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Pain Management

Chronic Pain and Trigger Points

According to a new report by the Institute of Medicine, “Chronic pain affects an estimated 116 million American adults–more than the total affected by heart disease, cancer, and diabetes combined.” Chronic pain is defined as “severe pain that lasts 30 to 60 days or more and taxes one’s professional and private life.” (Time) What is the cause of so much pain and suffering? There is a good chance that myofascial trigger points (TrP) may be to blame.

What is a TrP?

Myofascial TrPs are hyper-sensitive knots in skeletal muscle and fascial tissue. The spot is painful with pressure and can cause referred pain-pain that manifests away from the TrP site. Trigger points are extremely common and are a primary cause of chronic pain.

What causes a Trp?

A TrP forms in fascial tissue affected by mechanical stress or overload, which may be due to acute trauma, poor posture, repetitive movement, over-training, or inadequate sleep. The affected tissue contracts (shortens) and blood flow can become restricted, leading to a metabolic backup; poor nutrient delivery and waste product build up within the tissue. The build up of waste forms a toxic glue that adheres to surrounding tissue causing joint and movement restrictions, neurological impingement, and pain.

Trigger Point Symptoms

TrP cause motor dysfunction, stiffness, and restricted range of motion; resulting in overload to the central nervous system. The neuromuscular system becomes stressed, causing weakness, fatigue, numbness, tingling, balance problems, headaches or migraines; chronic pain and injury; less efficient motor skill performance, and a long list of other symptoms.

“The severity of symptoms caused by myofascial trigger points ranges from agonizing incapacitating pain caused by very active TrP to the painless restriction of movement and distortion of posture due to latent trigger points that are so commonly overlooked.” (Travell & Simmons’)

Active TrPs can cause headaches, neck and jaw pain, or low back pain. Often symptoms are misdiagnosed as arthritis, tendinitis, bursitis, carpal tunnel syndrome, or a ligament injury. TrPs can also cause symptoms such as dizziness, earaches, sinusitis, nausea, heartburn, false heart pain, heart arrhythmia, genital pain, and numbness in the hands and feet. Even painful disorders such as fibromyalgia have been connected to myofascial trigger points.

There is also an emotional toll to chronic pain. Anxiety, stress, depression, anger, and fatigue often accompany chronic pain and affect one’s ability to cope in their daily life.

Prevention and treatment of chronic pain is often “delayed, inaccessible, or inadequate.” (ABC News)

Trigger point therapy

Trigger point therapy is a specialized form of massage therapy. Treatment consists of ischemic compression: concentrated pressure placed directly on a specific myofascial trigger point to break cycles of pain and spasm. Passive stretching and corrective exercises are also utilized. Trigger point therapy restores muscle tone and balance; enhances the function of muscle and joint biomechanics; improves blood flow and lymphatic drainage; and reduces painful spasms. Trigger point therapy can be part of a comprehensive program complementing all other health care modalities.