Why are trigger points so painful?

When muscles are stressed or injured, they usually 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. Sensitive areas of tight muscle fibers can form in muscles after injury or overuse.

These sensitive areas are called trigger points. A trigger point in a muscle can cause strain and pain throughout the muscle. When this pain persists and gets worse, doctors call it myofascial pain syndrome. Other less common causes of trigger points are due to nutritional and metabolic factors, and 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. In people with myofascial pain syndrome (MPS), tender points are known as trigger points. These areas develop in the tight and tight bands of the muscles (the fascia).

When pressure is applied to these trigger points, pain (called referred pain) occurs 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. Trigger points can also be complicated, since pain can occur at the site of the trigger point (when lightly pressed) or cause pain in a nearby area.

Under normal conditions, the pain caused by TRPs is mediated by myelinated fine fibers (Ad) and unmyelinated fibers (C). 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. Since a trigger point is a muscle contraction mechanism locked in a shortened position, treatment involves unlocking the contraction, and 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. Most of the symptoms of trigger points reported by a person come from active trigger points, and often those dense, tight bands within the muscle can compress and trap many types of nerves, causing a complex variety of symptoms. Trigger points usually arise from repetitive, sustained activities, such as lifting heavy objects at work or working on a computer all day.

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. When you try to strengthen, or simply use, these affected muscles from the activation point to perform an activity, they don't perform because many fibers are already blocked in the contraction phase and the other fibers are tight and weak. Trigger points may refer to pain in the local area or in other areas, the most common patterns are well documented and diagrammed. Other diverse ways in which trigger points can form include muscle contraction and tension due to mental or emotional stress, a direct injury, such as a blow, strain, fracture, torsion or tear, due to car accidents, sports injuries or falls, and even because of inactivity, such as sitting or lying in bed for a long time.

Those 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. 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.

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