radiating to distant site.
- Myofacial Trigger Points inhibit (turn off) normal muscle activity making the muscle weaker. “My muscle is smaller and weaker than the same muscle on the other side.”
- Pain with stretching or contraction of affected muscle. “It hurts when I try to use it or when I try to stretch it out.”
- Autonomic signs and symptoms: “I get nauseous, I feel like I am going to vomit, I have goosebumps, a racy heart, and I get sweaty when you press on that spot.”
Why did I get this Myofascial Trigger Point?
- I do activities that aren’t necessarily strenuous, but I have done them repetitively over a long period of time.
- I got whacked in that spot, I fell, I had a car accident, I hit it on the door.
- I am an emotional person and I hold my stress in my shoulders and neck.
- I have poor posture and I slump a lot causing those small postural muscles to do work for which they are not designed.
- I was in a cast for 6 weeks and my muscles are all bound up.
- I have low vitamin D, B, iron that causes my muscle pain to continue.
- I have gluten sensitivity which inhibits the absorption of vitamins B and D.
- I have persistent joint pain or pain from my guts that cause changes in my central nervous system causing muscle pain.
- I have not worked out in a while and my muscles are not used to this type of work anymore and I have some very painful knots in my muscles.
- I have not worked in a while and my muscles are not used to this type of work anymore and I have some very painful knots in my muscles.