Understanding Trigger Points: Causes, Symptoms and Treatments

When muscles are stressed or injured, they often form tender “trigger” points that feel like dense, tight knots in muscle tissue. Pressure on a trigger point causes muscle fibers to shorten and hurt to the touch, and this can cause “referred pain” to radiate to other areas of the body. Trigger points can be caused by a variety of factors, including postural stress, repetitive activities, nutritional deficiencies, and even emotional or mental stress. When left untreated, trigger points can lead to muscle atrophy, fibrosis, and decreased tensile strength.

Fortunately, there are a variety of treatments available for relieving trigger points. Sensitive areas of tight muscle fibers are known as trigger points. When pressure is applied to these trigger points, it causes pain (called referred pain) in a different part of the body. Trigger points can be developed in all muscles and in many muscles at the same time.

This is one of the reasons why you may feel pain when you move or move around. Myofascial pain syndrome (MPS) is the term used when this pain persists and gets worse. Other less common causes of trigger points are due to nutritional and metabolic factors. Although few studies have demonstrated the exact effect of these factors on trigger points, there is extensive specialized clinical experience suggesting that low levels of normal and subnormal vitamins and minerals act as strong factors that perpetuate trigger points.

In addition, there are specific comorbidities such as hypothyroidism, iron deficiency, statins, vitamin D insufficiency and vitamin B12 deficiency which may link muscle pain as a possible secondary symptom. One of the most common causes of discomfort at trigger points is postural stress or poor posture. When symptomatic trigger points are left untreated, surrounding muscles relax which can result in more tension and overlapping pain patterns. Dry needling is another highly effective treatment for relieving trigger points which uses needles (acupuncture needles) to release a trigger point. When it comes to treating trigger points, your physical therapist can do this in a variety of ways. Finding and applying pressure to a trigger point will cause pain which will be felt immediately or in an area a short distance away (referred pain).

If you could look at a trigger point with a microscope, you'd see that it's inside a tight band which is a tight muscle strand that feels like a cord or a tendon. If you have myofascial pain syndrome, treatment will be more successful if you see your healthcare provider soon after symptoms occur and before the trigger points are established. Various harmful and harmless events such as mechanical stimuli or chemical mediators can excite and sensitize Ad and C fibers and therefore play a role in the development of TRPs. One theory states that activation points are formed by the excessive release of a chemical called acetylcholine which causes a sustained depolarization of muscle fibers leading to a sustained contraction of muscle fibers. Latent trigger points are those muscle knots that often aren't noticed unless you press directly on them and that will go unnoticed at first and possibly for years. This postural strain can cause activation points that lead to active activation points causing radiating somatic pain, muscle atrophy, fibrosis or tissue hardening and a decrease in tensile strength. Trigger points usually arise from repetitive, sustained activities such as lifting heavy objects at work or working on a computer all day.

They can also be caused by direct injury such as a blow, strain, fracture, torsion or tear due to car accidents, sports injuries or falls or even because of inactivity such as sitting or lying in bed for a long time. In order to treat trigger points effectively it is important to understand their causes and symptoms. Trigger points can cause strain and pain throughout the muscle which can lead to referred pain radiating to other areas of the body. It is also important to recognize that nutritional deficiencies can act as strong factors that perpetuate trigger points. Fortunately there are treatments available for relieving trigger points such as pressure applied directly on the affected area or dry needling using acupuncture needles.

It is also important to address any underlying causes such as postural stress or nutritional deficiencies in order to prevent further recurrence.

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