Informative video on Trigger Points
Trigger Point Injections
Myofascial trigger points with their referral patterns were first identified and discussed by Dr Janet Travell. and Dr David Simons, who wrote Myofascial Pain and Dysfunction. The Trigger Point Manual. This textbook is still the reference for trigger point pain patterns. Trigger Points resulting from muscular injury and/or overuse – can cause extreme pain and/or dysfunction. When a muscle is fatigued and overworked, overloaded, or receives a direct blow, a localized contraction of the smallest muscle unit occurs, interfering with blood supply to the area. This contraction produces a sensitized bump (not visible on the surface of the skin). The muscle tissue on either side of the bump lengthens, causes it to feel like a cord. Irritation to the muscle fiber causes an aching pain that is difficult to localize. Other associated symptoms include sensitivity to touch, numbness, pins and needles, muscle weakness, fatigue, sleep issues, and problems with balance.
Compression of the bump or nodule, or stretching of the muscle, reproduces the pain or causes the pain to be felt elsewhere in the body.
The goal of treatment is to release the muscle contraction, evidenced by a twitch response. Trigger points can be treated in a number of ways including direct compression, massage, spray and stretch techniques, and localized injections. Dr. Stebbing uses her hands, acupuncture needles and standard needles to release trigger points.
In addition to injury and overuse, trigger points can be the result of ill-fitting shoes, postural abnormalities and ligamentous instability. Causes of trigger points are explored with each patient. Treatment with arch supports, exercises, or prolotherapy is recommended to avoid re-triggering of the affected muscles.